Missoula Medical Aid has a simple premise, said David Allen Cates, one he's tried to adhere to in his 18 years with the nonprofit: Funnel resources from a place where they're abundant to a place where they're not.
"It's a way of sharing – helping really talented Honduran people get a break and use some of their talents," said Cates, who's stepping down as executive director, a post he's held for around 14 years.
The nonprofit sends volunteer medical teams to rural areas in the Central American country three times a year. There, among other things, the teams perform medical check-ups, dispense vitamins and basic medications, and provide toothbrushes and fluoride. The group also pays for staffing at medical and eye clinics run by a Lions Club, and an orthopedic surgical team to work in hospitals.
"It works because of the huge number of volunteers and all of our Honduran collaborators," he said. Locally, those include the many doctors, surgeons and more who've volunteered.
The collaborators include the nonprofit Save the Children, La Esperanza Lions Club, local government and more.
"The organization stayed small, but became very efficient because we have these wonderful relationships," he said.
The organization was started in 1998, when Hurricane Mitch struck Central America and was devastating in Honduras. According to a Missoulian article from the time, 60 percent of the population was homeless and 40 percent was missing in the immediate aftermath in the city of San Lorenzo.
Bill Woody, the owner of Nightingale Nursing Service in Missoula, read about the event and began organizing a medical and rescue team with fellow Missoulians including Dr. Kristin Rauch, Peggy Cain, Scott Fels, Anne Ranf and Ron Simpson.
Cates, who at the time lived in Central America as a professional basketball player, asked how he could help, and Woody asked him to sign on as a team leader. Cates, a novelist who had just finished a manuscript, said yes.
Then a 43-year-old who'd "never been a leader of a line of ducks," Cates discovered the role suited him.
"I could work as a translator. I could help the Americans on our team understand what we were seeing, and help the Hondurans understand us," he said.
He continued helping to raise money and going along on the trips. It became so time-consuming that he asked for some form of compensation. The board created a quarter-time executive director post, which it has remained to this day.
The only other employee is Jordan Labbe, an operations manager based in Missoula, who handles all the bookkeeping, travel and more. "She does everything," he said.
Since Cates is leaving, they hired a Honduran, Doris Martinez, as an operations manager in that country.
The new executive director is John "Jack" Rockefeller of Boise, Idaho. He's served as assistant dean of Johns Hopkins Medical School and worked for the United Nations and the Clinton Foundation, among other accomplishments.
"He's like a pro and I'm like a junior college player," Cates said. Rockefeller has the skill set to steer the organization into more partnerships and share its model, which has been successful on a small scale.
Outside the nonprofit, Cates teaches writing and has published five novels, most recently "Tom Connor's Gift" in 2014 and a collection of poetry, "The Mysterious Location of Kyrgyzstan," earlier this year.
He said those interests had a way of keeping the scope of the nonprofit more limited.
"In a way, I built the organization around what I was capable of giving. The organization needs more than that now," he said.
Each year, the organization sends between 30 to 50 volunteers to Honduras on three trips: one in the spring, one in October and one in January.
Many parts of its projects grew organically over the years. For instance, Cates heard that La Esperanza Lions Club had a dental clinic and equipment that weren't in use. He inquired about sending a dentist for a week, and the club agreed.
Afterward, they asked how much it cost for the trip, which was around $2,500 including an interpreter.
They told him, "If you can raise $4,000 up in the states, we could pay a Honduran to work in the clinic three hours a day, five days a week," he recalled. "All year long."
Missoula Medical Aid raised the money, and the club managed and supplied the clinic. The government, which requires medical and dental school graduates to perform a year of social service, sent another doctor.
They also were able to pay for an eye doctor at the clinic. Likewise, the trips for orthopedic surgeons have been happening for 11 years. They often start small and grow: during the first trip, a surgeon got one operation done. In October, he and his team did about 24 in four and a half days.
"That's the way the partnerships start: You say you're going to do something, you do it," Cates said.
They also have a Head Start-like program that provides food for kids. It helps the kids get socialized before they start school and mothers take turns making the meals with food supplied by the nonprofit.
"You can feed 150 kids under the age of 6 a nutritious meal for five days a week every week of the year for $500," he said.
In other projects, they pay for seeds or fertilizer for groups of women in rural areas to grow a cash crop. Save the Children trains them and the government helps assist.
"Pretty soon they have a harvest, some money in the bank," he said, a feat in an area where people don't have any money at all.
He said it's been a privilege to visit them and hear "how this little contribution that has been made has animated them."
"I work with super-intelligent, creative people who want to do something," he said.
The experience in the rural villages changes your perspective, he said.
"As Americans, we tend to measure our lives based on our careers," he said.
There, he's met people who live according to three questions that he's brought back with him.
"Did I eat today? Did I work? Did I love? That's how you measure of how you had a good day," he said. "And that's a good measure of whether your life is going well."