Like last year, 2021 has been another challenging year, but we are grateful to you for helping Mano a Mano continue to partner with Bolivian communities – on projects they request & ultimately own – to improve their lives. Mano a Mano’s biggest strength is our community-based partnership model – bringing many people together to accomplish things that none of us could do on our own. Every activity, every project new or old, every event, depends on the dedication & effort of many people. As we look back at what we were able to do in 2021, we want to thank you:

Without you – every person working together and doing their part – none of this would be possible. Thank you!

Annual Reports from Previous Years: 2018-2020

Check out our previous Annual Reports from the past 3 years (all financial statements, 990s, and previous year’s annual reports are available HERE):

Together, We Help Hundreds of Thousands of People in Bolivia

Hundreds of thousands of people in Bolivia benefit from Mano a Mano’s health, education, water, road, aviation, food & farming, and medical surplus distribution programs!

Shipped 180,180 Pounds of Supplies From Minnesota to Bolivia


Despite some shipping costs increasing by 150% and other new shipping challenges due to COVID, Mano a Mano shipped 7 containers with 180,180 pounds of medical supplies and equipment from Minnesota to Bolivia in 2021. (We averaged 187,951 pounds shipped over the previous 4 years.) In addition, we also distributed tens of thousands of pounds of supplies to other nonprofits and to people in need locally in the Twin Cities. All of these supplies would have ended up in local landfills; instead they are helping people in Bolivia, Minnesota, and other countries.

“We feel very happy and moved to work together, we want to be a bridge and a helping hand that is willing to reach out to any hand in the world. Let us have an attitude of solidarity, as a municipality let us help with our good will to also reach out to other smaller municipalities in the department that need help.” – El Gobierno Autónomo Municipal de Tarija and the Secretaría de Desarrollo Humano y Gestión Social Municipal

Celebrated the Initiation of the “Punata Regional Complex”


Mano a Mano celebrated the initiation of the “Punata Regional Complex” – a comprehensive project in the Cochabamba Valley’s Punata region over the next three years that includes a 3rd expansion of the Laguna Sulti agricultural water reservoir (complete); a new public school (50% complete); a deep well for potable water (complete); a three-mile road; infrastructure needed for moving our aviation program from the Cochabamba airport; and preparation for a rural Center for Ecological Agriculture (CEA).

Banner honoring Epifanio Velasquez at Laguna Sulti. This is part of the Punata Regional Complex project.

Served Nearly One Million Patients in our Clinic Network


Mano a Mano’s network of 176 clinics will have nearly one million patient visits this year. We currently have 4 clinic projects under construction. As a part of the Bolivian health care system, Mano a Mano’s network of 176 clinic projects provide monthly reports to the Bolivian Ministry of Health. Our clinic program’s approach is that health outcomes can be dramatically improved with simple yet effective interventions, beginning with the basic ability to consistently access quality services in their own communities. While COVID-19 has been (rightfully) the dominant current health issue, primary health care is needed now more than ever; our network of clinics serve a vital role in providing access to primary health care for communities in rural Bolivia.

“When we visited Mano a Mano Bolivia in Cochabamba, we were very surprised when we found out how the financing was obtained [by US donors] to make the project affordable. Now they give us an equipped health center, which was built in a very short time. All this gives us lots of joy.” – Ariel Siles Cespedes, Municipal Mayor of Tarabuco (Sarafuya is a town of 1,702 in the municipality of Tarabuco, department of Chuquisaca)

Built Deep Water Wells and Expanded a Large Water Reservoir Project


Mano a Mano’s 500+ water reservoirs, water ponds, and wells provide consistent access to water for 65,000+ people in rural Bolivia. We currently have multiple deep water wells underway, and recently completed a water reservoir expansion.

Mano a Mano’s expansion of the Laguna Sulti water reservoir is now complete! The rain recently arrived and filled the reservoir. One rain and the reservoir is about to overflow by the large overflow opening.

Provided Emergency Flights for 254 People


For nearly 15 years Mano a Mano’s aviation program has focused on 2 programs for Bolivian communities that have minimal access to health care (at no cost): emergency rescue of ill and injured individuals, transporting them to urban hospitals for life-saving treatment; and weekend clinics for which we transport volunteer health care professionals into remote areas to provide primary medical & dental care. From January-October 2021, we have: made 498 flights, with a total of 545 flight hours. The Cessna Caravan aircraft, which Mano a Mano purchased in 2018, flew 51% of these flights; airlifted 254 patients, primarily individuals suffering from severe COVID-19, to specialized care in urban hospitals; and transported 215,600 pounds of cargo, including PPE and oxygen concentrators, to healthcare providers located throughout Bolivia. Aviation program staff make every effort to maximize each flight, by including cargo on flights made for other purposes.

Center for Ecological Agriculture in Cochabamba, Bolivia


Mano a Mano’s Center for Ecological Agriculture (CEA) provides training & tools for rural Bolivian farmers to improve food security & nutrition in their communities.

  • It’s exciting to see the greenhouses that Mano a Mano has been building with the community of Corani Pampa being put to use!
  • At any given time, Mano a Mano and our 5 counterpart organizations have dozens of projects in the works: clinics, schools, water wells and reservoirs, roads, training programs, medical supply distributions, emergency flights and transport, and more. All of these projects are done in partnership with Bolivian communities (and none of these projects are easy). Some projects take place on a daily basis, some are currently underway and will be completed in the weeks and months to come, and some are in the planning stages for this year and beyond. Just to give one example, here is the schedule at our Center for Ecological Agriculture (CEA) in Cochabamba, Bolivia over a few weeks in August (the CEA is part of the work of our counterpart organization Mano a Mano Internacional)
  • Mano a Mano’s counterpart organizations Nuevo Mundo (started in 2005) and Internacional (2012) (we are 5 counterpart organizations in total) have lived rent-free in their Bolivian founders’ homes since they were created. Each organization began with a singular purpose and depended heavily on volunteers. From these humble beginnings, they have grown in size and scope, with highly skilled staff who take on complex projects. Soon, both organizations will have office space of their own in a shared building. Construction began in early 2020 but was delayed by the pandemic; it has been moving forward throughout 2021.

Thank You to Our Volunteers in Minnesota & Bolivia!

2021 in Pictures

Note From Mano a Mano Executive Director Nate Knatterud-Hubinger

Mano a Mano has completed many new projects in 2021, with many more projects underway and planned for the future across our five counterpart organizations. The hundreds of projects we have built over the past 27+ years continue to operate as intended, providing access to quality services – water, food, health care, transportation, education – that are basic human rights for rural Bolivian communities. But none of this is easy. Some of these projects are years in the making; our staff traveled to one community to meet with leaders dozens of times, before we ever reached the point of signing a partnership agreement and raising enough funds for the project (and raising funds – which kickstarts every Mano a Mano project – is a never-ending process).

Our projects are spread throughout Bolivia, so our staff regularly drives 8+ hours each way to visit sites, and with larger projects they may stay on site for weeks at a time. Our heavy equipment and vehicles break down regularly due to heavy use in difficult conditions. As one recent example, to replace 2 tires on our front end loader ($2,500 apiece!), they are so big they wouldn’t fit on our plane, so instead of a 30-minute flight it was a 25-hour trip by truck one way – from the worksite to one of the few cities in Bolivia that carries these supplies. (And they often don’t have the required items at all in Bolivia, which is why many items for repair & maintenance of our heavy equipment and aviation program are bought and shipped from the US.) Shipping costs have increased dramatically over the past 12-18 months; one container would cost ~$2,500 to purchase up until 2020; they are now ~$6,300 (+150%!), with shipping & Bolivian Customs costs having similar increases. We have still shipped 7 containers this year.

Of course, COVID has been the biggest added challenge. We have not traveled to Bolivia or hosted any events in nearly 2 years, and we have had to cut back on our volunteers in the office, who we depend on to collect and organize medical supplies to ship to Bolivia. Restrictions, quarantines, and stay-at-home orders have been regular occurrences in Bolivia, and have delayed and limited many of our projects and programs.

But thanks to you and many others, we are still able to get things done. Mano a Mano consists of only a couple of paid staff in the US, and we depend on you – our volunteers and donors – to be able to partner with Bolivian communities. We are extremely grateful for your support!

– Nate Knatterud-Hubinger, Executive Director, nate@manoamano.org

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