Thank you for being a part of Mano a Mano! Together – “hand in hand” – we can help Bolivian communities in ways that none of us could do on our own.
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.
2021: Year in Review
Together, We Help Hundreds of Thousands of People in Bolivia
- 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).
- 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.
- 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.
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!

What Mano a Mano Does: Create Partnerships
- Collect donated medical supplies and equipment in Minnesota for shipment to Bolivia where they are donated to people & organizations throughout the country. Supplies are also distributed to people in need in the Twin Cities, and to other nonprofits.
- Construct schools & clinics in partnership with local communities.
- Construct water projects (reservoirs, wells, water ponds) in partnership with local communities.
- Construct and improve roads in partnership with local communities.
- Provide flights in cases of emergency, and transport medical professionals for weekend health clinics, primarily in the Bolivian Amazon.
- Provide training & tools for rural Bolivian farmers through our Center for Ecological Agriculture in Cochabamba.
- Provide training, maintenance, & support programs to complement infrastructure projects.

Thank You
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, [email protected]

2021 in Pictures
- One of Mano a Mano’s weekend health clinics in Poza Honda in November 2021.
- Arriving in Mapiri to transport a patient on the Mano a Mano plane, May 2021.
- 7: Mano a Mano transports some supplies by plane, like this distribution to Baures, Bolivia.
- A Mano a Mano emergency flight in Sucre in 2021.
- Heavy machine mechanic students like Walter Rios learn welding, hydraulics, motor repair, tire repair, sheet metal work and painting. They graduate in six months with a certificate in heavy machine mechanics.
- “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
- 7: Donating a wheelchair for Gustavo in Trinidad, Beni in May.
- Banner honoring Epifanio Velasquez at Laguna Sulti. This is part of the Punata Regional Complex project.
- 3: Mano a Mano staff and volunteers load containers, making sure to not waste any of the valuable space.
- Abundant potable water began to emerge from the Pampa Grande well last week.
- An emergency flight in June 2021 outside of our hangar at the Cochabamba airport.
- Mano a Mano Nuevo Mundo staff working on the Chirusi water well in July 2021.
- Picking up Santiago and his family in Oromomo, early October 2021.
- Dedication brochure for the improved runway in Toro Toro, Bolivia, completed in May 2021.
- Transporting a patient to Santa Cruz (here at Viru Viru airport) for intensive care, May 2021.
- Working on the 2-story school project in Chirusi.
- Read about Mano a Mano in this article in the Midway Como Frogtown Monitor.
- Mano a Mano staff and heavy equipment onsite at the Laguna Sulti water reservoir expansion project, 2021.
- 3: Almost done loading!
- Nursing students from CEFTE-Chapare take a break from their volunteer work with Mano a Mano, sorting supplies sent from Minnesota to prepare them for distribution throughout Bolivia. Medical professionals from Hospital Combase also take part in these volunteer sessions, here providing some guidance and training for the nursing student volunteers.
- Farmers from Laguna Sulti have received training through Mano a Mano’s Center for Ecological Agriculture.
- Transporting heavy equipment from Cochabamba to Toro Toro to start construction on the airstrip.
- PTs, Mano a Mano volunteers, and Mano a Mano Co-Founder Joan Velasquez meeting during our recent giveaway on May 8th at our St. Paul warehouse.
- Mano a Mano picking a patient up in Santa Ana de Yacuma.
- A container of medical supplies sent from Minnesota arriving at Mano a Mano’s warehouse in Cochabamba, Bolivia, 2020.
- Loading Mano a Mano’s Cessna Caravan at our hangar at the Jorge Wilstermann Cochabamba Airport
- Mano a Mano providing an emergency flight after an accident.
- Distributing medical supplies and equipment sent from Minnesota for Mano a Mano Bolivia, February 2021.
- Volunteers on the path to Yucomo with Pascuala’s wheelchair.
- One of Mano a Mano’s flights in 2020, in front of our hangar at the Cochabamba airport.
- Community sorting boulders for the foundation.
- Pampa Grande leaders at our counterpart organization Mano a Mano Nuevo Mundo’s office to sign the agreement for their water well.
- All 3 containers filled and ready to start on their way to Bolivia – March/April 2021.
- Pato Enyo
- Machine operators and local residents watch intently as water begins to flow at the Chirusi well.
- 2 containers with 46,829 pounds of supplies starting their journey from Minnesota to Bolivia in June 2021.
- Volunteers from Bolivian organizations like GEOS contribute many hours to help to sort medical supplies at our Cochabamba warehouse.
- Drilling a deep well in Pucara, 2021.
- Mano a Mano providing a flight for Oscar. Photo Credit: El Guardian Beniano.
- Students from Metro State and St. Kate’s help load containers with medical supplies and equipment for Bolivia.