Launched at a kitchen table in Mendota Heights Minnesota Mano a Mano began collecting and shipping medical supplies to impoverished Bolivian communities in 1994. Twenty years later an organization that once operated exclusively from the founder's basement has now successfully implemented over 300 infrastructure projects including medical clinics schools roads and water reservoirs. As a result of their efforts over 700 000 Bolivians who face one of the highest rural poverty rates in the world now have access to health care for the first time.

Gaining Ground is the inspiring case study of how this volunteer-based grassroots organization is making history in Bolivia and offers an autobiographical look at the "how to" and "lessons learned" of their international development work.

Inside Gaining Ground discover:
A blueprint for developing your own international NGO

- Why the grassroots community partnership model works
- How to facilitate participatory development
- Approaches to achieving sustainability and self-sufficiency
- Alternatives to standard organizational structure
- The critical nature of a bicultural perspective
- A detailed history of this organization

Joan Velásquez Ph.D. co-founded Mano a Mano with her husband Segundo and wrote Gaining Ground in response to numerous requests for guidance in navigating humanitarian initiatives. She hopes that this book will inspire others to reach out to marginalized communities in all corners of the world and will remind readers that people of modest means and intense commitment can make a difference.