In early 2006, during a trip with the non-governmental organization Shoulder to Shoulder, family physicians from Virginia Commonwealth University and administrators from Thundermist Health Center visited a small, rural community in Intibuca, Honduras named Pinares. After meeting people from the community, the group was hooked and decided to return. 

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Using principles from Shoulder to Shoulder and community-oriented primary care (COPC), the Pinares project took form, with the construction of a clinic in the summer of 2006 and the development of SAGE in 2015. True to its COPC roots, the project has involved a wide range of participants and has sought to address a spectrum of social determinants of health. Central to its mission, SAGE works closely with the Pinares Health Committee, a group of representatives from the surrounding communities. Together, SAGE and the Comite set the health agenda, determine which projects to pursue, and manage projects.

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Medical Brigades of 5 to 20 participants (Physicians, Medical Students, Nurse Practitioners, Nurses, Pharmacists, Physical Therapists,  and Dentists) visit the community two to three times a year to provide medical care, assistance with projects and to coordinate with the Health Comite.

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Prior initiatives in Pinares have addressed under 5 nutrition, school lunches, education, leadership skills for young women, water quality, indoor air quality, cervical cancer screening, micronutrient deficiencies, dental hygiene, parasite eradication, egg production, tilapia farming, secondary school scholarships and composting.