Fundação Esperança got its start in 1969, with the arrival of Friar Lucas Tupper, an American doctor and a priest of the Franciscan Order. His choice of Santarém, a small community on the Amazon and Tapajós Rivers, was not by accident, given that the Diocese was of the Franciscan Order. At that time, the city had few doctors and there were no available medical or sanitation services in the surrounding river communities. Many children were dying of polio, tetanus, diphtheria, and intestinal worms before their second birthday. Frei Lucas, as he was called locally, knew that most of these illnesses could be avoided through the use of vaccinations and sanitary education. With the assistance of the church and community, he constructed the Clínica das Pobres (Clinic of the Poor); and then with the help of Esperança, Inc. in the United States, a hospital boat was build to support the program. Volunteer doctors and surgical teams followed.

After the death of Frei Lucas in 1978, a non-profit organization called Fundação Esperança (Esperança Foundation) was formed under Brazilian by-laws. A modern physical structure was put in place with the help of ASHA, the American Schools and Hospitals Abroad program. The organization continues to provide health services to the people of Santarém and the region and has expanded its mission to include education via a school of professional education called CEPES and an institute of higher education, called IESPES. Fundação Esperança sees its mission that of improving the living condition of the population through the use of education, research, health services, distribution of technology in the Amazon Region.