By Nora Laberee
Scheie Vision Summer 2019
In 2006, a small non-profit healthcare clinic began treating the fast-growing Latino population of Philadelphia. Once run in a church basement in South Philadelphia, Puentes de Salud (“Bridges of Health”) Health Clinic now accommodates 10,000 visits per year at its newly built facility on Penn Medicine’s Rittenhouse Campus. These facilities include an eye clinic, where Scheie physicians and residents frequently volunteer time.
The clinic is run by staff members and many volunteer physicians, nurses, educators, and other health and wellness professionals. Tomas Aleman, MD, Associate Professor of Ophthalmology at the Scheie Eye Institute, has been one of these dedicated volunteers for seven years. César Briceño, MD, Assistant Professor of Ophthalmology at Scheie, also began volunteering at Puentes shortly after joining the Penn faculty in 2016. Each year, about 50 Penn students also donate their time to Puentes de Salud.
About Puentes de Salud
Puentes de Salud offers a wide range of services, including clinical care such as women’s health services, prenatal education, diabetes management, and eye care. Puentes also has a wellness initiative, through which it offers behavioral health treatment, attorney services, group discussions, yoga, and arts and culture classes.
Puentes also places emphasis on the value and importance of education for both children and adults in the community. It offers after-school tutoring and mentorship programs, summer literacy programs, leadership programs for teens, and English as a Second Language (ESOL) and financial literacy classes for adults. Puentes has built itself around the needs of the community, and when that community is growing by tens of thousands each year, its services have overwhelming value.
Puentes de Salud’s co-founder, Steven Larson, MD, Associate Professor of Emergency Medicine at the Hospital of the University of Pennsylvania, has been a dedicated physician at Penn since his time in medical school. “I’m what they call a Life-er here,” he joked about his time at Penn.
When Dr. Larson began traveling at the beginning of his career, he was particularly drawn to South and Central America. His mother is Puerto Rican, and he found a “a sense of giving back to the Latino community.” “I used my Continuing Medical Education (CME) time to go down to conferences in Central America,” he explained. “But you can’t do that full time.”
By 1993, Dr. Larson had found a way to continue serving the Latino population while also working in Philadelphia as an emergency medical doctor at the Hospital of the University of Pennsylvania. He began volunteering as a medical consultant for Project Salud, a migrant health clinic that operated out of Chester County and provided health services to the local agricultural labor force. He began treating undocumented and uninsured workers in the mushroom fields of Kennett Square, a population that made up the majority of the fields’ staff. Together with his Puentes co-founder, Dr. Larson began seeing uninsured patients back in Philadelphia, too. From there, demand grew and the Puentes team grew with it.
Eye Care in the Clinic
Now, years later, Dr. Larson has helped to bring Puentes to the forefront of clinical treatment for uninsured and undocumented patients in Philadelphia. Ophthalmology has been a part of that mission since the clinic’s inception. “My relationship with the Penn Ophthalmology Department started way back then in Chester County, when I had a patient with diabetes who was dealing with retinal hemorrhaging,” he said. Dr. Larson sent the patient to Albert Maguire, MD, Professor of Ophthalmology at Scheie. Dr. Maguire went on to care for many patients that Dr. Larson sent his way from the Kennett Square mushroom fields.
Over 25 years later, the connection between Puentes de Salud and Scheie has remained strong. At Scheie, Dr. Aleman specializes in the study of hereditary retinal degenerations, and is currently working on an ongoing gene therapy trial. Dr. Briceño specializes in ophthalmic plastic surgery, with expertise in thyroid eye disease and reconstructive surgery. At Puentes, however, both doctors provide more general ophthalmic care to patients.
“Right now, we provide comprehensive ophthalmic care and oversee anything that can be managed with medicines or spectacles alone,” said Dr. Briceño.
One of the more common health issues seen at the clinic is diabetes. Because of the vision issues that can stem from diabetes, such as cataracts and diabetic retinopathy with macular edema, eye care is a crucial component of Puentes de Salud’s clinical services operation.
If a minor procedure is required, physicians at the clinic will take care of it, but Puentes does not have the capability to perform laser eye surgery or other more involved procedures. “The most challenging aspect is that we are currently unable to perform surgery on patients at Puentes,” explained Dr. Briceño. “I am hoping that in the future this will change.”
But the care that Puentes can provide at this clinic is critically important in what is a largely uninsured, undocumented community. Their services, provided at little to no cost to patients, help those who otherwise may not receive any care.
“Puentes is providing a service that is not only in high demand, but often denied by other institutions,” Dr. Aleman explained. “Patients seek solutions and refuge at Puentes, and I only hope we can maintain this service indefinitely.”
For urgent medical issues that cannot be treated at Puentes, staff and volunteers can utilize Pennsylvania’s Emergency Medical Assistance Program (EMA) for immigrants. Emergency Medical Assistance is available to immigrants who have severe or life-threatening symptoms; this program allows them to access hospital services and treatment without insurance.
Puentes de Salud: Looking Forward
Dr. Larson and his co-founder, Jack Ludmir, MD, Senior Vice President for Physician Engagement and Integration and the Associate Provost for Community and Global Initiatives at Thomas Jefferson University, have gained significant support across the University of Pennsylvania Health System (UPHS) and beyond. Kevin Mahoney, recently named the new Chief Executive Officer (CEO) of UPHS, has been a strong Puentes de Salud supporter and Board Member for years. “He was instrumental in the renovation of Puentes in 2015,” Dr. Larson said.
Puentes also has strong ties to the Penn Nursing School, and its leadership is working to develop new partnerships with the Penn Dental School, Neurology Department, and Cardiology Department.
Like Dr. Larson, Dr. Briceño has a long history of volunteer work. “I’ve participated in volunteer clinical work throughout my career. Before Penn, I volunteered at the Hope clinic at the University of Michigan,” he said.
Dr. Briceño also has his own personal connection to this work. “I feel a personal responsibility to give back to the Latino community,” he said. “As an immigrant to the United States who grew up in the inner city, I understand how much of a lifeline affordable healthcare can be.”
For the growing immigrant population in Philadelphia, the host of services offered at Puentes are not just a lifeline for their health, but also a way to enrich socially, educationally, and financially. Clinics like Puentes de Salud are making a tremendous difference in the lives of uninsured and undocumented children and adults living in Philadelphia.
Health clinics for the uninsured have become vital parts of our communities. Dr. Larson and Dr. Briceño agree that clinics like Puentes are not unique to our city. “There are kind providers all over the country volunteering their services in numerous ways,” said Dr. Briceño. “I am proud to be counted among them.” The backbone of these clinics is volunteers, and Puentes is no different. “Puentes is always in need of volunteers, both on the clinical and non-clinical sides,” Dr. Briceño said.
For now, the Puentes team anticipates continued growth as a vital center of health and wellness for the Philadelphia community.
Photo Credit: Peggy Peterson Photography.