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From Philadelphia to the Philippines: Sister Physicians Share Passion for Health Equity on Local and Global Level

Nicole and Trina Salva with their mother Nieva Duque
Nicole (left) and Trina (center) with their mother Nieva Duque.

Growing up in their hometown of Wilmington, Delaware, it was not uncommon for Catherine “Trina” and Nicole Salva to hear their parents answering phone calls all through the night or see them being approached by people with questions about medications or ailments while out running errands. This was part of the daily routine as children of independent practitioners.

“They had a really special role in our community,” said Trina.

“They would see a patient at a store and walk over to check in on them, and their patients were always so happy to see them,” said Nicole. “It was heartwarming.”

Watching these thoughtful interactions led the Salva sisters to pursue their own careers in medicine. Now, they’re both OB-GYN physicians at Penn Medicine – Trina Salva, MD, an associate professor of Clinical OB-GYN, joined the Hospital of the University of Pennsylvania (HUP) in 2006, and Nicole Salva, MD, a physician in Penn OB-GYN – Midwifery Care, joined Pennsylvania Hospital (PAH) in 2010.

Although serving at different Penn Medicine entities, the sisters find overlap in their work and share the same passion for providing access to women’s health services for underserved populations.

Family Practice

Their parents, born and raised in the Philippines, came to the United States to complete their residencies at hospitals in Philadelphia. Their father, a family medicine physician, and mother, an OB-GYN physician, eventually moved to Delaware and established their own private practices. The sisters remember their parents being on call seven days a week, 24 hours a day, practicing medicine out of a house they converted into a shared office space, where they quickly established close connections with patients and their families.

“Growing up, I probably held every single staff position in the office, from welcoming people at the front desk to cleaning the office to acting as a medical assistant,” said Trina. “I spent a lot of time with patients this way, and it was inspiring to observe my parents’ interactions with the people in our community.”

Watching their mother as an OB-GYN especially motivated their career paths. Trina described her fascination with the “miracle of childbirth” and being able to help patients build their families, while Nicole appreciated the longevity in patient relationships.

“My mom had multigenerational patients,” said Nicole. “It was very cool to see patients, then their daughters, and even granddaughters, all coming to her practice.”

As OB-GYN physicians at Penn, the sisters are able to experience this type of family-centered population in their respective departments, while also participating in Penn-led service programs that promote health equity for the Philadelphia community.

System-Wide Service

Nicole and Trina with two nurses at a hospital in Cagayan de Oro
Trina and Nicole volunteering with two nurses at the JR Borja General Hospital in the Philippines.

When Nicole was a resident at PAH, she volunteered with Trina at Penn’s Latina Community Health Services. The clinic, partnered with the ambulatory health care clinic Puentes de Salud, provides comprehensive prenatal and obstetrical care for the city’s Latinx population.

“A lot of interest in volunteering at the clinic stemmed from my curiosity in finding resources to better serve this particular population,” said Nicole. “I liked the idea of building relationships with the patients, not just asking about their diagnoses, but asking how they were doing emotionally and listening to their needs.”

In November 2021, Nicole was appointed as the physician liaison for PAH’s Diversity, Equity, and Inclusion Steering Committee. She has been collaborating with its six subcommittees — community, clinical, education, people, culture, and research — to strategize ways to boost equity and access to care and also eliminate racism and bias within PAH and in surrounding neighborhoods.

“I listen to the concerns of our workgroups and their goals for removing any disparities at the hospital,” said Nicole. “One of my goals for the committee is to expand our community outreach and focus on preventive health, finding ways to get more members of the community to annual screenings early on to prevent poor health outcomes.”

Trina was drawn to the clinic from studying Spanish literature in college and training at a medical school with a predominantly Dominican patient population. Prior to Penn, in 1995, Trina had also participated in AmeriCorps, where she lived on the Arizona-Mexico border for a year and provided labor and delivery support for uninsured and undocumented women, along with offering educational sessions on reproductive health to teenage girls.

It was from this experience that Trina had an instant connection to HUP’s Helen O. Dickens Center for Women’s Health. Dickens, Penn’s first African-American woman professor in OB-GYN, was an advocate for preventive health for underserved populations, granting access to resources like educational classes and family planning assistance to teenage girls of color in Philadelphia.

“Helping patients navigate the health care system is something Dr. Dickens did really well,” said Trina, who has served as the medical director for the center since 2011. “Her mission has guided not only me, but my sister, to ensure that patients are getting the medical intervention they need, and getting it with loving care.”

Philanthropy from Philadelphia to the Philippines

Trina and Nicole with their aunt Grace Duque Dizon
Trina and Nicole with their aunt Grace Duque Dizon.

In addition to serving the Philadelphia region, the sisters have expanded their advocacy to the Philippines — their family’s birthplace. In 2019, Trina and Nicole accompanied the Philippine American Medical Association of Georgia — an organization that their aunt, an anesthesiologist, is involved in. Joining a group of doctors and nurses, the sisters traveled to the city of Cagayan de Oro in the Philippines to provide surgical care for women with limited access to OB-GYN services. While on the trip, they also had the opportunity to visit their extended family who live in the country.

“It was a nice way to reconnect. Even though the pandemic temporarily paused the trips, we’re already starting to plan the next one,” said Nicole. “We hope to make this an annual tradition, and possibly get more people at Penn involved for global engagement.”

Along with reconnecting with family in the Philippines, the sisters make time to see each other outside of work to celebrate holidays and go ice skating with their daughters — Trina with a 13- and 16-year-old; Nicole with a 4- and 8-year old. The Salva sisters also enjoy the family atmosphere in their roles at Penn.

“Having these close relationships with colleagues and patients is one of the highlights of working at Penn,” said Trina. “We’re all working together to ensure equitable care and treatment for our patients.”

“It’s a tightknit community. We’re a family at Penn,” said Nicole. “I’ve been seeing the multigenerational patients that my mom had, treating mothers and their daughters, and it makes patient care feel much more personal.”

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