Called to Care
It’s grey and cold. A half dozen Pacific University optometry students huddle, collars up against the wind, under the portable tent that’s propped next to a large white truck with “Mobile Eye Care” emblazoned on its side. In the truck, or IVAN as it’s called (pronounced "eye-van"), Jared Haggen ’11, a third-year optometry student, peers into the eyes of Olivia Luchiton, who’s worried about her glaucoma.
“Will you look at this?” Haggen asks supervising doctor Susan Littlefield, O.D. '94, who runs Pacific’s mobile eye van. Littlefield, Director of Community Outreach Service for the College of Optometry looks over the chart, then scans the patient’s eyes.
“You’re exactly right,” she says, smiling at the student. She turns to the patient. “The pressure’s gone up a little, Mrs. Luchiton, but things still look fine. I’m glad you came in to check.”
IVAN, the brainchild of Kenneth Eakland, O.D. '84, Associate Dean for Clinical Programs, was designed to bring eye care to those who can’t or don’t access it – children, migrant workers, homeless, the poor. This vision screening in Portland’s Pioneer Square is one of more than 300 eye care events first-to fourth-year students will offer this year. The free screenings not only help identify eye diseases and other health problems, they also provide students with valuable hands-on experience.
Service to the less privileged is nothing new for Pacific. It was originally established as a school for orphans of the Oregon Trail. Today, that dedication to public service underscores the University's many healthcare programs.
A Wealth of Programs
“Service to the community is a core value that comes from our history and is deeply embedded in this place,” says Sara
Hopkins-Powell, Executive Dean and Vice Provost of Health Professions. “But each program defines service somewhat differently.”
In addition to the mobile eye van, the College of Optometry offers eye clinics with fees on a sliding scale based on income. For those who can’t afford the reduced rates, funds are available like the Shirley Corey Sustaining Memorial Fund for vision care for needy children and the Simon Fund for eyeglasses. “Serving the poor goes along with the oath we take,” says Fraser Horn, O.D. '05, Assistant Professor and Director of Pacific’s West Side Clinics of Optometry. “If we can reduce or eliminate healthcare costs as a barrier, we help our community and we help our students become well-rounded practitioners with experience serving all sorts of populations.”
In addition, Pacific’s School of Professional Psychology operates a program in downtown Portland and the IRIS Clinic in Hillsboro that serve the poor. Under the supervision of faculty, psychology students see individuals, couples and families for as little as $10 per session. “Last year, we served 750 low-income clients in Portland and 50 clients at our IRIS clinic,” says Lisa Christiansen, MS '98, Psy.D. '01, Director of Psychological Services. “We’ve become known as a good provider for people who fall through the cracks and don’t qualify for other programs or services.”
Jay Thomas, Professor and Assistant Dean in the School of Professional Psychology, says poverty exacerbates the mental health problems faced by the poor. “The fewer resources you have when you’re under a lot of stress, the more it’s going to impact you,” he says. “Many people we see also have other medical problems, particularly if they use drugs and alcohol.”
Lisa Rowley, Program Director for the School of Dental Health Science, says since February 2007, Pacific’s new Hillsboro dental clinic has served 3,000 patients. More than half have incomes below the poverty line and 80 percent have no health insurance. “Dental care is difficult to access because it’s expensive and many dental offices don’t have Spanish-speaking staff to serve the people in our area,” she says. “The clinic offers assessment, teeth cleaning, fluoride treatments, sealants and limited tooth filling at less than half the standard cost.”
In the School of Physical Therapy, low-income clients are seen at the faculty practice clinic, where Pacific students shadow clinic faculty. “The majority of our patients are referrals from Virginia Garcia,” says Richard Rutt, Director of the School. The Virginia Garcia Clinic, located in the Pacific’s Health Professions building, is a community clinic designed to serve primarily low-income Hispanic patients. “Many patients have inadequate insurance or no insurance. We charge them on a sliding scale based on their income.”
An evaluation at a PT clinic would normally cost $100-125. At Pacific’s clinic, the cost is $15. If that’s too expensive, a payment plan is available.
The Physician Assistant program also sees a lot of needy clients at the Essential Health Clinic, the only free health clinic in Washington County. Physician Assistant faculty and students have volunteered at the clinic since 2000. First-year PA students shadow faculty; second-year students work directly with patients alongside faculty.
“This clinic allows our students to see a segment of the underserved community they may not see later in their clinical years,” says Randy Raldolph, PA-C, MPAS, Program Director
of the School of Physician Assistant Studies. “It allows us to mentor our students in a clinical setting. We also hope it helps them recognize we need to give back as professionals through charitable work.”
Along those lines, a new interdisciplinary program launched last year takes faculty and students from dental hygiene, pharmacy, physical and occupational therapy to Nicaragua to provide healthcare for elders abandoned by their families. A dental hygiene student who participated in the program said working with occupational therapists showed her that many elderly face problems like holding a toothbrush or opening the toothpaste. “This program broadens students’ perspective and gets them to see that people have problems other than those in their mouth,” says Rowley.
In addition to its own programs, Pacific students serve the community and gain valuable experience working at the Chemawa Indian School in Salem, the Russell Street Clinic in Portland, the Virginia Garcia Clinic and other programs. The proximity of the Health Professions Campus to Tuality Healthcare’s Hillsboro hospital and clinics provides easy access for students to gain clinical experience while serving the low-income community. It’s a win-win for the hospital, for Pacific and for the community says Brian Costa, Tuality’s Director of Community Relations. “Tuality’s partnership with Pacific provides opportunities for enhancing services to the community,” he says. “It also allows us to nurture local students in healthcare professions.”
Working with people who are poor or who come from other ethnic cultures can be challenging. To ease the cultural gap for students, Pacific offers medical Spanish. For dental hygiene and PA students, it’s a requirement; for other majors, an elective.
The schools also offer classes in ethics, communication and socio-economic and cultural issues. The real learning, however, comes with hands-on experience.
“This clinic allows our students to see a segment of the underserved community they may not see later in their clinical years.”
– Randy Raldolph, PA-C, MPAS, Program Director of the School of Physician Assistant Studies
Dean Hopkins-Powell says one of the goals of serving the poor is to make lasting changes not only in the community, but in the students. “We want our students to continue to serve low-income people after graduation,” she says.
Serving poor people has had an enduring impact on dental hygiene student Diana Drovorub ’09. She’s just finished cleaning the teeth of a patient with severe periodontal problems. Before coming to Pacific, Drovorub assisted in a dental practice where patients had insurance or could pay for treatment. “This experience has opened my eyes,” says Drovorub, herself an immigrant from Russia. “So many people don’t have health insurance and don’t even seek help. When I graduate, I want to continue volunteering or working at a community health center.”
Drovorub's patient, Julia Carter, a retiree on a fixed income, has dental insurance, but can’t afford the $150 co-pay four times a year at a periodontal office. Today’s visit, which includes a fluoride treatment, cost $50. “This clinic is a wonderful community resource, especially with the bad economy,” says Carter, rising from the chair. “The treatment is equal—no, it’s even better—than what I was getting at the periodontist’s.”
On her way out, Carter suddenly turns and hugs the student. “Thank you so much,” she says. “You’re wonderful.”
PT student Jose Renya ‘09 says his commitment to serving low-income Spanish speakers comes, in part, from his own background. The son of a mother who emigrated from Mexico and whose family picked crops when he was young, Renya works at the nonprofit ¡Salud! providing for healthcare access to vineyard workers. “I want to set an example of repaying our community for my daughter,” he says.
When he graduates in May, Renya says he’ll continue working with low-income Hispanics. “There aren’t a lot of Spanish-speaking physical therapists,” he says. “I can build rapport with them and I want to continue serving them.”
Faculty members like Susan Littlefield, OD, are also impacted by the work. Four years ago, Littlefield worked in a private eye clinic near Seattle. The money was good, but she says, “Something was missing.” When she saw Pacific’s ad for someone to run the mobile eye van program, she jumped at the chance. Now, she makes less money. Some days she works 16 hours, but she’s fulfilled. “You can’t do this work without being changed,” she says. “It’s easy to judge people, to pass them on the street and decide they put themselves in that circumstance. But once you hear their stories, you see them as people.”
The optometry students are up early to set up for Washington County’s Homeless Connect. It’s a resource fair where community members and social service providers bring desperately-needed goods and services like eye care to the poorest. The students provide full eye exams and glasses to anyone who needs them.
The sun hasn’t even broken and already there’s a crowd. They stand patiently, sleeping bags, rag tag blankets, tattered jackets wrapped against the cold. When the doors open, they stream in, rushing to find what they need.
In less than half an hour, the day-long optometry schedule is full. The students will see 40 people today, churning out full exams every 15 minutes. One in ten will have to wait until the next eye care event. Littlefield looks over the crowd, “The more you get into the work, the more you realize how much need there is,” she says softly.
By the time “John” gets into the exam chair, he’s been waiting three hours. He’s in his late '50s, but his faced is deeply lined, his cheeks permanently reddened from exposure. He looks 70. Like many homeless people, John once had dreams, but the Vietnam War, a divorce and drugs got in the way. He’s been on the street for more than 30 years. His eyes have been bothering him, but he can’t remember the last time he had an eye exam.
When John puts on the reading glasses, he sucks in his breath sharply. “I can see it,” he says, a grin creasing his face. “I can read it. I told them I could read."
It’s been a long day. Littlefield and the students are packing up the last of their equipment.
John is headed for the library. ■
This story first appeared in the Fall 2009 issue of Pacific magazine. For more stories, visit pacificu.edu/magazine.