Serving the City’s Homeless

A volunteer-run clinic helps shelter residents keep their sight.

”Whether crossing the street or trying to avoid trouble, poor vision intensifies the vulnerability of an already vulnerable population,” says ophthalmology resident Lauren Hennein, MD. When Dr. Hennein floated the idea for a shelter-based vision clinic two years ago, Alejandra de Alba Campomanes, MD, MPH, became an enthusiastic faculty sponsor. Dr. Hennein and medical student Ogonna Nnamani dug in to make it happen.

Training to Care

With The California Endowment’s $20,000 equipment gift to That Man May See, the monthly clinic opened in fall 2017. It joins other UCSF services at Division Circle Navigational Center, a shelter run by the St. Vincent de Paul Society in San Francisco’s South of Market area.

The clinic has no paid staff. A handful of medical and premedical students are led by Dr. Hennein and Mrs. Nnamani. Volunteers provide care under the supervision of ophthalmology residents, fellows, and faculty. Project Homeless Connect pays to have glasses made. Students learn to do intake, collect histories, perform comprehensive exams, coach patients on their conditions, and document next steps.

Dr. de Alba is thrilled. “Providing care at the shelter allows us to serve those in the most unstable circumstances,” she says. “Aspiring doctors are learning the value of community service as well as patient care and the tools of ophthalmology.”

Sarah Menchaca, Dr. Neeti Parikh
Volunteer Sarah Menchaca learns from attending faculty ophthalmologist Dr. Neeti Parikh

Connecting to County

The clinic is a bridge to sight-saving treatments at Zuckerberg San Francisco General Hospital and Trauma Center. Jay Stewart, MD, chief of ophthalmology there, saves appointments for patients referred from the shelter.

“Those already experiencing sight loss are the most motivated to follow up,” says Dr. Stewart. “We want to make it easy.”

Momentum and Hope

“Even though we want to serve more people, our first goal is to make the clinic sustainable,” says Dr. Hennein. “Eventually, we’d like to open our doors twice each month.” Right now, leaders hope to acquire a portable slit lamp to provide more comprehensive services.

Volunteering at the clinic is extremely popular. “It is inspiring to see young students’ eagerness to learn and their enthusiastic commitment to help in such a respectful, compassionate way,” says Dr. de Alba. “It gives me so much hope.”

Shelter Clinic Volunteers pictured above:
Back row, from left: Ana Marija Sola, Joseph Atangan, Ermin Dzihic, Charlie Kersten, Dr. Murtaza Saifee. Front row, from left: Sarah Menchaca, Kiki Spaulding, Dr. Lauren Hennein, Tianyi Zhang, Heer Purewal

Thanks to The California Endowment, That Man May See, and Akorn Pharmaceuticals for donations; additional faculty sponsors Drs. Stewart and McLeod; premedical student clinic director Kiki Spaulding, Project Homeless Connect’s Alison Van Nort, MSW, and faculty and student volunteers.

Improving Vision Care in China

UCSF ophthalmologists are improving quality of care for vision patients by teaching and consulting at vision clinics across China.

It isn’t every day that ophthalmologists see their names dancing across a Jumbotron. This bold welcome met two UCSF clinician scientists last fall at the equivalent of a county hospital in Changchun, China. Vitreoretinal specialist Jay Stewart, MD, and oculofacial plastics specialist M. Reza Vagefi, MD, were the honored guests at a three-day teaching event.

Advancing Training, Care, and Understanding

Drs. Stewart and Vagefi spent one day consulting on how to help patients with complex vision disorders, and another day in surgery, teaching advanced methods. “I was able to share a method for approaching the orbit that avoids leaving a scar on the skin,” says Dr. Vagefi. A third day was devoted to theory and clinical application.

An eye doctor examining a patient's eyes with an ophthalmic device.
Dr. McLeod offers expertise on a difficult case.

“This was our second trip,” says Dr. Vagefi, “and each has offered a unique learning experience. In China, patients are in charge of their own medical charts and carry them from doctor to doctor. For the most part, only senior ophthalmologists perform eye surgeries.”

“After our first visit, we recommended a video system be installed in the operating room as a teaching tool,” adds Dr. Stewart. “This will help advance the skills of younger ophthalmologists.”

 

Initiative to Improve Quality

These trips are part of a larger initiative to lift the quality of care for Chinese vision patients. In China, ophthalmologists often lack access to training on par with the best available in the United States and Europe, with only a handful of outstanding vision centers providing comprehensive training.

Organized by the nonprofit Lifeline Express, Western specialists help fill gaps in professional knowledge at interested hospitals and clinics and recommend improvements. Pediatric specialist Creig Hoyt, MD, was the first UCSF ophthalmologist to participate in the program, and he soon interested others.

A group of four people closely observing a screen together.
Chinese ophthalmologists consult with Dr. Hoyt.

This year Dr. Hoyt will teach at a clinic on the Tibetan plateau. Glaucoma specialist Ying Han, MD, pediatric ophthalmologist Alexandra de Alba Campomanes, MD, and Stephen D. McLeod, MD (cornea, external disease, and refractive surgery), have also led professional development missions.

 

Inspiring Deeper Learning

“The impact of this work continues to unfold,” says Dr. Vagefi. “After our first visit, a junior ophthalmologist traveled to Shanghai, inspired to seek additional training in orbital surgery.”

These UCSF ambassadors are establishing ties to vision institutions across China and offering invitations for ophthalmologists to apprentice as international fellows at UCSF. This year Drs. de Alba and Hoyt will host visiting Chinese scholars whom they met while working for Lifeline Express.