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Student provides care to a patient at Haven for Hope

Helping the homeless heal
Students provide care to patients at Haven for Hope


April 2013

by Rosanne Fohn

Through their clinical training and volunteer work, UT Health Science Center San Antonio students and residents have many opportunities to learn while providing valuable service to the community.

Working with underserved patients at Haven for Hope - San Antonioís transformative program for homeless men, women and children - provides a different perspective for students in the School of Medicine, and Dental School students and residents.

"Most of the patients we see are trying to make a positive change to improve their lives. Many of them have been affected by addiction, abuse, abandonment, bankruptcy and illness," said Paul Orjuela, D.D.S. The 2012 Dental School graduate saw patients there during clinical rotations as a student. He now provides more complex care as a resident in the Advanced Education in General Dentistry (AEGD) program.

Changing lives
One of his patients was a former businessman whose life unraveled due to drug addiction and business problems. "In a matter of three years he lost his family and home. He became ill and lives in a shelter. He came to our clinic because he needed about 40 percent of his teeth extracted due to decay and he needed other major restorative care. It is incredible how drugs can destroy a personís life, spirit and body in just a few years," Dr. Orjuela said.

He also provided care for a young woman who had a large abscess and had been unable to eat for two days. "We extracted the tooth, prescribed antibiotics and told her how to keep the extraction area clean. I ran into her the next time I was in the clinic. She approached me in the waiting room, shook my hand and reminded me of the treatment I provided," Dr. Orjuela said.

  Medical student Ebele Achebe checks a patient's blood pressure.
Second-year medical student Ebele Achebe, offers calming words and a reassuring smile to a patient at Haven for Hope as she checks the patientís blood pressure.
"I found out she had been homeless for two years and has a 3-year-old. She wanted to thank me because she was able to study for her computing class, passed her exam and was applying for jobs," he said.

These are familiar stories to the approximately 100 senior dental students who participate in a weeklong rotation at the San Antonio Christian Dental Clinic at Haven for Hope. Thirteen AEGD residents, such as Dr. Orjuela, provide care there on Tuesdays and Thursdays as part of their clinical training. And this semester, about 30 senior dental hygiene students began rotations at the clinic, said Elaine Neenan, M.S., D.D.S., M.P.H., associate dean for External Affairs in the Dental School.

Students gain life lessons
Meanwhile, nearly 200 medical students per year work at the Centro Med Haven for Hope Clinic on Wednesday evenings. "We have first- through fourth-year medical students at the clinic working as volunteers or as part of their classes," said Jessica Mendez, community service learning program coordinator and assistant to the director in the Center for Medical Humanities & Ethics, which coordinates the medical studentsí efforts at all five of the centerís student-run free clinics.

Fourth-year medical student Tiffany Cortes said she has learned important lessons while volunteering there. The clinic serves Haven for Hope residents as well as others who cannot afford care.

"There was one woman who developed a rash that kept spreading," Cortes said. "Eventually her ankles, hands and wrists became swollen. Then, she developed sores in her mouth and throat. When she came to us she said she had tried all these different medicines but it kept getting worse. She had to quit her job at an elementary school because she couldnít work, and without a job she no longer had health coverage."

After consulting, the medical students on duty that evening proposed that the patient might have lupus. Supervising faculty member Richard Usatine, M.D., agreed. He recommended the patient be tested for the chronic autoimmune disease.

Unparalleled experience
"What I have enjoyed the most is being able to help people get back on their feet," said Cortes, who is from Corpus Christi. "It is easy for a medical condition to grow and hinder a person from being able to work. I have enjoyed learning about different diseases and conditions in class and then being able to see them in the clinic.

"Iíve also gained so much by working with my peers. The upper-level students have the chance to teach the less-experienced students. I enjoy helping them get oriented in the clinic. We learn a lot from each other," she said.

As a result of their experiences at Haven for Hope, both Cortes and Dr. Orjuela, who is from Harlingen, plan to care for underserved patients in their careers.

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