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Program Spotlight

Health Frontiers in Tijuana (HFiT) Clinic

The Health Frontiers in Tijuana (HFiT) clinic lies in the middle of a dusty street within walking distance of the red light district in Tijuana.  At 10:00am every Saturday, the doors to the clinic open and people from all types and walks of life begin seeing doctors and medical students from UCSD and the Universidad Autonoma de Baja California (UABC).  Many of the patients have little to no access to healthcare; a significant portion are drug addicts or involved in the sex industry; a majority have been waiting over an hour for the doors to open. 

“It’s a really exciting time to be involved with the HFiT clinic and the UCSD Division of Global Public Health as a whole,” graduate student and HFiT student coordinator Daniel Yee says. “Especially at UCSD with the UCSD Global Health Institute, there’s been a large focus on improving collaborative efforts between people across different departments and institutions.  I’m sure we wouldn’t have been able to accomplish even half of what we’ve done so far at the HFiT clinic without the cooperation of the UABC and UCSD faculty and students, many of whom come from different backgrounds and specialties.” 
Indeed, Yee comes from a background in biology himself, having graduated from UCSD in 2012 with a Bachelor’s in General Biology and currently pursuing a Master’s in Biology also at UCSD.  Still, even with a course load of mostly biology classes, he maintains a close connection with global health issues.  Yee was the president of the UCSD chapter of the Fellowship of International Service and Health (FISH) for 2 years, an entirely student-run 501(c)(3) that organizes medical missions to Tijuana with the help of physicians from the U.S.  Nowadays, Yee’s experience in FISH is coming in handy as he helps build infrastructure for the HFiT clinic.  

The HFiT clinic is a binational student-run free clinic that partners UABC and UCSD undergraduate, pharmacy, and medical students together to provide healthcare for the underserved in Tijuana.  The idea for the clinic originated from former UCSD medical student, Amy Eppstein, and UCSD faculty members, Dr. Steffanie Strathdee and Dr. Jose Luis Burgos.  HFiT was formally established in April 2011 after 3 years of development and searching for an ideal location, and the clinic operates weekly on Saturdays.  It is now part of MED 290, an elective course for UCSD medical students where they learn about the “joys and challenges of healthcare for the underserved” and gain practical experience in outpatient services under the supervision of UCSD and UABC doctors. 

“What Amy, Dr. Burgos, Dr. Strathdee, Dr. Ojeda (who is a UCSD professor who specializes in the health of underserved and vulnerable populations), and Luis Alberto (president of Prevencasa, the NGO that helps operate the clinic) have managed to do with the clinic in the span of three years is incredible.  I’m really just helping to fill in the cracks, because all of the heavy lifting and planning has already been done,” Yee smiles.  “There’s a lot of potential for what this clinic can do—not only in the services it can provide, but also in the research and educational opportunities it affords.  Downtown San Diego and Tijuana are separated by less than 20 miles and share a lot of the same characteristics between their respective populations, so anything we can do in benefit the Tijuana population will also indirectly benefit San Diego.” 
Currently, the clinic offers a variety of services for its patients.  In addition to free consultations, patients are encouraged to participate in surveys that are offered by researchers from UCSD and UABC, and the clinic also has the beginnings of a pharmacy so that if they are available, patients can bring home free medications without having to visit a pharmacy themselves (one of Yee’s projects this year has been to implement a system to manage the pharmacy and recruit pharmacy students from the Skaggs School of Pharmacy to operate it).  The clinic also operates a needle exchange program and supports several other public health initiatives that are backed by the Mexican government.

So what’s next for the HFiT clinic?  “There are plans now to establish a women’s and a pediatric’s clinic and I’m trying to create a student organization that will enable undergraduate students to get more involved,” Yee says.  “I remember as an undergrad myself, I always wanted to do things that would help make a big difference, and this definitely fits that description.  Even if they aren’t the ones practicing medicine, undergraduate students are crucial in helping the clinic run smoothly and can make a big impact—they can serve as patient navigators and health advocates, they can fundraise—there is always some way for people to help out, to get involved.”

For more information about the HFiT clinic, please contact:
Dr. Jose Luis Burgos (jlburgos@ucsd.edu), or Dr. Victoria Ojeda (vojeda@ucsd.edu)

For more information on getting involved at the HFiT clinic, please contact: 
Student Board of Coordinators (hfitfreeclinic@gmail.com)

To donate to the HFiT clinic, please visit: UCSD Online Giving

Los Laureles Canyon

Story by Emily To & Marie Albano

Laureles Workers

Despite the international borders that divide the United States and Mexico, the two countries share more than just common cultures and tastes for cuisine. They have also been forced to share both the environmental and public health challenges that have come with the development of man-made settlements in fragile ecosystems. In the Tijuana-San Diego region specifically, natural boundaries like watersheds are bisected by the national borders and pose unique challenges for the management of ecosystems and scarce natural resources. Due to accelerated population growth in recent years, concentrated in these unplanned settlements called colonias, infrastructure gaps in the bi-national Tijuana River Watershed have led to chronic problems of cross-border flows of sediment, trash and hazardous waste.

A prime example of this is Los Laureles Canyon in the City of Tijuana, where large populations lack many basic utilities, and the inadequate management of sewage, hazardous substances and solid waste pose chronic risks of exposure to pathogens and environmental toxicants. The streams of debris, sediment, and untreated wastewater runoff that flow across the border into the United States directly impacts California’s Tijuana Estuary nature preserve, located at the base of the Watershed. The Tijuana Estuary, the largest intertidal coastal wetland in the southern United States, is an essential breeding, feeding and nesting ground and a key stopover point on the Pacific Flyway for over 370 species of migratory and native birds, including six threatened and endangered species.

Laureles Town Laureles Road

"Los Laureles Canyon has profound urban and ecological problems," said Keith Pezzoli, a Lecturer with the UCSD Department of Urban Studies and Planning. Professor Pezzoli is collaborating with many others to boost sustainability in Los Laureles. The UCSD-TV documentary "Los Laureles Canyon: Research in Action" follows the story as Pezzoli and his colleagues tackle some of the area’s problems “which are increasingly common in low-income human settlements worldwide--we've been experimenting with new ways to join science, education and community outreach. The UCSD-TV documentary tells this story with a hopeful outlook."

Pezzoli has been working closely with Oscar Romo of the Coastal Training Program at the Tijuana Estuary and Hiram Sarabia of the UCSD Superfund Research Program. Along with other experts in public health, environmental health science, climate change and urban planning from both the U.S. and Mexico, they are documenting the San Diego-Tijuana border region’s many challenges and devising an action plan. The researchers have been testing soil samples, interacting with residents in Los Laureles Canyon, and gaining an understanding of how academic research can have a direct impact on people's lives.

Laureles Wall

Seeking to improve the quality of life in the rapidly growing human settlements of Los Laureles Canyon, UCSD students and researchers are devising proactive plans, in partnership with community groups and government agencies, to deal with serious ongoing problems of pollution and erosion of the unstable hillsides. The focus is on integrated cross-border watershed management and wetland restoration. One project involves the installation of pervious pavers on the main roads in Colonia de San Bernardo, one of the colonias situated in Los Laureles Canyon. The pavers are hexagonal shaped bricks formed from a mixture of water, cement and gravel. They will act to decrease the hazards of flooding that can devastate buildings and roadways in the canyon by regulating the flow of runoff after storms, and they will also prevent the continuous erosion of the canyon by holding in water and releasing it slowly into the ground. The natural bacteria living under these pervious pavers help bioremediate the toxicants that accumulates there. Another project involves the use of recycled tires to create retention walls for erosion control. The retention walls are designed as works of art that help the community create a sense of belonging around the public spaces.

With their continued efforts, Dr. Pezzoli and his team of researchers and student volunteers hope to improve the quality of life within colonias such as San Bernardo, and ultimately, to alleviate the environmental strains felt across the U.S.-Mexico border. Though a seemingly small step forward in the battle for sustainability, the installation of the pavers and retention walls is a true testament to how tremendous benefits may be reaped from simple solutions.

UCSD students and researchers have teamed up with Professor Oscar Romo in an attempt to scale up this type of cross-border collaboration and engaged scholarship. Professor Romo recently established a Science Center in Los Laureles which is a field-based station that provides an excellent platform for students and faculty to participate in use-inspired and problem-solving research for the community. There is ample opportunity here to link concerns about the built environment and global health.

For more information about how to get involved, please contact Oscar Romo at OROMO@parks.ca.gov, Hiram Sarabia-Ramirez at hsarabia@ucsd.edu, and/or Keith Pezzoli at kpezzoli@ucsd.edu.

Organizations involved with the Los Laureles project:
The Global Action Research Center: http://theglobalarc.org Urban Studies and Planning Program, UCSD
NIEHS Superfund Basic Research Program (SBRP)
Center for Iberian and Latin American Studies (CILAS), UCSD
Climate Change Science at UCSD & the IPC3 Assessment Report

PHOTOS, VIDEO AND TV DOCUMENTARY:

An extensive photo gallery focusing on Los Laureles Canyon can be viewed at http://www.flickr.com/photos/theglobalarc/sets/72157623568691705/

For video see the Global ARC’s Vimeo channel: http://vimeo.com/11199258