VCU doctor's initiative aims to improve immigrants' health

Dr. Mark Ryan writes on his blog about the day in June when robbers burst into the hostel in the Dominican Republic where he and others on a medical mission were staying.

A scuffle ensued, which left him with scratches, bruises and needing stitches in the back of his head.

Rather than pack up their duffel bags and head home, Ryan and others, including pharmacy and medical students from Virginia Commonwealth University, finished the trip after moving to a more secure location.

Undeterred, in a few days Ryan and another group will head back to the Dominican Republic for another medical mission.

"We don't want these would-be thieves to keep us from helping patients in need," Ryan said.

"We were never threatened in the community where we work, so why penalize our patients over the actions of a few bad men?" he said.

For his international work and for mentoring future physicians, Ryan, 34, was honored in October with a service award from the Medical Society of Virginia Foundation.

Ryan is a family physician at VCU's Hayes E. Willis Health Center and he supervises medical students training at CrossOver Ministry clinic. He is also medical director of the Student Organization for Medical Outreach and Sustainability, started by pre-med students at the College of William and Mary, Ryan's undergraduate alma mater.

David P. Aday Jr., a professor at William and Mary who has students involved in an ongoing project in the Dominican Republic, described Ryan as "the model family doc: completely focused on caring for the whole person rather than discreet symptoms, even in the crush of a clinic in which we see 700 patients in a week."

Ryan's work with medically underserved populations, which he blogs about, is taking another turn -- this time locally. He has started an initia tive he calls Una Vida Sana, Spanish for "a healthy life." In it, he and collaborators are reaching out to immigrants who may not have a regular source of health care, partly because they don't think they need it.

Though free clinics such as those run by CrossOver Ministry reach many immigrants, Ryan said people with undiagnosed high blood pressure, high cholesterol or pre-diabetes may not recognize that getting medical care now can stave off more serious illness. Those are the folks he wants to reach.

"These are folks that are establishing long-term communities," Ryan said. "If we don't provide some attention, over the course of the next 10 to 15 years, I think we are going to see our safety-net providers increasingly stressed by folks coming in with illnesses they never knew they had." He stresses that these are his views, not necessarily those of VCU.

But the notion that such a service was needed came to him during his clinical work at the Willis Center. He spends about half his time there seeing pediatric patients, many of which are children of immigrants. Ryan speaks fluent Spanish, the result of his early years spent living in the Dominican Republic, Venezuela, Argentina and Panama with his parents, who were U.S. foreign-service workers.

Ryan said as the parents of the children he sees at the center get comfortable with him, they start asking questions about their own health.

"Since I am not officially their doctor, legally it's a little bit difficult to give any formal advice because I am not doing a full evaluation," he said.

The Una Vida Sana project is a way to meet the need for routine, basic screening, he said. Like the international efforts, it offers service-learning opportunities for students in pharmacy, languages, nursing and medicine who want hands-on field experience.

So far, the initiative has consisted of screenings with two local congregations with large Spanish-speaking populations. Blood glucose, blood pressure, weight and waist circumference were measured. Ryan said the screeners referred about three people to CrossOver Ministry clinic for further care. One was a man with diabetes who was getting medications from a family member in Mexico who stopped sending it.

"We've had some events to see if the idea would work. Now that it might, we have to figure out something long term," Ryan said.

"The vision I have right now is to have a rotating schedule of set dates that we'll work on and go site to site, and then have the ability to increase our capacity for large events like the Imagine Festival in the fall, when a lot of the Spanish-speaking families come together."

Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.