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A Buddhist Model
- 1. A BUDDHIST MODEL ADDRESSING VISION HEALTH DISPARITIES THROUGH COMMUNITY-CLINICAL PARTNERSHIPS BY ABHI DALAL, MEDICAL VOLUNTEER WITH TZU CHI MEDICAL FOUNDATION
- 2. INTRODUCTION • Buddhist Monk Cheng Yen saw the inequalities in her community.1 • Seeds were planted when she and several housewives began recycling plasticware to fund relief efforts.2 • Our patient-care philosophy is motivated by Buddhist practice.3 • In Southern California, the Mobile Clinic provides vision care to socially marginalized and highly vulnerable communities.4 • Vision Health Disparities is understudied and underestimated.5
- 3. QUALITATIVE RESEARCH • Utilized my qualitative research skills on the patient histories I collected.1 • Step 1: Coding patient histories.2 • Step 2: Theorizing health disparities.3
- 4. UNDERSTANDING PATIENT HEALTH DISPARITIES
- 5. ETHNOGRAPHIC FINDINGS: THE PATIENTS’ LIVED EXPERIENCES Unexpected Circumstances and Poverty • An African American lady Sharon spoke about how she “was like any other middle-class woman until her husband spent all her money.” • A male patient Michael recounted he “is experiencing homelessness after becoming hospitalized and then losing work.”1 Poor Eye Health2 • David reports that he has had “eye problems forever and cannot see out of [my] right eye.” • According to Patricia, she “has had vision difficulties for over 5 years. She cannot read from a distance and so has difficulties with driving.”3 Lack of Eye Health Resources/Knowledge • Medi-Cal does not cover prescription eyeglasses. • David mentioned that he “picked out eyeglasses from Walmart but these were not helpful.” • Sharon stated that “she tried over-the-counter reading glasses and eyedrops but neither were helpful and her glasses caused her side-effects like headaches”.4
- 6. RACIAL JUSTICE • Culture and structure are both implicated in producing inequality. • We have witnessed the racial differences in the quality and quantity of healthcare.1 • We have seen how social disparities mutually reinforced each other and contributed to a decreased health status.2
- 7. LEVERAGING COMMUNITY RELATIONSHIPS • Community integration to address health disparities.1 • Effective patient engagement to spearhead medical related quality of life.2 • Community partnership and ownership generates funding and sponsorships.3
- 8. ORGANIZATIONAL CULTURE: TZU CHI MEANS “COMPASSIONATE RELIEF” • Our founder’s mission was inclusive and service-oriented.1 • A Buddhist Model.2
- 9. CONTACT INFORMATION Abhi Dalal • ad4839@berkeley.edu • abhi.k.dalal@gmail.com
Editor's Notes
- 1Impetus to begin Tzu Chi Medical Foundation. 2Efforts are global now, including supplying hospitals with PPE to restoring communities in the Philippines ravished by a typhoon. 3Facilitating care that is compassionate and equitable. 4We visit mental health clinics and homeless shelters, a window into underserved communities that illuminates vision health disparities. 5There is an increasing risk of avoidable vision loss along racial lines with the rise in diabetes, the obesity epidemic, the rapidly aging population, and the uneven spread in effects of these correlated conditions.
- 1 “Data with a soul” as Brene Brown chimes. 2I familiarized myself with the patient narratives by reading them line-by-line and I identified general emergent themes and the relationships in-between. I highlighted these patterns by creating a codebook to organize the patient histories. 3I formulated an integrative theory after examining the nature of codes and relationships amongst the codes. I have drawn from the experiences of all the patients to understand their health disparities.
- 1Tzu Chi Mobile Clinic’s patients face a combination of poor eye health, poverty, and a lack of resources that hold our patients back from addressing any one of these challenges, let alone their decreasing autonomy.
- 1Our patients come from poverty although they might not have started such and they are caught in its vicious cycle. They can be living hand-to-mouth and have limited resources to advance in life. 2Their limited abilities are exacerbated by their poor eye health and the lack of resources. 3Poor eye health disrupts one’s ability to function and contribute fully, adding insult to injury (excuse the pun). 4Our patients try to help themselves in lieu of professional treatment and in the absence of sound eye hygiene knowledge. They are not able to cure their vision conditions and restore their functioning.
- 1My heart broke when a Spanish-speaking Dominicano confided in me that his newly diagnosed glaucoma had lay unaddressed for so long despite raising his concerns to multiple providers. 2For example, we had as a patient an impoverished Black mother whose worsening vision prevented her from working to her fullest ability and also lacked transportation to her medical appointments.
- 1Our mobile clinic team partners with service organizations, where our patients are seeking their aid and actively trying to progress in life. 2Our patients are working hard to restore their abilities with the service organizations that Tzu Chi Mobile Clinic partners with. Thus, with vision medical services and treatment, our patients would be better equipped at navigating their unfortunate circumstances and poverty. In short, given our patients are actively trying to progress in life, they benefit tremendously from their enhanced vision and enhanced livelihood. 3All of our services are free-of-charge to patients. The mobile clinic receives much of its funds from local grants and charitable donations including what patients can freely give back themselves. Nearly all the work is provided by medical relief volunteers. We are grateful that our partner affiliates volunteer their time during the clinic day, providing interpretation into Spanish and equipment like additional tables.
- 1Tzu Chi Founder Cheng Yen says that it is important to volunteer and contribute to learn best how to work with others from diverse walks of life and to become a better human being in the process. 2Tzu Chi Mobile Clinic brings Buddhist principles into our work, spearheading healing beyond the clinic walls in partnership with service organizations and addressing structural racism through our comprehensive approach.