CHAPTER 5
Tzu Chi USA Mobile Clinics
Fresno, Central California
Written by Yuanling Chang, Jennifer Chien, Aishu Huang, and Sherry Shih
Edited by Yingying Lee
Translated by H.B. Qin
Published #72 | Spring 2024 Issue
Tzu Chi volunteers check the eyesight of underprivileged school children during Tzu Chi Vision Mobile Clinic outreach in Fresno, California, bringing hope with warm smiles. Photo/Jaime Puerta
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California’s Central Valley is one of the breadbaskets of the United States, with a dense labor force working hard day in and day out to cultivate the land. These diligent agricultural workers are primarily underserved or new immigrants who rely on their meager earnings to feed their families. Due to economic deprivation, many choose not to buy medical insurance or can only afford low-cost policies. As a result, 14,000 to 20,000 children here don’t have medical insurance. In the event of illness, farmworker families have no way to cope, let alone overcome language barriers, cultural differences, and a lack of transportation, which make the situation even worse.
Life Migrating From Farm to Farm
Fresno is an area with vast farms, where a farmworker’s life encompasses moving from place to place in a cycle dictated by crop cultivation and harvesting schedules. Even if Tzu Chi wants to provide free clinic services here, it’s hard to keep up with the agricultural workers’ migration, making mobile healthcare services the ideal way of offering medical care. As the workers move to farms in different directions, the medical staff and equipment can follow behind, as if rushing to a country fair where they can provide timely medical services to this transient population.
On August 19, 2001, nearly 45 Tzu Chi International Medical Association (TIMA) members and 50 volunteers from Northern, Central, and Southern California joined forces to hold Tzu Chi USA’s first free clinic event in Fresno. A team from the Buddhist Tzu Chi Free Clinic in Alhambra, Southern California, transported medical gear for the event, including portable dental chairs and other equipment, to the site. The clinic event was held at The Boys & Girls Clubs of Fresno County and provided 1,078 consultations to nearly 355 community residents.
Monique Washington, age 24, brought her one-month-old baby to the clinic and said, “I never thought I’d see six dentists around a table serving a bunch of strangers. I thought I was coming here only to get healthcare literature and didn’t realize I could get a filling. It relieved the toothache I had for six weeks!”
The team divided the site into two parts: One offering free haircuts and distributing necessities, the other for free healthcare services. Forty-five healthcare workers were assigned to serve at various pre-designed stations in the free clinic area. The first stop was the blood glucose and cholesterol testing station, where eight nurses were so busy that they had to schedule water and meal breaks.
The news media, including ABC, CBS, NBC, and Spanish TV stations, sent reporters for on-site coverage. When seeing Barbara, a local ABC news reporter, Jose, an 11-year-old Hispanic boy, immediately asked for an autograph, but she smiled and told the boy:
These strangers are the unsung heroes you should be learning from today!
Twenty-eight-year-old Maria and her family of five had not been to the doctor in three years. Every time they got sick, they had to wait for a natural recovery. This time, the children and adults took the opportunity to get checkups and dental scaling, which they hadn’t had in a long time. Maria needed to walk three miles to get home after collecting the supplies she received, yet she didn’t mind, saying, “At least my family is still in good health, and we’ll have peace of mind when we go to our next city to work.”
A Malaysian Couple
For each subsequent medical outreach event in Fresno, the team borrowed portable equipment from the Buddhist Tzu Chi Free Clinic in Southern California. Volunteers traveled long distances without rest to repeatedly transport the borrowed gear to Fresno in their cars. (Later on, in 2005, local donations enabled the purchase of three sets of portable dental equipment).
By 2003, the volunteers in Fresno had accumulated enough experience to independently carry out free clinic activities, beginning with quarterly clinic events that year. In 2004, the number of free clinics increased to one per month. By 2005, in addition to the monthly free clinic, one additional day of service was added in the week the clinic took place, so patients could return to follow up with changes in their conditions while doctors could adjust prescriptions.
“Tzu Chi has so many missions and services that the Fresno team can’t do all of them. So, the team discussed and decided to focus on one mission: To cultivate free community clinic services. The majority of Tzu Chi volunteers in Fresno joined Tzu Chi through free clinic activities, and many of them are medical professionals and patients we’ve served before,” said Steven Voon, Executive Vice President of the Buddhist Tzu Chi Medical Foundation and Executive Director of Mobile Clinics. Voon, from Malaysia, married Olivia Chung (now Fresno Mobile Clinics Manager) in 2000, and she introduced Tzu Chi to him. The couple moved to the United States, and in 2002, Voon was invited to participate in a Tzu Chi free clinic event and soon became a vital driving force behind the Fresno mobile clinic team’s activities.
Voon describes himself as the kind of person who, when they set out to do something, will want to do it perfectly: “When I became a Tzu Chi volunteer and participated in more free clinics, I realized that there was a lot of room for improvement in Tzu Chi’s mobile medical services, from filling out the forms for the patients to the entire free clinic process. So, when I was working during the day, I couldn’t help but think of ways to improve, and when I turned on my computer, I was always handling Tzu Chi affairs.”
With such dedication, Tzu Chi USA’s mobile healthcare services in Fresno are flourishing. They include two medical consultation and prescription services per month; two appointment-based Smile 4 U dental services per month; two to three See 2 Succeed vision programs per week; Senior We Care vision and dental programs; Care 4 Highway 99 vision and dental programs; the iCare20 vision program; Healthy Fresno County (initially a large neighborhood clinic held once annually); and Healthy Walk Healthy Team.
Tzu Chi USA Mobile Clinics
Fresno, Central California
“From 2015 to 2019, many of our community partners recognized our work providing free medical services that have benefited countless people in the local community,” Olivia Chung said. “They appreciate that Tzu Chi’s mission to serve the community is the same as theirs, so they’re happy to partner with Tzu Chi and support our medical activities through grants, sponsorships, and material support. As a result, Fresno’s mobile medical care receives more and more grants each year,” she reported.
See 2 Succeed
Tzu Chi’s affiliation with See 2 Succeed, a local nonprofit partnership that works with schools in the Central Valley to offer free eye exams and glasses for children in underserved communities, is a perfect example of a flourishing collaboration in Fresno. Since 2015, Fresno’s mobile clinic team has worked with school districts to kick off the See 2 Succeed program, targeting preschool through third-grade students with free vision clinics two to three times a week. May 4, 2023, marked Fresno’s milestone of providing the 5,000th pair of eyeglasses to underprivileged students through the mobile clinic team’s See 2 Succeed free vision care program in elementary schools.
See 2 Succeed had reached 23 school districts in Fresno by 2023. Olivia Chung plans to include all the school districts in Fresno by 2024 so that every student needing prescription glasses to improve their eyesight can better study and learn.
Care 4 Highway 99
Another successful mobile medical care program in Central California is Care 4 Highway 99. The 420-mile-long U.S. Route 99 stretches through California’s Central Valley and, from south to north, connects Fresno, Modesto, Stockton, and Sacramento, California’s capital, with all four cities served by Tzu Chi free clinics.
From the south end of Route 99, Steven Voon leads the mobile clinic team north to support Tzu Chi teams that provide free clinics in the larger cities along the highway and smaller adjacent communities and farming towns. In this way, the team can meet the medical needs of many farmworker families in this vast agricultural region.
“Our medical care is provided in collaboration with charity initiatives. We not only provide medical care and medication to treat the suffering of those disadvantaged and sick but also accompany them and provide proper financial support to protect families in need through the protective net of love,” Olivia Chung said.
Chung and other Tzu Chi volunteers in Central California have made continuous efforts to expand mobile medical services from scattered locations to connected lines that are ever-expanding. “We recently purchased two sets of portable optometry equipment to be placed in Modesto and managed by a team of Modesto volunteers led by Yingli Yang, who would take the equipment to neighboring free clinic sites,” Chung explained. Modesto is between Fresno, Stockton, and Sacramento, thus close to many service areas, so the location allows more flexibility when mobilizing human resources and equipment.
Chung plans to work with more towns to increase the number of free vision clinics. “In 2024, we’ll increase the number of free clinics in Modesto, Stockton, and Sacramento, with 12 primary vision checkups and 12 optometric clinics, totaling 24 clinics,” she outlined.
When Fresno’s mobile clinic team receives the optometric result and prescription from the Modesto team, they can start making glasses in our Vision Mobile Clinic and send them to the relevant Tzu Chi offices the next day; the patient will receive a brand-new pair of glasses from the volunteer within 48 hours. The Central California team will solve the patients’ vision problems through a ‘relay of love.
The Fresno mobile clinic team has signed a Memorandum of Understanding with the County of Fresno to implement a two to three-year free clinic program in Central California’s rural areas starting in 2024. “In the remote towns of Central California’s agricultural areas, many communities don’t have optometry clinics. Through this program, the Tzu Chi Vision Mobile Clinic could reach more remote towns and communities, and we’ll also take the Dental Mobile Clinic there so that our services will be more in-depth and help more families in need,” Chung said. Her hope for the future is to build a Tzu Chi medical network essentially.
From Zero to Four
Fresno’s Mobile Clinic story began in 2008, when, in response to the increasing number of free clinic events the Central California team was offering and their desire to travel to the countryside and remote communities along highways to provide regular free clinic services, the Buddhist Tzu Chi Medical Foundation converted an unused medical vehicle in Southern California (Tzu Chi USA’s second Mobile Clinic) into a mobile unit equipped for Western medicine. The Foundation then dispatched the refurbished vehicle to Fresno for service as the area’s first Mobile Clinic.
Then, in 2010, Steven Voon traveled to New York City, from where he and two volunteers took turns driving for two days and nights to bring Tzu Chi USA’s third Mobile Clinic, purchased in 2005 and stationed in the Big Apple, to Fresno for use in Central California’s free clinic outreach. At that time, this Dental Mobile Clinic had been idle since there was no suitable parking spot, and it wasn’t easy to maneuver on New York’s narrow streets.
Thanks to a donor’s generosity, in 2016, the Fresno mobile clinic team received Tzu Chi USA’s sixth Mobile Clinic, this vehicle equipped for vision care. Since then, the team has been operating three Tzu Chi Mobile Clinics – one for Western medicine, the second for dental care, and the third for vision care. The fleet represents mobile medical offices that can provide a full range of primary healthcare services.
Moreover, the size of Fresno’s fleet didn’t stop at three. In 2020, Kaiser Permanente, a long-time partner of Fresno’s mobile clinic team, pledged to donate a Mobile Clinic to Tzu Chi USA in recognition of its long history of organizing free clinic events in Central California. Subsequently, Fresno would receive another Dental Mobile Clinic, enhancing free dental care services that are always in high demand.
On August 28, 2021, 140 guests from various places gathered in Fresno to celebrate the 20th anniversary of Tzu Chi’s free community clinic services in Central California. Since 2001, Tzu Chi volunteers have traveled to underserved rural areas in this region and provided more than 1,000 free clinics. Wade Nogy, Senior Vice President and Area Manager at Kaiser Permanente, attended the celebration and presented the Mobile Clinic gift to Tzu Chi on this occasion.
William Keh, then-CEO of the Buddhist Tzu Chi Medical Foundation, was very touched by the fact that the community had gone from a medical desert to a place where charitable medical care had taken root. “It’s an honor to witness the achievements of Tzu Chi’s medical team in Fresno. They went from having zero Mobile Clinics to four! Thank you to the team! Thank you to everyone present; you are all Tzu Chi’s heroes!” Keh said.
Tzu Chi USA Northwest Region’s Executive Director Mingjin Hsieh also admired the outstanding work done by the Central California medical team. “In all fairness, the medical resources in Southern and Northern California are much better than those in Central California, where medical care is truly in need. All along the way, Tzu Chi Fresno’s mobile clinic team has connected with the mainstream, attracted volunteers, and won the hearts and minds of many people!” he noted.
“Fresno started with nothing. Twenty years ago, we had to drive to the Free Clinic in Southern California to borrow dental equipment, and it took us eight hours to drive there and back; another eight hours to return the equipment,” Steven Voon recounted as he recalled all the efforts at the beginning, which the team shouldered only to make free clinics in Central California a success. “I’m thankful we received the first donation in 2005 and purchased three sets of portable dental equipment. Afterward, we received Fresno’s first Tzu Chi Mobile Clinic in 2008, while the free clinic team grew…” he said.
As the Mobile Clinic fleet also grew, the Fresno team could use the Tzu Chi Mobile Clinics to transport advanced equipment to remote areas where medical resources were limited and rudimentary, providing dental checkups and scaling, plus blood pressure and glucose tests for the farmworkers stationed there. Central California’s agricultural workers typically have little money and no cars, don’t speak English, and have no immigration status. When they couldn’t go to clinic offices to seek medical treatment when sick, Tzu Chi volunteers would mobilize and come to them to address their healthcare needs.
A Thousand Times I Love You
At the beginning of 2021, when the COVID-19 pandemic appeared to subside due to the introduction of vaccines, and California was gradually coming out of lockdown, the mobile clinic team immediately resumed its average of three to five weekly free clinic activities. Eight volunteers from the team set off early in the morning on May 20, 2021, toward Madera, a small town one hour’s drive away, to provide a free clinic for 25 local young children, marking the 1,000th free clinic that the Tzu Chi Fresno mobile clinic team has held since its establishment.
“It’s a great day, May 20; its harmonic is ‘I love you!’” Olivia Chung, Fresno Mobile Clinics Manager, said expressing a broader and more profound sentiment than that contained in romantic love. Her touching words were beautiful as Chung talked about the 1,000th free clinic, forgetting that the sun was blazing and the temperature was over 110 degrees Fahrenheit that day. All the Tzu Chi volunteers gathered there were also oblivious to the heat; their thoughts focused on helping the children they were about to serve with their eyesight issues.
“The number of free clinics has reached four digits. Now that we’ve reached 1,000, 2,000 should be coming soon!” Chung exclaimed, and it wasn’t some sun-drenched dream. As she looked at her calendar full of events and projects, Chung was confident that it was an achievable goal.
Over the 15 years from 2001 to 2016, Fresno’s mobile clinic team held 507 free clinics. Then, starting from 2017, the team provided nearly 500 clinics over five years. During that period, there was almost one year’s disruption due to COVID-19 pandemic lockdowns, after which free clinic services resumed in January 2021. Once again, Tzu Chi Mobile Clinics traveled along California State Route 99, serving communities in need. In March of the same year, the Fresno County government invited the Mobile Clinics to provide COVID-19 vaccination to farmworkers in remote areas, weaving a net of comprehensive health care.
Traveling to the Most Remote Communities
Many well-known organizations, groups, and government agencies appreciate and have recognized the efforts and positive performance of Tzu Chi Fresno’s mobile clinic team in reaching out to remote communities. As a result, they responded by taking the initiative to explore and seek collaboration with Tzu Chi.
Before the pandemic, the team had partnered with Alinea Medical Imaging. This organization, whose Mobile Clinics have reached many communities, large and small, provides breast cancer screening services for women in California, helping detect breast lesions early through convenient mobile mammograms. If a screening test results in the need for a second exam or treatment, the organization will help uninsured patients apply for a grant from organizations that work with Every Woman Counts (EWC), which covers the cost of the exam and treatment.
At a breast cancer screening free clinic in 2019, a Hispanic woman needed further testing, and EWC’s grant helped the patient save hundreds of dollars in testing costs, which are a significant burden on local farmworker families. Knowing that most Hispanic women in Central California lack awareness of breast cancer prevention and that the Mobile Clinic for breast cancer screening can go to towns of all sizes and remote farmworker communities, the Fresno mobile clinic team plans that, starting in 2024, Tzu Chi volunteers will provide human resources support and invite professional doctors to spread knowledge about breast cancer prevention among Hispanic women, plus popularize and promote testing. This venture will also open a new page for Tzu Chi’s gynecological free clinics.
The mobile clinic team in Fresno is also in the process of launching iCare 20. The initiative aims to engage the full play of Tzu Chi Vision Mobile Clinics’ function and add another vision care program to See 2 Succeed (serving students from underprivileged families) and Our Migrant Family. “The program targets different age groups and provides them with visual checkups and analysis of eye diseases,” Olivia Chung explained. Her eyes lit up with joy when she talked about future collaborations that the team is actively pursuing with the Fresno Department of Public Health and city or town halls in neighboring cities and towns.
Fresno’s mobile clinic team has a long list of planned free clinic programs, but, as yet, they can’t cover all the dark corners in Central California needing healthcare services. The fact that Fresno County encompasses over 30 school districts reflects the region’s vastness and the scattered layout of townships. The team drives Tzu Chi Mobile Clinics, which are essentially moving offices, to these scattered and remote places to care for underserved and sick farmworkers and their families free of charge. The fleet shuttles through townships and along highways, and whether once, a hundred, a thousand, or another thousand times, each free clinic is possible thanks to the team’s unlimited perseverance and determination, every member committed to the vision that, one day, Tzu Chi USA’s charitable medical network will fully cover this bountiful farming area, currently still a desert in terms of medical care.
