CHAPTER 3

TIMA USA Northeast Region

Written by Daphne Liu and Jinger Ning
Translated by H.B. Qin

Pictured here is a free clinic event in October 2018 for family members of Tzu Chi USA Long Island Branch Office volunteers.

Tzu Chi’s free clinic services mobilize volunteers of all ages who work together to guard people’s health in New York with love. Pictured here is a free clinic event in October 2018 for family members of Tzu Chi USA Long Island Branch Office volunteers. Photo/Huaihsien Huang

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The human right to health care has always been a topic of debate in the affluent United States. Despite recent reforms that improve access to health insurance coverage for all, the achievement of worry-free medical care still has a long way to go.

Tzu Chi USA Northeast Region volunteers are mindful of Master Cheng Yen’s words, “Other people’s sky is above our heads, other people’s soil is under our feet. We must know how to give back to the local community” and began to help immigrants in the region who couldn’t afford to pay for medical care under challenging circumstances. The Northeast Region formed its medical team after the chapter’s establishment in 1992. Since then, the team has developed alongside social changes and evolving immigrant and community needs, its services now covering Flushing, Long Island, Manhattan, and Brooklyn in New York, and Boston in Massachusetts, upholding a commitment to make up for the shortcomings of the U.S. medical care system while leaving touching footprints in Tzu Chi USA’s medical mission.

The Early Stages: Healthcare Education and Screening

Shushi Min (middle), a 96-year-old Traditional Chinese Medicine (TCM) doctor, takes the pulse of a Tzu Chi volunteer’s family member at the Long Island Branch Office
Shushi Min (middle), a 96-year-old Traditional Chinese Medicine (TCM) doctor, takes the pulse of a Tzu Chi volunteer’s family member at the Long Island Branch Office in 2016. The Northeast Region Office in Flushing, or sometimes the Long Island Branch Office, has offered an annual free clinic for family members since 2007. Min’s daughter Eva, a TCM doctor, also often volunteers at Tzu Chi free clinics. Photo/Peter Chu

“Medical service is about reaching out to people and communities,” Susan Su explained. Su was the first seed of Tzu Chi USA Northeast Region’s medical mission in New York and started her career in community health care with this idea in mind. As a nurse who served at Elmhurst Hospital, she formed a medical team with Dr. Henry Ding. Dentists Dr. Kenneth Liao and Dr. Hueiju Lin later joined the team, with more medical professionals coming in after that.

“In the early days of free clinics, Tzu Chi contributed human resources and cooperated with other organizations,” Su recalled. In 1992, Tzu Chi organized the first free clinic event in collaboration with Taiwan Center Inc., which was a first for Flushing and laid the foundation for Tzu Chi’s later free clinics. Since 1995, the community free clinic, or Health Fair, has been held annually in collaboration with various medical institutions, including Elmhurst Hospital and Flushing Hospital. Tzu Chi’s role was to coordinate as well as mobilize volunteers.

In 1997, Liao took over as head of the medical team. “At that time, free clinics were mostly about health counseling and screening, with no treatment,” he recounted. In the free clinics’ early stages, they offered healthcare counseling, blood sugar and oral cancer screenings, flu shots, and dental care. “These medical services may not relieve pain and suffering, but they reach out to the community and let more people know about Tzu Chi.” Liao learned more about Tzu Chi through his participation in the free clinics, too.

Don’t underestimate the importance of brushing your teeth; it can help patients a lot and save a lot of unnecessary medical expenses every year.

Dr. Kenneth Liao conducts an oral cancer screening
In the early days of free clinics, Dr. Kenneth Liao conducts an oral cancer screening. Photo/TIMA Long Island

Many healthcare service providers helped Tzu Chi with its efforts to reach out to the Flushing community, which is predominantly Chinese. Their health lectures on Sundays in 1992 were an unforgettable tribute to early immigrants. “New immigrants scramble to make a living, which makes them neglect their health, and in the end, their lives are at stake,” volunteer Peggy Yao explained. Having helped many cancer or chronic disease cases, she invited professional nurses, social workers, dietitians, and community physicians to provide healthcare education by sharing information about hepatitis B prevention, diabetes, and other topics. Yao, who majored in psychology, also started a series of mindfulness and stress relief courses, which helped many new immigrants.

In 1997, Tzu Chi provided blood pressure measurement services on Saturdays. Medical volunteer Suying Yang, who lived in Upstate New York, traveled three hours by public transportation weekly for the two-hour blood pressure service. “Once the train was seriously delayed. Changing trains took me four hours. When I arrived, it was almost past the service time. But a group of older people had not left and had waited for me to come and chat with them,” Yang said. Although these healthcare services didn’t involve medical treatment, the care and love brought by the volunteers was what the community also needed.

In addition, the medical team also promoted blood tests for bone marrow donation in the early days. Moreover, in 1997, Elmhurst Hospital designated a medical vehicle to serve low-income individuals every Saturday. Tzu Chi volunteers assisted in making appointments, greeting patients when they arrived, and taking down their information. The impetus to introduce and develop Tzu Chi USA Mobile Clinic services in New York later on originated from this activity.

volunteer King Wu provides dental care education
Dental care has always been a program that the medical team in New York attaches great importance to. Every free clinic will have an area for dental care volunteers to instruct the public or schoolchildren on the correct way to brush their teeth. As seen here in a 2019 free clinic in Flushing, volunteer King Wu provides dental care education, which he has been doing for a long time. Photo/Tony Chen

Development Through Service Expansion

In 2001, the Tzu Chi USA Northeast Region took on its first solo large-scale free clinic, marking a new milestone in its medical services and extending its outreach to Long Island and Brooklyn. The year before, in 2000, with the establishment of TIMA earlier in 1998, healthcare workers in New York had formed the TIMA New York chapter, mainly composed of medical professionals. The establishment of the TIMA Boston chapter in 2005 and the TIMA Long Island chapter in 2006 would follow.

Scaling Up Free Clinics

During that period, the free clinic service began to involve more than 20 doctors from different medical specialties, and large-scale free clinic events took place twice a year. “The first one took place at the Sheraton Hotel Flushing in 2001; the site for free clinic events since then. The free clinics attracted many doctors, including Dr. Fansun Yao, the convener of TIMA New York, who joined the free clinic activity in 2002,” Dr. Kenneth Liao shared. He added that many new immigrants can’t afford insurance, which results in high medical costs. Due to the complexity of referrals to specialists, Tzu Chi’s free clinic service, which covers nearly 20 departments, allows people to solve all their problems in one trip. Yao was the main contributor to this. “As anesthesiologists are busy with surgeries, I used my free time or holidays to call colleagues or students I know and invited them to the free clinics. They were all very willing to give back to the community,” Liao said.

County Commissioner Steve Levy (second left), then convenor of TIMA Long Island, Dr. Richard Huang (left), then Long Island Branch Office director Joan Sung (second right), and dental surgeon Dr. Hueiju Lin of TIMA New Jersey (right), take a group photo in front of the Tzu Chi USA Dental Mobile Clinic
In 2006, Suffolk County in Long Island invited Tzu Chi to organize large-scale free clinics. At a 2010 free clinic, County Commissioner Steve Levy (second left), then convenor of TIMA Long Island, Dr. Richard Huang (left), then Long Island Branch Office director Joan Sung (second right), and dental surgeon Dr. Hueiju Lin of TIMA New Jersey (right), take a group photo in front of the Tzu Chi USA Dental Mobile Clinic. Photo/TIMA Long Island

The biggest advantage of running the free clinic on our own was that it could build up medical records for people in the community and help new immigrants.

Susan Su and the medical team designed a process that allowed everyone to bring back a health checkup report, which also helped with referrals. Moreover, the subsequent time care recipients came to a free clinic event, they would have a medical record. At this point, the free clinic service had already taken on the concept of a clinic office.

Dr. Fansun Yao (left), the convener of TIMA New York, explains the process and precautions before the free clinic begins
Flushing's annual free community clinic mobilizes more than 100 volunteers, with the one in 2016 being the grandest, in which over 200 volunteers participated. Dr. Fansun Yao (left), the convener of TIMA New York, explains the process and precautions before the free clinic begins. Photo/Hsiuchun Wong

In 2003, the Long Island Branch Office provided low-income families with medical counseling during each hot meal distribution at St. Ann & the Holy Trinity Church, which marked the start of the regular free clinic model. Then, in 2006, TIMA Long Island was founded, with Dr. Richard Hwang as the first convener. The first large-scale Tzu Chi free clinic event took place in September of the same year at the invitation of Suffolk County, Long Island. A team of 145 medical professionals and volunteers from New York and Long Island joined hands and served 84 low-income minority group individuals, benefiting 392 patients.

The current convenor, physical therapist Joe Chang, was one of the founders of TIMA Long Island. “Physical therapy and Chinese acupuncture were quite popular in every free clinic. As many of these low-income families are blue-collar workers, pain or occupational injuries are very common,” Chang recalled. The compassionate physical therapist often bought pain patches for his patients at his own expense and provided instruction in rehabilitation exercises. “Sometimes, when I saw a patient, I chatted with them. Once they felt cared for, their pain often was halfway gone,” he recounted.

Despite the relative affluence of Long Island residents, Tzu Chi free clinic volunteers still saw cases of people suffering. Kenneth Liao recalled when he and Hueiju Lin went to Long Island to help care recipient families with oral care education. Hector, a patient, had his leg amputated due to diabetes, and Lin took the initiative to learn about his condition, which led to his inclusion in Tzu Chi’s individual care recipient cases. Liao explained that medical care is just the beginning. Tzu Chi’s comprehensive care involves teamwork and the continuous support of medical professionals. “Tzu Chi volunteers are the strongest pillar of all medical activities,” he said.

Susan Su, who has experienced the hardships the Northeast Region’s medical mission has faced, is grateful to her friends Shuhung Hung, a nurse; Chinshen Liu, an activity team volunteer; successive Tzu Chi team leaders Shenhsiung Hsiao and Tom Chuang; and Shouyun Yan, the head of the volunteer team, who integrated a large number of volunteers and fully dedicated to every large-scale free clinic.

長島物理治療師蔡逸杰(上圖,左) 協助裝義肢
Roger Tsai, a physical therapist from Long Island, attends to Hector, who lost his leg due to diabetes. Tzu Chi volunteers raised funds to pay for airfare to send Hector back to his home country, the case revealing how Tzu Chi's care combines charity and medical support, aiming at comprehensive attention. Photo/TIMA Long Island

TIMA Boston began organizing free flu shot health days after its establishment in 2005. When Boston volunteer Stone Chen learned that free flu shots were not available in Massachusetts at the time and that disadvantaged ethnic groups lacking medical resources could not get care, Tzu Chi held community health days in different towns and cities every fall, with the later addition of other free medical services, such as health checkups, nutritional counseling, and dental care. It was not until 2011, when Massachusetts achieved medical coverage and free flu shots for all, that Tzu Chi suspended such free clinic activities.

Building a Reputation Through Blood Drives

In 2002, Tzu Chi New York held its first blood drive at the Landmark Building office in Flushing, with 264 bags of blood donated. “This blood drive was a first for the Chinese community and changed the perception of Americans that Chinese are indifferent to public affairs,” Kenneth Liao, who had been actively promoting blood donation, explained. As the summer vacation season is a period of blood shortage, Tzu Chi later increased the blood drive to three times a year, with the highest record of 300 people participating in a day in 2006. Tzu Chi Long Island also began to promote blood donation. “At first, we held the event in the office, and then the blood donation vehicle was stationed outside Tzu Chi Academy. In recent years, we moved inside the school. There could be 30 bags of donated blood each time,” Joe Chang recounted.

Tzu Chi USA Northeast Region’s promotion of blood donation set a record for the highest number of blood donations by an Asian organization, which has influenced the neighboring Mid-Atlantic Region and Greater Washington D.C. Region chapters. Other Asian organizations, such as Fo Guang Shan and Herald Community Center, also joined one after the other. Over 20 years, Tzu Chi participated in the New York Blood Center’s annual dinner ten times to receive commendations and was one of the few Asian organizations awarded; in 2019, Tzu Chi received the Diamond Award, the highest honor. “Even during the 2020 pandemic, we still held a blood drive in Long Island and New York in October and November, respectively,” Liao said. According to the New York Blood Center, blood in stock was below the 50% alert level, and the Center thanked Tzu Chi for its willingness to call on the public to donate blood even during the critical pandemic period. Statistics as of early 2021 show that the Tzu Chi USA Northeast Region had set a record high of 487 bags of blood a year, and the cumulative blood donated is 6,455 bags.

Gaining Experience as the Medical Mission Evolves

community free clinic at the Sheraton Hotel in Flushing on-site
On the occasion of the Tzu Chi USA Northeast Region’s 25th-anniversary celebration in 2016, a large-scale community free clinic takes place at the Sheraton Hotel in Flushing, covering nearly 40 specialties across two floors. Doctors from the Queens County Dental Society support the event with 27 dental beds, the highest ever for a free dental clinic. Photo/Peter Chu

The free clinic activity grew bigger in scale over time. When the Tzu Chi USA Northeast Region celebrated its 25th anniversary in 2016, the free clinics encompassed nearly 40 specialties. “I remember doctors who came from out of state to support the activity were impressed and marveled at our free clinics in New York,” Kristine Tseng, the then medical officer in charge of large-scale free clinics in the New York area, said. “Many patients came to us for a second opinion from a different doctor, which helped them a lot, and the community needed our free clinics,” Tseng added.

Daw Hlakyi, a Burmese diabetic patient, couldn’t afford his expensive medical bills because he didn’t have medical insurance. Dr. Jonathan Chang, a Burmese-Chinese TIMA doctor, referred him to the free clinic. While attending the event, Hlakyi said, “My daughter and I saw the doctor today and were relieved. I hope Tzu Chi can organize free clinics every year.”

The First Free Dental Clinic

During this period of free clinics, the team no longer only offered counseling and consultation; Tzu Chi added dental treatment for the first time at free clinic sites in New York and Long Island. Kenneth Liao recalled that in 2014 and 2015, the Northeast Region secured 12 dental chairs from the National Headquarters Region. Scaling and extraction services started from then on. At the Northeast Region’s 25th-anniversary celebration event in 2016, Liao shared that the free clinic had 27 beds available for dental services, “the most ever,” he said.

With the dental scaling at free clinics, the number of clinic attendees increased yearly, and many people came early to queue up for this deep cleaning service.

Eric Adams (middle), then-borough president and now New York City Mayor, comes to thank Tzu Chi. Present are TIMA New York members Dr. Kenneth Liao (left), Dr. Fansun Yao (second left), and Dr. Jonathan Chang (third left), the then Northeast Region’s Executive Director George Chang (third right), volunteer John Cheng (second right), and Brooklyn Chinese Representative Winnie Cheng (right)
At the 2016 Brooklyn free clinic held at the Brooklyn Borough Office, Eric Adams (middle), then-borough president and now New York City Mayor, comes to thank Tzu Chi. Present are TIMA New York members Dr. Kenneth Liao (left), Dr. Fansun Yao (second left), and Dr. Jonathan Chang (third left), the then Northeast Region’s Executive Director George Chang (third right), volunteer John Cheng (second right), and Brooklyn Chinese Representative Winnie Cheng (right). Photo/Peter Chu

I remember the first person who came in was experiencing homelessness. It took me quite some time to clean and examine his teeth. I can’t forget the look on his face when the treatment was over.

Beyond Dentistry

In addition to dentistry, the Tzu Chi USA Northeast Region later included ophthalmology testing services. The first glaucoma testing took place in 2017 at the Columbia University Medical Center, providing vision, visual field, intraocular pressure, and fundus examinations. In 2018, the Northeast Region purchased its first ophthalmology testing equipment. It was what optometrist James Chuang and ophthalmologist Liwu Chen used, and quite helpful in preventing glaucoma, retinal perforation, and macular degeneration. Zhugu Li, a patient who had long suffered from floaters, came to a free clinic for a glaucoma checkup. “The doctors were very polite to the patients, and there were also volunteers who helped to translate and explain a lot of medical terms, which moved me to tears,” he shared.

Optometrist James Chuang carefully checks a patient's eyesight
Optometrist James Chuang carefully checks a patient's eyesight at the free clinic in Brooklyn in 2018, the first time the team used professional ophthalmic instruments to serve the public. Photo/Peter Chu
Tzu Chi volunteer Ken Tan (right corner) instructs young volunteers on using electronic medical records
Tzu Chi volunteer Ken Tan (right corner) instructs young volunteers on using electronic medical records at the 2019 free clinic at St. Anne’s R.C. Church in Brentwood. Tzu Chi USA began promoting electronic medical records in 2015, with Ken Tan and Joe Chang, the then-and-current convenor of TIMA Long Island, being the first seeds. Photo/Huaihsien Huang

Ophthalmology’s glasses fitting services launched at a free clinic in Brooklyn in October 2018. The Northeast Region’s Medical Officer, Kristine Tseng, often prepared 5,000 lenses with volunteers at the office after work, continuing until 10:00 PM when she went home. “We’re grateful for the support of Tzu Chi Medical Foundation’s Deputy CEO, Steven Voon, who taught online from California, as well as support from ten Tzu Chi volunteers, including Ting Liu, Kally Wang, and Fang Huang,” Tseng said. Sixteen people benefited from the first glasses fitting service, which warmed up to the launch of two Tzu Chi Vision Mobile Clinics in 2019.

The community has widely recognized Tzu Chi’s free clinics in various places in New York, and the large-scale free clinic in 2016 was essentially the biggest free clinic in the history of the Flushing community. A free clinic event in the Brooklyn Borough Office followed in November of the same year. With the increasing number of new immigrants in the New York area, Tzu Chi volunteers saw a growing need for medical care. A free clinic was also held immediately following the establishment of the new Brooklyn Service Center in 2017. “Here is a place where the need for free clinics is even greater than in Manhattan and Flushing,” Fansun Yao, the convener of TIMA New York, said, noting that often immigrants lack medical insurance and many have never even seen a doctor. For instance, Al, an immigrant from Guatemala who came to New York 18 years ago, was uninsured and had never had a medical checkup. “My trip here solved my stomach pain and teeth issues; I’m very thankful for Tzu Chi,” he said after attending a free clinic.

Physical therapist Joe Chang (left) and Haili Gao (second left) both consult patients
Physical therapist Joe Chang (left) often participates in free clinics in New York and invites peers to join him. He introduced Tzu Chi to physical therapist Haili Gao (second left). Here, both consult patients at the first free clinic in the Manhattan Service Center. Photo/Hsiuchun Wong

The Manhattan Service Center hosted its first free clinic in 2019. Meanwhile, TIMA Boston also resumed its free clinics in 2019. Its convenor, Jack Huang, a Traditional Chinese Medicine (TCM) doctor, organized four free TCM clinics in response to the community’s need for TCM. “Each of these activities is the best way to introduce Tzu Chi,” Kristine Tseng, the Northeast Region’s Medical Officer, said. She was pleased that many of those who came to the free clinics felt deeply moved by the mobilizing power of Tzu Chi and joined the team as a result, which led to the regular training of dental and ophthalmology volunteers.

Facing Challenges in the Post-Pandemic Era

Arelys Santana assists in the training of Hispanic ophthalmology volunteers
Arelys Santana, a Hispanic dentist with the Queens County Dental Society, has participated in several Tzu Chi free clinics at the invitation of TIMA's Richard Yang. She joined TIMA New York in 2016 and then began her intern training. In 2020, she assisted in the training of Hispanic ophthalmology volunteers. Photo/Huaihsien Huang

The COVID-19 pandemic outbreak in 2020 disrupted the lives of people worldwide. Greater New York area TIMA teams took on the role of providing support to frontline medical professionals and traveled around the region to deliver medical supplies. “When people are full of fear, TIMA is responsible for calming them,” Dr. Richard Yang said. The medical team held more than 20 online medical lectures during the pandemic, promoting vegetarianism and advocating healthy habits, fitness, and physical activity, hoping to inject a positive force and hope into the community. In 2021, there was an urgent need for the COVID-19 vaccine in the United States. The Northeast Region partnered with the Coalition of Asian-American Physicians to provide vaccination services to the Chinese-American community in the Greater New York area.

A challenge could be an opportunity. Although the pandemic halted many free clinics and community services, it gave the volunteers the best training and preparation to continue working for the next 30 years of the Tzu Chi USA Northeast Region’s medical mission.

TIMA USA
Northeast Region

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