Bridging gaps in healthcare: The journey of a student-run free clinic in Puerto Rico<i></i>

Founding of Clínica del Sur: Disparities in healthcare access and affordability exacerbate the constraints presented by a complex socioeconomic landscape in Puerto Rico (PR). According to the U.S. Census Bureau, the median household income in PR is $24,112, and 41.7% of people live in poverty on the island [1]. While the U.S. Census Bureau states that just 5.1% of people in PR do not have healthcare coverage, the healthcare system in PR struggles with employee shortages and lack of federal funding [2]. This makes healthcare less accessible despite Puerto Ricans having health insurance. As the elderly population continues to grow to the point that the percentage of elderly people in PR is among the top ten globally, challenges arise in accessing healthcare with family members migrating to the U.S. [1]. In 2019, medical students at Ponce Health Sciences University (PHSU) sought out to address these healthcare disparities. Despite significant earthquakes and the COVID-19 pandemic, the Student-Run Free Clinic (SRFC) Clínica del Sur was born in 2022. The clinic serves as a reliable resource for underserved populations and an opportunity for preclinical health sciences students to gain clinical experience and conduct research. Since its founding, Clínica del Sur has been run by students in medicine, psychology, nursing, and public health. Since then, the clinic has expanded to offer dermatology, dental, and neurology services. Clínica del Sur strives to provide comprehensive care in these areas to best serve the needs of its community similar to the Student-Run Clinic of University of Texas Río Grande Valley School of Medicine, which treats patients who do not have access to primary care [3]. Other clinics such as Qlinic, an LGBTQIA+ clinic at Cornell University, focus on one area of healthcare such as behavioral therapy in mental healthcare [4]. As a member of the National Association of Free and Charitable Clinics (NAFC), Clínica del Sur has been funded by the following organizations: Americares, Direct Relief, Brother’s Brother Foundation, Fundación Intellectus, and Heart to Heart Foundation. Through this membership, the clinic has also received a grant from CeraVe, from which the Sun Protection Campaign was launched to raise awareness and provide education on sun protection. Equipment has been acquired through the grant to improve the clinic’s dermatology services. For example, many patients are lost to follow-up due to the complicated structure of the island's healthcare system. To relieve patients of this burden, the clinic acquired a camera to capture photos of areas of concern on the skin so that patients have the necessary information in their file for their referral for continued cost-free care. The clinic is also a member of the Society of Student-Run Free Clinics (SSRFC), through which it hopes to gain funding and networking opportunities.