Doctor’s 20-Year-Old Dream Blossoms Into South Bronx Clinic : Medicine: The Spanish-speaking staff at San Juan Health Center reaches out to the community. The focus is on personal care.

In an abandoned building in the South Bronx filled with needles, garbage and broken pipes gushing gallons of water, Dr. Richard Izquierdo hatched a dream.

He imagined a clinic where doctors, like their Puerto Rican patients, would speak Spanish. Where poor people--just like middle-class people--would see the same doctor every time they needed treatment and could call for advice 24 hours a day. Where no one would be turned away, and where everyone who walked in off the street for a rash or a cough would walk out with a plan for better health. And where the doors would stay open--no matter how bombed out the neighborhood got.

“I was too dumb to know that it couldn’t happen, so I did it,” he said.

Izquierdo, 64, bought the building in 1968 with $3,000 in borrowed money, and a year later he opened the San Juan Health Center with a group of private-practice doctors. But within a few years he realized that a dozen solo practitioners could not provide the comprehensive care he envisioned.

This year, the San Juan Health Center celebrates its 20th birthday as a nonprofit clinic. With 15,000 registered patients, 72,000 patient visits a year, and 20 to 30 new patients each day, it has become one of the largest independent clinics in the state.

The doors open at 6:30 a.m. New patients are sent off for the nutritional and social service screening provided to everyone. Regular patients wait to be called for appointments for diabetes, hypertension, asthma and other common problems.

“I don’t know what I would do if I didn’t come here,” said Deborah Rivers as her 13-month-old, Shavona, was given a tuberculosis test.

Kim Jenkins brings her 3-year-old and 7-month-old sons for checkups. “You see the same doctors. That’s why I like it. Somebody is looking at your chart who’s familiar with it.”

Not only do the doctors speak Spanish, but the nutritionists also plan their dietary recommendations around traditional Spanish food.

“We laugh and cry in the language of our patients,” said Izquierdo.

There are programs for AIDS, tuberculosis and prenatal care; off-site clinics in a local high school, drug rehab center and a homeless shelter; and special sessions for adolescents.

“The first day of the adolescent session was an eye-opener,” Izquierdo recalled. “There were a half-dozen teen-agers. Three were pregnant and four tested positive for TB.”

And when a state institution for the retarded closed in 1988 and placed its clients in group homes, the clinic agreed to help. “Today we are the largest health-care provider to mentally retarded in the Bronx, with 800 patients,” Izquierdo said.

But health care is only part of what the clinic provides. There’s a Halloween parade, ceremonies honoring teen-agers for academic achievement, a newsletter that lists patient birthdays, and volunteer work that helps both the clinic and the person doing it.

“I’m building job skills, and I’ve learned a lot about computers,” said volunteer Bernice Perez, 38, as she handed a stack of papers to an administrator.

Jessica Rivera, 15, who has been a patient at the clinic since she was born, worked there last summer and now wants to go to medical school. “They inspired me,” she said. “They treat you like a friend instead of a patient.”

Dr. Acklema Mohammad was a teen-ager when she began working part time for Izquierdo; now she is head of pediatrics. And the director of external affairs, Rosemarie Longo, was Izquierdo’s patient as a child.

The clinic is an economic Rock of Gibraltar in an area that was once a burnt-out moonscape overrun with pushers and hookers. When it first opened, it had but a few dozen patients a day, most of them “bums,” as one administrator put it.

Today, the Hunts Point area where the clinic is located is making a comeback. Women push strollers on every corner, and shops and restaurants bustle along Southern Boulevard, the main drag.

“The health problems of this community don’t only stem from disease,” said Paloma Hernandez, Izquierdo’s daughter and the clinic’s executive director. “So we have to be committed to improving the whole socioeconomic status of the community. We’re part of the infrastructure.”

Every inch of the clinic’s 16,000 square feet is crammed with tiny offices, examining rooms, waiting areas and equipment. There are 113 people on staff, including 15 doctors, plus another dozen consulting specialists.

The $5-million budget is mostly paid for by Medicaid reimbursement, but foundation grants are being sought to fund the purchase of a nearby vacant lot where a much larger facility could be built. Izquierdo’s latest goal is to double his space and his patient load, and even perhaps open a birthing center and a food pantry.

He can hardly believe that his original vision ever came to pass.

“I started all of this?” he said, looking around. “I can’t believe it, that it was once just a dream in my head.”