This immigrant child needed a vaccination; that foster child required a physical; the indigent parents of a boy in a wheelchair learned where he can receive specialized orthopedic care; that child who moved to Las Vegas to live with his grandmother after his mother died needed regular insulin injections — so go the workday memories of Dr. Lyanna Joy LaFredo, a Kirk Kerkorian School of Medicine at UNLV faculty physician who leads UNLV Health school-based clinics that are part of a partnership with the Clark County School District (CCSD), a collaboration giving students and their siblings access to healthcare at no cost to their families.
Born and raised in the Philippines, where she went to medical school prior to her pediatric residency through the State University of New York at Buffalo, LaFredo is no stranger to caring for the medically underserved and financially insecure, providing care for children at clinics in South Carolina and Arizona before joining the medical school earlier this year.
“I guess you could say that it’s my mission in life to help those who truly need help,” she says.
Three full days a week you can find LaFredo at the UNLV Health Pediatric Family Support Clinic at 1720 Maryland Parkway, part of the CCSD Family Support Center that primarily serves newcomer and refugee students. It opened earlier this year, not quite a year after the first CCSD-based UNLV Health pediatric clinic began seeing students at Bailey Middle School, where students from nearby Hickey Elementary School and Sunrise Mountain High School are also able to make appointments. At both clinics, patients, often part of families without insurance, range in age from 3 to 21. While there is no cost to families — children are treated for everything from colds to asthma and receive specialty care referrals for treatment of ADHD and depression and anxiety — UNLV does bill private insurance and Medicaid when possible.
Grants fund the family support clinic — it’s across the street from Global Community High School — that sees the doctor and medical assistant Bianca Lazo Rivas caring for around 15 patients each day. At the Bailey clinic, the product of a donation from Dr. Gopal Das and Jeannette Das, the medical team sees close to 20 students a week during the two half-days they work there. During the remainder of her work week, LaFredo sees patients at the UNLV Health Pediatric Clinic not far from the medical school.
As strange as it may seem, a traveling salesman who visited LaFredo’s family home in the small coastal city of Dagupan in the Philippines started her on the path of a career in medicine that has now landed her in a desert city 7,000 miles from where she was born.
“My mother bought this children’s encyclopedia set called Disney’s Wonderful World of Knowledge and one volume was on the human body and I kept returning to that book. I was about middle school age then and the human body, anatomy, fascinated me. It just seemed natural to go into medicine, to help children grow and develop and become their own persons.”
The oldest of seven children — her parents helped her grandfather run the family business, a local gin distillery — LaFredo was raised speaking her native Tagalog and English, which is the principal medium of educational instruction in the Southeast Asian country. Because of her intellectual prowess, she was able to attend the University of Philippines College of Medicine straight from high school. While thousands of students apply for the school each year, only 160 applicants were accepted, with 120 of those having bachelor’s degrees. “I took two years of pre-med courses at the school before joining the regular med school curriculum.”
She appreciated the Introduction to Patient Care curriculum offered by the medical school, part of which made students go through the process of being seen by a physician. “The goal was to experience what a real patient goes through so we’d have more empathy as doctors. Our outpatient department didn’t take appointments. Everyone was a walk-in, so I had to stand in line for hours to register and be triaged before finally being seen. It wasn’t fun, but it was an important experience that I won’t forget as I deal with the underserved. Their life isn’t easy.”
During her residency in Buffalo, LaFredo’s desire to become a pediatrician was heightened. “I just love to see children grow up healthy so they can be what they want to be.” It was also the place where she fell in love with a musician. The married couple now has an eight-year-old son.
Not surprisingly, for someone who grew up in a tropical climate, after her residency in snowy Buffalo, LaFredo has chosen to practice in areas of the U.S. where you generally only find freezing temperatures in a refrigerator, not outside. After working with the underserved in Columbia, South Carolina, for three years, she moved to Kingman, Arizona, where she practiced for more than a decade, becoming medical director of Joshua Tree Pediatrics, which is affiliated with Kingman Regional Medical Center. Wherever she has practiced, her admiration for the parents of special needs parents grows.
“I am in awe of their fortitude and heart,” says the assistant professor of pediatrics at the Kirk Kerkorian School of Medicine. “The day-to-day challenges are great — from dealing with feeding tubes, helping with toileting children, even in their teens, to dealing with behavioral challenges where their children act out. Their patience, born out of love, is so amazing … Sometimes they get overwhelmed and they cry when they talk about their children with me. They need that opportunity to express how they feel and then they go back to loving their children, so proud, for instance, that their teenager just learned a word.”
In the six months that LaFredo has been with the medical school, Frederick “Rick” Smith, administrator of the department of pediatrics, said one thing is clearly evident about the physician who is able, if necessary, to speak in Spanish to patients and their parents about their medical concerns: “She has a passion for caring for the underserved.”
She’s also passionate about being part of the medical school. “The people here are dedicated to bringing better medical care to Las Vegas. I’m so happy and proud to be part of that.”
