blog.orbis.org

An Unforgettable Year

Blog submitted by Dr Grace Prakalapakorn. Grace has been an ORBIS staff ophthalmologist onboard the Flying Eye Hospital for the past year.

Hello and Welcome aboard ORBIS!. Please find your seats, ensure your seat backs are in the upright position, tray tables are stored and your seat belts are fastened. Sit back, relax and enjoy the flight! 

 A year in the life of a staff ophthalmologist aboard the ORBIS Flying Eye Hospital was a busy one. There was always a lot of work to do and never a dull moment. When we were in plane mode, the days began early, often ended late and we would sometimes work for three straight weeks without a day off! Even when we had a “day off,” we would on occasion hold vision screenings or community outreach projects in schools or within a community. Off the plane, the work did not end. I conducted clinical reviews of surgical patients, helped with hospital based programs, evaluated local eye centers and hospitals and worked on program planning for upcoming programs. 

This year, I wore many hats alongside that of a staff ophthalmologist, including but not limited to a biomedical engineering assistant, ER doctor, tour guide, plane custodian, circulating OR nurse, community outreach volunteer, patient advocate, Cyber Sight® contributing author, character in a documentary, educator, student, goodwill ambassador, and even flight attendant (would you like some cream and sugar with your coffee?)!! ORBIS offers opportunities not only to the patients and doctors that participate in its programs, but also to its staff: how many people can say they’ve been to Nigeria 4 times in 8 months?! :)  

 Being a part of the Flying Eye Hospital was a very unique and rewarding experience. The most memorable part of the year was the people: the patients and their families, host doctors, crew members and our fabulous volunteers. One of the most memorable moments of my year was hearing the cries and tears of an elderly lady as her patch was removed the day after cataract surgery. She had been living with bilateral cataracts for many years and had become dependent on those around her due to her poor vision. Another is watching a young infant take those first few steps and walk around by herself after cataract surgery, whereas before surgery she was too timid to leave her mother’s arms because of her severe visual impairment. These are not uncommon stories you will hear around the world and to reflect about the difference we made in their lives and those of their families and communities by making them more independent and less of a burden on the resources of those around them. It always brings a smile to my face knowing that I was a part of that. But the work we do goes beyond these two individuals, we work to build capacity and enable and empower the local community, doctors, nurses, engineers, and technicians to care for those around them and hopefully teach others. 

 Thank you ORBIS for the work you do and for a wonderful year!!

Photos by Perry Athanason

A Great Day in China

Blog submitted by Rajan Chandrasekaran

Rajan is a staff nurse on the Flying Eye Hospital and has been part of the crew since March 2007. 

During our Flying Eye Hospital program in Dalian, China, we were given the opportunity to conduct a rural outreach program with our partners from the He Eye Hospital. This is something that ORBIS regularly does and is organized by our communications manager, Perry Athanason.

Perry told us that this program’s outreach campaign was to help screen up to 400 children in a school outside of Dalian. I was very excited about this, as pediatric eye care was the major focus of the Flying Eye Hospital program. Our role was to help screen these children for refractive error, and to help record the data using forms provided by our host hospital (this was an ongoing project of our hosts and we dedicated our time to help them screen the children, and help raise the awareness of childhood blindness).

It was Saturday and the ORBIS team arrived at the school to find several hundred kids organized in several classrooms of the school. I was very surprised to find that the kids were not crying and screaming, as you might think when you gather hundreds of children – they were very well behaved and all very cute.

All the kids were told to stand in a line so we could check their visual acuity, which was followed by an examination with a direct ophthalmoscope (to check the back of the eye). I found the kids to be very cooperative and they each read the eye charts while smiling and having fun.

ORBIS also held a seminar for the parents of those children offering them some basic tips on preventable blindness in pediatrics and what to look for in their own kids that may signal that they are having problems with their eyes.

As we finished the screening day and were preparing to leave, it was a surprise for the ORBIS team to find all the children lined up in the play-yard waiting to sing us songs before we departed. For 15 minutes, the children performed songs and dances they had learned in school to show their appreciation for helping them and it was one of the most adorable things I have seen in my time with ORBIS.

It was a great experience to participate in this outreach program and all the kids were awesome, I was very happy to be a part in helping the parents, teachers and the children prevent blindness in their schools and community.

Photo by Rajan Chandrasekaran

Follow up with Bello from Niger

Blog Submitted by Amna Al-Gallas, MD

Amna is a Staff Ophthalmologist on board the ORBIS Flying Eye Hospital. Amna joined the crew in February 2010.

It was the last day of my one-week return visit to Niger as I went back to follow up our patients who were operated on there, almost two months before, during our first Flying Eye Hospital program ever in Niger. It was another hot long working day that was only made easy by the smile of grateful patients whom I have examined as they tried to express how happy they were with the results. By the end of the day, I was informed that there were no more patients waiting and that some patients could not show up because they lived far away. I started to collect my papers and equipment but my mind was busy, as if something was missing and I decided to wait and use the time to do some paper work. Few moments later, a child came running to me. She was wearing a beautiful pink dress and a big smile on her face. She handed me a plastic bag with ORBIS logo on it and uttered few words in local language which I couldn’t understand. She opened the bag, took out a pair of glasses and put them on, I then recognized the little angel right away, “It’s you, Bello!” I said, smiling back at her.

 Her mother came afterwards, apologizing for being late and expressing how happy and enthusiastic her daughter was to come. Bello was a 7-year old girl from Niger who came to ORBIS through our rural outreach screening program in Libore. At that time she had opacities in both eyes which largely compromised her vision. She underwent a certain laser procedure, to remove the opacities, and she was given specific type of glasses to help improve her vision. I examined her and she was doing very well with good improvement of vision. Her mother said that since the procedure her daughter was doing better in school and had good grades. She also said that Bello was always wearing her glasses and taking good care of them. After I finished and gave the mother the necessary instructions, Bello gave me a big hug and walked away with her mother, waving goodbye with a great big smile.

I gathered my things and walked out. I looked back at the patients as they were heading home. I was tired, starving and thirsty but I was filled with joy, knowing that another ORBIS mission has succeeded. All the hard work of ORBIS team has paid off and transformed lives in Niger, such as Bello’s, and gave them a new future, a new tomorrow!

See Bello's story below in our Eye Report from Niger.

Volcanic Ash Does Not Impair ORBIS Vision

Blog submitted by Lynn Donovan.

The April 2010 Volcano Eruption in Iceland had a massive effect on world travel. It essentially held people captive wherever they were in their travels for approximately 10 days. During this time, ORBIS had Hospital Based Programs scheduled in Africa, and China. I would like to share my story of the effect it had on the staff involved in the Kampala, Uganda Program.

On Saturday, April 10, 2010 Dr Grace Prakalapakorn, and I traveled from Kaduna, Nigeria to Lagos from there we were to go to separate locations. Dr Grace was to go home to Atlanta, Georgia in the US, and I was to go to Kampala, Uganda for another Hospital Based Program. Upon arrival to Lagos, Dr Grace found her flights to be canceled. This caused a dilemma, as she was not to stay in Lagos alone, especially when she was not certain how long it would be before she would be able to travel back to the US. After discussion it was decided the best option was for Dr Grace to travel to Kampala with me, as there would be a confirmed hotel room to rest, and adequate Internet access to plan future travel.

It was then discovered that Dr Bernadette Martinez was delayed on travel for the program and was still in China trying to reschedule flights to arrive in Kampala. Dr Gordon Douglas, the Volunteer Faculty Surgeon for the Kampala program, was delayed as well, as he had also been re routed. Both Dr Bernadette and Dr Douglas were to arrive Monday, the first day of the program- screening day, but in the afternoon and evening respectively.

After many e mails with our Medical Director, Dr Hunter Cherwek, it was decided that Dr Grace, Dr Jonathan Lord, and myself would go to Mulago Hospital to explain to the Trainee Staff Doctors, and the patients that arrived for screening, that due to circumstances from the Volcanic Ash the doctors scheduled to see them would not be able to do so until the next day. It was a good thing that Dr Grace was there and able to cover in Dr Bernadette’s absence.

When Monday evening came around Dr Douglas and Dr Bernadette had both safely arrived in Kampala. The program went on with screening day on Tuesday and one less surgical day, however all 10 surgeries were performed in the two surgical days and all aspects of the Kampala Hospital Based Program were accomplished. Dr Grace was finally able to travel on Wednesday via the long way home. This was a very memorable event for me as I am sure there are stories around the world of the Volcanic Ash influence on the lives of others.

ORBIS was able to provide much needed services even when a natural disaster had occurred, and once again through teamwork and determination to achieve the ORBIS mission and goals of “saving sight worldwide.”

First Time Volunteer

Blog submitted by Mr. John Brookes

Mr. Brookes is a volunteer ophthalmologist from the United Kingdom. This is Mr. Brookes first time volunteering with ORBIS.

Having just returned from my first ORBIS program in Dalian, China, I would like to thank the whole ORBIS team for making this an incredible personal and professional experience in my career to date.

I have been involved in several charities over the past 10 years; I try and spend at least 2 weeks each year doing some surgical work abroad and this has taken me to India, Palestine and Egypt on many occasions. Having received several invitations over the past two or three years to take part in an ORBIS program, in my specialty of pediatric glaucoma, I finally succumbed. Admittedly, because first of all, I’ve never visited China before but secondly, I have always been an airplane fanatic having obtained my private pilot’s license in 2004. I was obviously very excited therefore of combining my love of ophthalmology and my interest in all things airborne!

I was incredibly surprised however at the size of the city of Dalian when I eventually arrived. Having never heard of the city before, I expected something a little less enormous. The people were incredibly warm, generous and grateful for all that we were able to offer.

I met my hands-on trainees on the screening day at the base hospital, He Eye Hospital. They were incredibly eager to learn with a constant stream of questions and never seemed bored with my endless lectures, videos and other teaching material.

Following the screening day, I spent the next two days at the base hospital with my hands-on trainees, carrying out glaucoma and cataract surgery on the patients we had identified on the screening day. I was however, extremely anxious to get onto the plane!

The fourth day arrived and I was at last going to board the iconic ORBIS Flying Eye Hospital at Dalian airport. From afar, I could see its majestic outline and the characteristic livery. Boarding the plane for the first time was a truly memorable experience. All my childhood dreams had come true. I sat in the captain’s seat and the maintenance engineer gave me a truly extensive tour of the plane, even going into the bowels of the plane beneath the cockpit and seeing the miles upon miles of electrical cables and wiring, which somehow get this plane in the air.

Setting my excitement aside I had to go into the operating theatre for my first experience of ‘live surgery’, broadcast to the 30 local doctors sitting next door in the lecture room. Fortunately, all went well with the surgery and I ended up quite enjoying myself.

The rest of the airplane was truly amazing; state of the art operating theatres, clinic space and audiovisual equipment we could only dream of at home! Overall, I had a wonderful experience as a medical volunteer and I would like to thank all the staff who organized these programs, which must require so much background work to have them running so smoothly.

Of course I would like to do another mission…..perhaps next time I could fly the plane?

Photo by Perry Athanason

Niger – A Program of Many Firsts

Blog submitted by Jacqueline Newton

Jackie is a Staff Nurse on the Flying Eye Hospital and has been a member of the crew since June 2008

When I think of Niger I am reminded of the first time I flew in to Niamey, it was beautiful, the dry desert with a trail of green along the Niger River. Climbing off the plane the heat seemed to cover you like a blanket.  

The construction of a new theater complex at the Niamey National Hospital was in progress but when I arrived the week before our program began, it was complete and the hosts were keen to use this complex during the upcoming Flying Eye Hospital program. The goal was to transform a brand new unit into a fully functional operating theater complex by the time the rest of the Flying Eye Hospital team arrived. It took hours of instructing and guiding the local staff in the development of their complex, which involved gathering theater equipment and supplies, as well as training of the local staff in aseptic technique.  

One of the days was allocated to cleaning and disinfecting the theater complex, it was at this time I realized the need for just the basics such as clean cloths, mops and disinfectant. There was no shortage of ophthalmic instruments but it took 2 days to sort through them all and organize them into instrument trays. Besides many other trays, 3 complete cataract sets were made up and were going to be used during the ORBIS program. By the end of the week not only did I feel I had bonded and won the trust of the local staff but that they and the theater complex were ready for the first surgery day.  

It was 8 days after I arrived that we had our first surgery day, which turned out to be a great success. After the first case, a huge feeling of accomplishment and a sense of pride and excitement about the potential of their new theater complex were felt by all the local staff. Another 5 days of surgery were successfully carried out, but my concern was whether the staff were going to keep up the management of the complex and continue to perform the skills that had been taught them during the 2 week ORBIS Nurse Training Program.     

Eight weeks after the Flying Eye Hospital program, I returned to Niger to take part in a hospital based program, run at the new theater complex, and it was at this time that I realized the importance of the Hospital Based Program. Although many other surgeries had been carried out since ORBIS had left, I spent another week instructing the local staff on the management of an operating theater unit and reinforcing the skills taught during the ORBIS Nurse Training Program.  

By the end of the Hospital Based Program I felt that the theater complex was left in the capable hands of the local staff determined to keep up the good work!

Photos by Perry Athanason

A View of Kampala

Blog submitted by Krishani Ranaweera

Krishani is the Communications Manager at ORBIS UK and has been at ORBIS since February 2009.

The ORBIS Flying Eye Hospital is no stranger to Uganda. Twice before it has landed at Entebbe International Airport, drawing the attention of the country’s medical professionals, media and government.

I, on the other hand, am not so well-travelled. But as communications manager for ORBIS UK I was lucky enough to witness the excitement of the ORBIS Flying Eye Hospital in action for the first time when I flew to Uganda to capture its work with eye care teams in Kampala and volunteer medics from around the world.

On Sunday 28^th February I joined a UK journalist and a volunteer photographer at Entebbe to welcome the plane as it touched down for its third and final sight-saving mission in Africa this year. The plane and its crew had flown directly from Nigeria to Uganda, but there was no time for rest. Immediately, work began to convert the plane from flight mode to hospital mode; unpacking crates of delicate medical equipment and setting up the recovery and operating rooms.  We helped where we could as this well oiled machine readied itself for the mission ahead.

Mulago Hospital - our main partner - was the stage for screening day. Mulago’s ophthalmologists had each referred 30 patients. Together with the ORBIS volunteers, they decided on the best training cases for treatment onboard the Flying Eye Hospital, focusing on child cataract and squint as well as adult glaucoma. 

On a wooden chair in the corner, one boy waited his turn with a stillness far beyond his seven years. His name was Kitonsa Kasozi. His mother, Deborah, told us of his problems seeing the school blackboard and how she decided to come to Mulago to ensure his education. Kitonsa had a squint in each eye; his condition is common in Uganda so his treatment would make an excellent training case.  He was invited to board the ORBIS plane for an operation on Thursday.

It was heart-warming to know that ORBIS was funding the surgery of every patient I met that day. Whether onboard the Flying Eye Hospital or at Mulago by the programme’s local ophthalmologists, no one would go untreated.

On the ORBIS Flying Eye Hospital the hard work and dedication of the staff and volunteers was plain to see.

And when Thursday came it was Kitonsa’s turn to board.

As calm as ever, Kitonsa greeted us with a smile and a high-five. Deborah, nervous but pleased to finally be here, joined me in the waiting area, whilst in the operating room volunteer ophthalmologist Dr Neely and Dr Grace from Mulago Hospital corrected the muscles in Kitonsa’s eyes so he could see straight for the first time in his life. In less than an hour he was in recovery with Deborah back by his side.

After the anaesthetic wore off – and thanks to a donated teddy bear – Kitonsa was back to his inquisitive self. Despite what must have been a painful and disorienting experience, he didn’t once cry, and with his lollipop and teddy bear in hand he and Deborah left the plane for a night at Mulago.

When we arrived early the next morning for post-op assessments, none of us were surprised to find Kitonsa and Deborah already there. They were grateful for the care they had received and didn’t want to keep anyone waiting. Kitonsa was doing very well. He will have to return for follow-ups, but his future looks bright. He told me that his favourite school subject is science and that he wants to be a doctor.  Deborah said she will support him in anything he wants to do as now everything is possible!

It was a rewarding week in so many ways. Patients have been given back the gift of sight and have given their neighbours the confidence to visit the hospital. Doctors have exchanged skills, and my team from the UK will share stories of the amazing people at Mulago hospital, onboard the plane, and of Uganda, with people like you.

Though the Flying Eye Hospital has been a beacon for eye care on several occasions there is much more work to do. The president is visiting the plane next week and we hope this will boost the chances of opening Uganda’s first ever eye bank. This is a much needed resource – objects in the eye are a major contributor to blindness and corneal tissue is needed for sight-saving transplants.

Although it was a week of firsts for me, this was already the third programme of 2010 for the Flying Eye Hospital. Another six missions lie ahead this year - six places where they will work with local eye care teams to provide treatment that will change the lives of patients forever. I won’t be there on those occasions, but I know they will continue to do amazing work.

You can meet Esther, another patient from Kampala in our Eye Report here:

Continuing to Save Sight in 2010

Blog submitted by Rebecca Saxton-Fox

Rebecca is the Flying Eye Hospital Administrator and has been with ORBIS since 2007.

Every Monday evening during Flying Eye Hospital programs, we meet as a team to discuss the day. This past Monday was one of the first times I was really excited to get into that room – I wanted to see the surgery list for the week. When Amelia, Flying Eye Hospital program manager, informed me that Moussa, a man I had met on Saturday, was had been scheduled for surgery onboard the Flying Eye Hospital, I was thrilled.

As the Administrator onboard the Flying Eye Hospital, I rarely get to follow a patient from screening through surgery, as I am often running around and not directly involved in patient care. However, on Saturday, I was fortunate enough to be able to join my colleagues during a rural screening outreach, set up by Perry Athanason, our communications manager. About 15 of us drove out to Libore, just outside of Niamey, to a school where about 400 people were waiting to have their eyes checked. These people were pre-identified by the leaders of their villages as having eye problems, and brought to this screening. The number of people there seemed pretty overwhelming, and we quickly set up our stations – we had our work cut out for us!

I found my place as one of the “hall monitors”, walking patients from room to room, trying to navigate my way through up to 4 languages (English, French, Zarma and Housa), and ophthalmology terms I was unfamiliar with. One of my favorite moments during the day was passing out sunglasses to little old ladies who had never worn glasses before. Heather, our nursing director, was instrumental in ensuring each lady received a pair that fit her face and matched her clothes!

By the afternoon, the majority of our patients were men. At that point, I had moved from the hall into the scheduling room, making sure that all patients who needed surgery or follow-up care were scheduled to either come in for one of our follow-up hospital based programs, or were scheduled to go to the National Hospital of Niamey to be seen by the local ophthalmologists who are receiving training during our program.

One man came in with “extremely high pressure” written across his sheet. I learned from the ophthalmologists who had examined him that he had gone blind in his left eye several weeks prior due to glaucoma (a disease where improper drainage of fluid in the eye leads to increased pressure in the eye, damaging the optic nerve). His right eye was a few weeks away from blindness as well.  I knew what that meant – he needed to come in to the hospital on Monday to be seen by our team. The man, Moussa, needed an emergency trabeculectomy – a surgery that helps to reduce the pressure build up in the eye – combined with a phacoemulsification surgery to remove the cataract that was blurring his vision even more.

“This is the only chance he has for this surgery. If he doesn’t come in on Monday, he will go blind soon,” said Amelia, citing the fact that with only 13 ophthalmologists in the whole country, and very limited resources, eye care in rural areas of Niger is almost non-existent.

I immediately left the room to find translators. I sat with him for a while, walking several different translators over to him to explain the importance of his appointment on Monday, and making sure he had a way of getting to the hospital in Niamey. I was afraid that with the information switching from English to French to Zarma, the unfamiliar faces, and the general apprehension that people have around doctors that the message would not get across. When he walked out, I was afraid we would never see him again.

Sitting from my back office aboard the Flying Eye Hospital, I can see into the room where Moussa is currently getting prepped for surgery. As in all of our cases, he will be operated on by one of our volunteer doctors, along with 2 local doctors from Niger. This way, when we fly out, the local doctors will have better capability to deal with cases like Moussa’s.

I’m overwhelmed and grateful for all of the hard work and time that our whole team, as well as dozens of volunteer translators and organizers from Niger has put into ensuring Moussa and the additional 400 or so people we screened on Saturday get the care they deserve.  Although I know that Moussa will never get his full vision back, he will likely be able to see better in just a few weeks, and will not have to live the rest of his life in blindness.

Photo by Rebecca Saxton-Fox

Land Ho!

Blog submitted by Stephan Card and Shaun Murphy

Steven and Shaun are fundraising for ORBIS by taking part in La Solidaire du Chocolat a trans Atlantic race celebrating the cocoa trade between France and Mexico.

We’re 14 miles from the gate now making about eight knots. Typically, there have been big squalls with absolutely no wind afterwards with a nasty north-easterly swell. It’s bloody horrendous with the boat wanting to move, but then the swell would just kill the boat. It was probably about two hours of torture yesterday. For the boats at the back it might not be a lot of fun when we get to the finish as all the parties will be over. Just a few tequilas and then people will start making their way home. Hopefully the Caribbean will be a bit easier as the last part of the Atlantic has been as full of headaches as the first part. We just take every day as it comes. We’re going to have a celebration tonight to mark finally seeing some land.

Squalls, Hail Storms and Lightning

Yesterday morning continue under the large kite, until the clouds started to darken, nearly a perfect drop until we realized I had left the clutch on the tack line open. Off went the tack of the kite, so once again recovering the kite from the water, this part of the drop we have off to a tee, stern retrieval. Solent and first reef was the order off the day with speeds between 10-14 knots with small squalls and an ETA to St Barts of 31 hours. Then the clouds darken still and you could see the squalls coming, second reef and Solent furled away as the squall hit us, the second reef departed from the main sail and a batten popped out of its pocket on the main sail. By now the squall was 28-30 knots as we were putting in the third reef. The waves breaking over the boat are refreshingly warm, unlike European waters. As the wind and rain increased to 45 knots, it was like being hit with hail stones, visibility was around 100 meters, this lasted around 20 minutes. The rest of the day was a mixture of light and fickle breeze and the ETA to St Barts went from 31 to 48 to unknown..... The hole we managed to find around 23.30 UTC was to last nearly three hours, the mainsail was dropped to stop the constant bang and rocking of the boat. Then we were off again with the most fantastic light show. Thunder and lightning everywhere, a few electronic items were unplugged as a precaution. As most children learn, we were also counting between the flashes and the bangs to find out the direction of the weather, but all too often it was impossible to know which flash belonged to which bang. Over a 100 photos were taken and only three managed to capture any lightning.... the moon put in an appearance around 0500 UTC which helped with the weather ahead. Around 6.15 was the closest we came to the thunder and lightning with only a couple of seconds between them, I guess some will work out the maths between speed and sound and tell us it was hundreds of miles away.... just before 6am this morning another hole was found, again this seems to be in our skill set. Fifty minutes later we are on our way again on a heading of 282 @ 8.2 knots and an ETA of 24 hours for St Barts...ummm...somehow I think not.

Sun Burn Fears

Blog submitted by Stephan Card and Shaun Murphy

Steven and Shaun are fundraising for ORBIS by taking part in La Solidaire du Chocolat a trans Atlantic race celebrating the cocoa trade between France and Mexico.

We’ve had a very pleasant night sailing and it’s a beautiful day this morning. We’ve got all the boots and clothes and oilies out in the cockpit trying to dry everything off. We’ve got about one meter or a meter-and-a-half gentle swell and 14 knots of breeze. The boat’s cruising along at eight knots. In fact, sun burn is the major concern at the moment. The problem at the moment is everyone is in the same breeze and doing about the same speed and this will probably continue until St. Barts. We’ve got a small list of jobs to do while the weather is quiet, nothing major at all. It’s a real shame about the Finnish team. If nothing else, our boat is very strong. We’re both fine although I fell across the cockpit and have a lovely bruise that I must take a picture of.