Blog Post by Sarah Jacobs
Dr. Sarah Jacobs participated as an associate ophthalmologist during Week 1 of the ORBIS Flying Eye Hospital program in Addis Ababa, Ethiopia. She is a graduate of the Mayo Medical School in Rochester, MN.
This afternoon, at the end of a day of paperwork and eye drops and cleaning and more paperwork, there was a knock on the door of the plane (that phrase sounded a lot more normal until I actually wrote it out). A woman from the ORBIS Ethiopian office was standing outside on the stairs with a group of grade school children who had arrived for a tour. A lecture was underway in the front classroom, and a surgery was in progress in the back OR. We silenced the kids with stern hushing, then led them to the laser procedure room.
I took the kids to the slit lamp in pairs, with one child as the patient and one as the doctor. I turned on the lights and adjusted the beams and let them look at each other’s eyes. Every child came away with an expression of curiosity and discovery on his or her face, as if they had just seen something truly amazing. Have you ever had a moment when you perfectly, clearly, joyfully remember why you do what you do? This moment was one of mine.
I grew up on a dead-end dirt road called Poverty Flat, in a small, windy northern Arizona town. I was the youngest of 5 kids in a family living well below the poverty line – grimy faces, hand-me-down clothes, pinto beans for dinner, and a backyard well for water. For most of my childhood, the town lacked specialty healthcare. Even if it had been available, we wouldn’t have been able to afford it. My mom had her first stroke when I was 12, and the general sense in my family was to accept it as fate. When my dad had a retinal detachment, the nearest retinal specialist was 5 hours away. We were poor. Care was beyond reach. Nothing could be done to change it. I hated the feeling of helplessly surrendering.
I studied hard, earned scholarships, and worked three jobs to put myself through college. I ploughed on through medical school, planning to pursue general family practice medicine. During my third year of medical school, I was on a service trip to the Dominican Republic where I worked with an ophthalmologist who changed my entire career trajectory. The people there had a local expression describing the blind: “Bocas sin manos,” meaning mouths without hands – people who must be fed but can’t do anything to contribute back to their families or the community. Think what an impact it can have on their productivity, quality of life, and sense of self-worth when their vision is restored.
Nearly 5 years ago, a South American woman told me a story about a gigantic airplane with an operating room inside that came to her city and made the blind people see again. Fairy tale. Or so I thought. This week, I found myself standing inside that airplane, volunteering as an associate ophthalmologist for ORBIS. I’ve been on medical service trips before – Dominican Republic, Ghana, Bolivia, Haiti, Chile, South Africa– but the ORBIS experience is distinct in several ways.
On other trips, we would arrive with hundreds of pounds of medication and equipment in duffel bags, then screen and treat hundreds of people each day. Every time, the same question haunted me: “What happens after we’re gone?” With ORBIS, an in-country doctor has been caring for the patients before we arrive, and continues to provide care after the plane flies away.
The purpose of and ORBIS Flying Eye Hospital program is not to perform as many cases as possible, but to teach new skills and stronger techniques to the local doctors and nurses so that they can continue the work for years to come.
For example, on Monday during the screening for children with strabismus (misaligned eyes), I met a local provider we’ll call Dr Z. He had been doing some straightforward strabismus surgeries, but was not comfortable with his ability to do more complicated cases. His eagerness to improve was striking. By Tuesday, he was sitting shoulder-to-shoulder with the ORBIS surgeon in the OR. By Thursday, he was operating confidently on complex cases. By Friday, he was planning when and how to arrange surgeries for his own patients. ORBIS treated 8 strabismic children during my week in Ethiopia. Dr. Z will hopefully treat thousands.