Dr. James Lehmann’s Full Circle Journey with ORBIS
Dr. Lehmann is a Cataract and Cornea Specialist from San
Antonio, Texas. He served as an ORBIS staff
ophthalmologist on the Flying Eye Hospital in 2005 and returns to ORBIS as a
volunteer faculty member. This interview was conducted during his latest
program with ORBIS in Addis Ababa, Ethiopia in 2012.
Interview and photos by Geoff Oliver Bugbee
Why ORBIS?
What makes ORBIS unique compared to other NGOs is that
we don’t just try to come into a region and do as many cataract surgeries as we
can - which is helpful to people, but you leave and they are not able to
replicate what you’ve done. What ORBIS
tries to do is take a kind of integrated approach. It’s not just about the delivery of
surgery. The nurses teach nurses how to
scrub, how to sterilize instruments, how to maintain sterile technique. The
anesthesiologists teach the local doctors how to monitor patients correctly,
how to choose patients for surgery. The
biomedical engineers do hands-on with the local biomeds and learn how to fix
machines that are broken and do routine maintenance. And that is truly unique about ORBIS - so
when the Flying Eye Hospital comes to Addis Ababa and they’re at Menelik
Hospital, when they leave they’re leaving the ability to continue what has been
taught.
What is the fundamental difference between working as a
staff member with ORBIS on the Flying Eye Hospital and being a volunteer faculty
surgeon?
When I was here in Addis Ababa for the first time it was
7 years ago as a staff ophthalmologist on this DC-10 plane. At the time I had just finished my residency
and had signed up to work as a staff doc for a year. And now, coming back as visiting faculty is
nice because I can see what a good impact ORBIS has had on Menelik II Referral
Hospital. Their eye bank is
functioning. I looked on the board the
other morning and saw that they had harvested 127 eyes this year which is
fantastic. The operating room seems to
have better equipment, is better maintained, and they’re doing a higher volume
of surgery.
On a personal note, it’s special to me because I’m able
to teach these local eye docs now and it’s kind of coming around full
circle. When I was an ORBIS staff
doctor, I was more of a “helper” - organizing and doing the heavy leg work to
support the whole dynamic process - much like the current crew who do it
impeccably well. But for me, it’s kind
of special knowing that I put in the time doing that then and now to come back
as a visiting faculty because I know how hard it is to be a staff member on
this plane. Not only that, what an honor
it is to be picked by ORBIS to be a volunteer surgeon on a program. They have a lot of eye doctors who want to do
this, so the trust that they’ve put in me is not taken for granted.
Could you talk about the training and skills transfer
process?
I’ve been impressed with how engaged the trainees have
been here in Addis and the audience participants here in the Flying Eye
Hospital classroom. They’ve been copiously
taking notes, asking questions - I think there’s a thirst for knowledge that
they have and it’s encouraging to be a part of that process.
Our goal this week was to essentially teach cataract
surgery to higher level trainees that are already doing some specialty work. We
focused on a wet lab where we would simulate the cataract surgery before
actually doing it on the patients. It
gave them the chance to get a feel for the instruments, get a feel for how the
surgery goes - and all of it on these little clay eye models. My two trainees are in their forties and
they’re already practicing consultants here in Addis - one of them does
glaucoma surgery and one does retina. It’s important for them to learn this modern
cataract technique - Phaco emulsification. It allows them to do combined
surgeries so they can take care of both the glaucoma and cataract at the same
time. The small incision cataracts which
work well here also make it more difficult to do glaucoma surgery or retina
surgery after the fact.
What motivates you to do this work?
As
a cornea specialist I always get to see the happy endings - that is, the
patient who has been the recipient of the cornea transplant and is seeing
better. But I had the opportunity a
couple of months ago to attend what was called a ‘Donor Quilt Ceremony.’ These
were people whose family members had donated a cornea after they had passed
away. Their pictures were sewn into the
quilt. The family of the donor would
tell their intimate stories to the recipients in the room. This powerful experience allowed me to see
the other side of the coin. I saw the
people whose loved ones’ cornea had given sight to somebody else and that was
big for me because I only see the happy side of the picture. And here I was able to see how tragedy can
sometimes lead to something fortunate.
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