November 09, 2012

A Fairy Tale or Flying Eye Hospital?

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.

Sarah-Jacobs-Ethiopia-FEH small“Ugh. Think of all the equipment in here that they can wreak havoc on,” said my inner curmudgeon. “Ooh! Remember the first time you looked at an eye?" said my better self.

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. 

August 09, 2010

Internship Visit to ORBIS

Blog submitted by Dillon Van Auken

Dillon Van Auken is a student from ACS International School, through ORBIS' partnership with ACS Dillon was selected to participate in an internship for that allows students to take part in an ORBIS program overseas. 

Today featured the commencement of ORBIS’s Da Nang program in the form of screening day, over which the ORBIS doctors (known as Volunteer Faculty or “VF’s”) examined around twenty-five patients to determine appropriate later treatment. 

As today was quite busy in preparation for the rest of the week, our job as interns was to mainly observe the doctors and identify prospective case-studies that we will be writing as the week goes on. Each of us went to certain specialty screening rooms, which included retinopathy, led by Dr Hampton; glaucoma, led by Dr Piltz-Seymour; and paediatrics, led by Dr Black. Gradually we moved in between rooms to grasp the wide array of ocular problems facing the local people and the subsequent treatment that they would be receiving from ORBIS.

Each doctor would examine the patients in front of several hands-on trainees, local doctors from Da Nang, other areas in Vietnam, and some from Cambodia and Laos. The doctor would examine the patient’s eyes with various instruments, whilst also explaining the observations to the hands-on trainees. It was truly amazing to watch the doctors do this, as they had to cope with actual treatment of a patient, teaching, and a language barrier all at once. Despite these tough requirements, each did so very calmly and efficiently.

After observing each patient, the doctors would decide whether to perform surgery on the Flying Eye Hospital, the Da Nang Eye Hospital, or to postpone surgery for local doctors to carry out at a later date. From each section, four patients were chosen to go to the Flying Eye Hospital, four were chosen to go the Da Nang Eye Hospital, and the rest were selected for later surgeries, although some did not require surgery at all.

ORBIS ACS Visit Da Nang 2010 Neha Lalani Dillon Van-Auken Jhenielle Reynolds Shaghigh Aryan (Westminster Academy) (7)So far, this trip has already been extremely moving and inspirational for me personally.  Observing the doctors today was one of the few times in my life where I have seen people be genuinely selfless and devoted to helping others.  Often, even in charity work, self-interest is still a major motivator, yet these doctors as well as the entire ORBIS staff are committed to genuine philanthropy. It was also very emotional to see the numerous patients, many of them children, with very severe eye conditions that could have been prevented with greater infrastructure and development. Yet, the sadness of their conditions is counteracted by the optimism that they will have treatment this week through the help of ORBIS. It will be great to see their progress at the hands of the wonderful ORBIS staff over the week.

June 17, 2010

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.

Bello and Amna pose for picture
 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.

June 08, 2010

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.

Image1 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.”

May 26, 2010

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.

Dr Brookes outside the Flying Eye Hospital
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

August 05, 2008

Eyes on Ethiopia

Ethiopia, one of the world’s poorest nations, is burdened with one of the world’s highest levels of avoidable blindness. An estimated 1.6% of the population is blind, with approximately 12% of this blindness caused by trachoma — a highly infectious eye disease that is entirely preventable. Trachoma is spread through contact with an infected person’s hands or clothing, or by flies that have come in contact with the discharge from an infected eye or nose.

Ethiopian_child_at_zithromax_distri

Continue reading "Eyes on Ethiopia" »