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Surgeon performs medical missions on Mercy Ships
Thomas R. Elmer Jr., MD, shares his experiences of helping hundreds of patients in Africa.
 John A. Hovanesian |
A note from the Ophthalmic Outreach Editor:
This month’s column was submitted by Thomas R. Elmer Jr., MD, of Amherst, N. Y. His energetic description of his work on Mercy Ships is typical of many ophthalmologists who first discover what a major impact their volunteer efforts can make.
John A. Hovanesian, MD
OSN Ophthalmic Outreach Editor
So you are telling me I get to operate 5 days a week and live on a cruise ship? I will have my own fully staffed, air-conditioned operating room with a porthole? I get to live in Africa and work with people from all over the world? So what is the downside? Well, you not only work for free, but you have to pay room and board while on the ship. No problem, sign me up. In fact, sign me up four times.
For most of us ophthalmologists, surgery is a passion and not a job. I had been telling people for years that I love eye surgery so much that I would do it for free. I didn’t think that any of my friends believed me, so I had to prove them wrong.
I am a part-time medical missionary. Thus far, I have made four trips to West Africa and performed more than 500 procedures for free. What ophthalmologist does not get satisfaction out of operating? For the most part, we make people better. I love performing LASIK to help people see their alarm clock better in the morning, but it is nothing like taking a person who has had hand motion or light perception vision for 5 years and making them see.
Becoming a medical missionary
My love for eye surgery was only one of the things that brought me to Mercy Ships. During my high school years, the Jesuits instilled in me a sense of service, and Holy Cross College at Notre Dame drove home our responsibility to serve the poor and the needy. After my graduation from the University of Notre Dame, I deferred medical school to spend 1 year serving low-income patients as a Holy Cross Associate. It was during that year that I knew that one day I would be a medical missionary.
 Thomas R. Elmer, Jr. |
Years later, I realized that ophthalmology was the best specialty if you want to make a big difference in a short amount of time. I will admit that living on a cruise ship was also appealing. After all, I had been living on my sailboat for 5 years in New Orleans while I was at Louisiana State University studying ophthalmology.
In the fall of 2003, after 14 years of higher education and a large debt, I deferred all job offers and found myself on a plane to Sierra Leone, Africa, arguably the poorest country in the world. Sierra Leone has spent most of the past 14 years in civil war. The country has been so unsafe that it has been difficult to bring in outside help. Luckily, the United Nations finally stepped in, and now it is relatively safe. Unfortunately, the civil unrest has led to a lack of basic needs including food, immunization and basic medical care. Completely preventable diseases such as polio have become commonplace. Needless to say, eye care is almost nonexistent. With no public electricity, running water or sewage, it is difficult to set up an operating room. The question is: In this seemingly hopeless situation, how can these people be helped?
In comes Mercy Ships. More than 25 years ago, a group was brainstorming on how to solve this common problem. A hospital ship that can go into an area of need and be fully equipped to help in “bringing hope and healing the poor.” It is perfect. Bring in your own equipment, electricity, air-conditioning, trained staff, food, operating rooms, etc.
First mission
After more than 24 hours of travel, I made it to the ship. The M/V Anastasis (Greek for resurrection) is a 522-foot Italian cruise ship converted to a vessel of hope for the poor of Sierra Leone. I quickly realized that I was the only ophthalmologist on the ship, and I had to screen patients and book surgery for the next 6 months. I had only 2 days to do it. I stood there with my direct ophthalmoscope in hand, and the patients lined up. You have never seen such a line.
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Image: Elmer TR |
I saw about 600 patients and booked close to 300 surgeries in 2 days. In all, it was one of the most amazing experiences that I have ever had, but there was not much time to think about it. I had to get to work.
Over the next month, I spent 8 to 9 hours a day, 5 days a week in the operating room. When I say dense cataracts, I mean really dense cataracts. Sierra Leone is known for its diamonds (in fact, diamonds are the source of much of its corruption and civil unrest). Those cataracts were just like diamonds. The phaco machine would not touch most of them, so I was doing extracapsular cataract extraction on about half of the patients I treated.
I soon realized that my Western training had not prepared me for that level of cataracts. I was good at suturing, but I was taking a long time to close those large limbal wounds. Over the next few weeks, I painstakingly taught myself how to perform sutureless extracapsular surgery using large posterior frown incisions. Once I mastered that I was much happier, and I spent more time taking patches off and less time suturing. I blocked and patched everyone because of the severity of the cataracts and because of the language barrier. The next day, I would take their patches off and watch their faces when they could see for the first time in years. Most of the time they would jump up and start dancing. I have it on video. I call it the “cataract dance,” and there is nothing like it.
After seeing my first cataract dance, I was hooked. One of my first patients was so excited that he danced right out of the clinic and left his walking stick behind. I went running after him and asked if I could keep it as a souvenir. He laughed at me like I was joking. “It’s just a blind man’s stick,” he said. “But I am no longer a blind man, so I no longer need it.” He is right, it is just a stick, but it is my greatest souvenir.
Now I have a collection of blind man’s sticks. Last year, I took two residents from SUNY Buffalo with me to Liberia, and next year I plan to take two more. Now it is their turn to collect the sticks. Yes, I am a part-time medical missionary. Evidently, I am a part-time stick collector, too.
For more information:
- Thomas R. Elmer Jr., MD, can be reached at Fichte-Endl Eye Associates, 2825 Niagara Falls Blvd., Amherst, NY 14228; 716-564-2020; e-mail: thomase@fichte.com.
- More information on Mercy Ships can be found at www.mercyships.org.