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What should physicians know about doing safe and successful ophthalmic outreach volunteering after natural disasters in countries around the world?
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Brush up on unused ophthalmic skills
 John A. Hovanesian |
If you volunteer in a disaster or poverty zone, consider these suggestions:
- Bring what you can. Any medications and supplies you bring and leave will broaden what you can offer the needy.
- Expect the unexpected. Read up on ocular syphilis, vitamin A deficiency, Vogt-Koyanagi-Harada syndrome, etc. before you go. You are not going to be treating blepharitis.
- Diversify surgically. Refresh your memory on how to do an intracapsular surgery, drainage of choroidals and a lid margin laceration. You will not have a team of subspecialists to refer to.
- Bring company. Coerce a friend of another subspecialty to join you. You will have a consultant, a second opinion and a companion for amazing memories.
- Triage. See all available patients before selecting your surgical cases. You will have limited time and supplies and cannot save everybody.
- Learn. Observe the skills of the local doctors and their limitations. Let them show you how they practice eye care without slit lamps, topographers and OCTs. You may be impressed.
- Teach. Give all the knowledge you can, as it will multiply the impact of your visit.
- Enjoy. This is the peak of your career. Savor your accomplishment.
John A. Hovanesian, MD, is an OSN Cornea/External Disease Board Member.
Be prepared to step outside ophthalmology
 James T. Banta |
In the days following a natural disaster, there are not always comfortable delineations of practice like in our daily lives in the U.S. First responders are often pushed well outside of their comfort zone, as was I upon my arrival in Haiti 48 hours after the quake. During this acute phase of medical relief, I spent most of my time dealing with orthopedic injuries, open wounds and dehydration. Sometimes horrific, non-mortal injuries had to be ignored in favor of life-saving interventions, as resources and manpower were initially scarce.
From an ophthalmic standpoint, we were surprised at the relative paucity of globe-related injuries in Haiti. The majority of ocular injuries were facial lacerations and abrasions, orbital fractures and traumatic optic neuropathies.
Although we made an important impact during our time in Haiti, the injured would have been better served with an orthopedic or trauma surgeon in our place, particularly in the initial phase of the medical relief effort. However, as is often the case immediately following a natural disaster, anybody with a medical background is better than nothing. Looking forward to preparations for future disaster relief efforts, a coordinated effort with prioritization of medical relief personnel is vital to ensure the best delivery of care.
Ophthalmology should initially be relegated to a secondary role. Once devastating, life-threatening injuries have been stabilized, ophthalmology’s impact grows immensely as we help with the basic eye care needs of an at-risk population.
James T. Banta, MD, is an assistant professor of clinical ophthalmology at Bascom Palmer Eye Institute, University of Miami.