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Local and global volunteer opportunities abound
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I made my first mission ophthalmology trip in 1979 under the direction of my then-senior partner, William S. Harris, MD, of Dallas. We traveled to San Pedro Sula, Honduras, and spent 1 week performing phacoemulsification and planned extracapsular cataract extraction with posterior chamber lens implants on an indigent population.
Our hosts were the San Pedro Sula Lions, and a group of well-known U.S. surgeons including the late Bill Harris, MD, Steve Shearing, MD, Guy Knolle, MD, and I performed phacoemulsification and planned ECCE with posterior chamber lens implantation on about 300 patients with severe visual disability. We returned the following year and each time imported and exported our own operating microscopes, Cavitron phacoemulsification equipment, IOLs, irrigating solutions, appropriate intraoperative and postoperative medications, packs, instruments and everything else needed. The local Lions Clubs arranged a small hospital for us to work in and performed an initial screening of the patients. We put two OR beds in one OR suite side by side and had two surgeons working at the same time. We brought our own volunteer scrub nurses and a nurse anesthetist. The logistical challenges were extraordinary, as were the challenges working with the import, duty and medical licensing authorities. As is typical in these endeavors, we worked 16-hour days and finished the day with a late dinner and then crashed into bed to rest up for another challenging day.
The day we left, the line of patients in need was as long as the day we arrived, and while every patient matters and it is extraordinarily rewarding to restore vision to those in need, I left these two experiences feeling that a program more integrated and collaborative with the local ophthalmologists, including a skills transfer agenda, might be more constructive over the long term.
In 1982, I volunteered to serve as an attending surgeon on Project Orbis in its first year. My destination was Colombo, Sri Lanka, and Orbis Founder David Paton, MD, had asked me to specifically focus on keratoplasty and in particular forge a relationship with Hudson Silva, MD, who had built a very productive eye banking organization on this island country. The goal was to access a reliable source of donor corneal tissue for all of the Project Orbis trips. We accomplished this mission.
On the Project Orbis airplane, while quality modern surgical care was provided to many needy patients, the primary agenda was skills transfer training for the local Sri Lankan ophthalmologists. We performed three to four penetrating keratoplasties each day along with several complex cataract cases. I would operate as the primary surgeon on one to two cases a day with a Sri Lankan surgeon assisting, but the rest of the day I assisted the local surgeons who were the primary surgeons. At the end of the week, I performed many fewer surgical procedures per day than I had done in my Honduran trips, but I left feeling more fulfilled. Later, when assessing my personal experience, I concluded that for me it was more rewarding to serve as a teacher of the local ophthalmologists than to simply knock out as many surgical procedures as possible myself. I have since enjoyed two other very rewarding trips on Project Orbis, which since 1982 has trained 40,321 ophthalmologists worldwide while performing 82,587 surgical procedures.
There are ample opportunities for well-trained experienced ophthalmologists in advanced countries to make meaningful contributions as a surgeon for the masses of cataract blind or as a teacher to local ophthalmic surgeons. Many trips seamlessly combine the two. I want to emphasize the well-trained experienced ophthalmologist as a critical factor, as the patients encountered are usually challenging and complex and these mission trips are not training programs. There are quality training programs available abroad as well, and many U.S. residencies collaborate with quality training centers in third-world countries to expand the experience of their young surgeons in training.
Two other programs I would like to mention are the Himalayan Cataract Project founded in 1994 and led by Sanduk Ruit, MD, and Geoffrey Tabin, MD, which has made extraordinary contributions to cataract care, especially in Nepal, Ethiopia, Ghana, Bhutan, India, Myanmar and Rwanda. A book worth reading for every ophthalmologist is Second Suns by the late David Oliver Relin. This is a very moving and potentially motivating story for the aspiring missionary ophthalmologist. As a founding member of the ASCRS Foundation, I am also very fond of the Robert Sinskey Eye Institute in Addis Ababa, Ethiopia, which is now entering its 13th year of service and incorporates a patient service and educational mission in collaboration with the Himalayan Cataract Project.
In addition, closer to home, the ASCRS Foundation sponsors Operation Sight, which provides needed eye surgery to our fellow Americans who cannot otherwise afford it. Our group at Minnesota Eye Consultants has offered an Operation Sight-like program for more than 20 years, and there are many patients in need in every community in the U.S. Further information on how to join this rewarding program can be obtained by contacting the ASCRS Foundation staff liaison Don Bell or the ASCRS Foundation leadership directors Steve Lane, MD, David Chang, MD, and Jim Mazzo.
Finally, every American ophthalmologist should participate in Eye-Care America, founded in 1985 by the American Academy of Ophthalmology. I have been a participant since 1985, and the AAO connects patients in need with volunteer ophthalmologists in their local zip codes. This program has served 1.8 million Americans over the last 33 years.
Bottom line, there is ample need and opportunity to serve both locally and globally, with a broad array of programs that can meet any ophthalmologist’s goals. The rewards can be life changing for both the giving ophthalmologist and the receiving patient.