American ophthalmologists partner with Honduran residency program
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International ophthalmology missions have been a career highlight for many American ophthalmologists.
In the recent past, steps have been taken to make many international sites more accessible and the work done more impactful. One such site is Hospital San Felipe in Tegucigalpa, Honduras.
Source: Timothy A. Soeken, MD, Michelle K. Rhee, MD, Andrew Klieger and Patricia B. Sierra, MD
At this site, there exists the potential to join a small but robust effort to meet the needs of an underserved population and help with the surgical training and education of future generations of ophthalmologists who will carry on this mission for decades to come (Figure 1).
At Hospital San Felipe, one will find the first and only ophthalmology residency and anterior segment fellowship in Honduras. Today, the department, led by Dr. Paula Deras, has four ophthalmology teaching faculty, five residents and two anterior segment fellows. The residency program has been in existence since 1992. However, due to the hospital’s limited budget, phacoemulsification training had not been part of its teaching curriculum. In 2017, U.S. surgeons Drs. Patricia Sierra and Kevin Waltz assisted their efforts by donating equipment in order to integrate phacoemulsification into the residency training.
Teams of visiting U.S. surgeons, or “brigadas de ojos” as the Hondurans refer to them, have now established regular visiting partnerships. Drs. Patricia Sierra, Kevin Barber, Mark Hansen and Russell Swan all regularly visit San Felipe once or twice each year. During their visits, they bring phaco supplies and spend a week dedicated to surgical training of residents. In July 2022, the U.S. military even sent a small team to collaborate at this site (Figures 2 and 3).
During the COVID-19 pandemic, Orbis sponsored a wet lab, which provided the opportunity to promote and maintain surgical skills of residents live and also though online coaching. Dr. Barber recently went a step further when he developed a live phacoemulsification distance mentorship program in which volunteer U.S. surgeons “precept” young Honduran ophthalmologists through Zoom. A study on these efforts is referenced in his 2022 publication in International Journal of Surgical Education (Figure 4).
In 2021, Dr. Barber and Honduran ophthalmologists Dr. Luis Lagos and Dr. Mariela Castillo initiated an anterior segment fellowship, hosted at San Felipe Hospital and One World Surgery, a nonprofit surgery center that hosts multispecialty U.S. surgical missions. It provides the opportunity for young ophthalmologists to gain an additional year of high surgical volume, often precepted by online surgical mentorship or by U.S. visiting surgeons.
This model of humanitarian collaboration at San Felipe, which focuses more on education, skills transfer and professional relationships, has the potential for a much greater impact than humanitarian work aimed just at performing a large number of surgical cases. Improvements in medical training can have exponential return with improved care across the country and for generations to come. In addition to visiting San Felipe to teach, many ophthalmologists are interested in learning from the current low-resource practices and patterns of the Honduran team, such as manual small-incision cataract surgery. This was especially true during a recent visit from the U.S. military, with interests in not only helping to teach the Hondurans, but also to gain insight and experience for its own ophthalmologists and support staff. This bidirectional approach to engagement allows for great satisfaction on the part of both parties because all engaged have the opportunity to teach and learn.
Needless to say, the involved Honduran ophthalmologists, residents, fellows and San Felipe Hospital staff and patients have displayed gratitude and hospitality. As such, there is an open invitation for other U.S. surgeons to join in this endeavor if they have an interest in international/global ophthalmology and volunteering.
If you are interested in distance surgical mentorship through streaming wet lab or live surgery, please contact Dr. Kevin Barber at kbarber@acecaresglobal.org.
- Reference:
- Barber KM, et al. Intl J Surgical Education. 2022.
- For more information:
- Andrew Klieger can be reached at aklieger24@scdsstudent.org.
- Michelle K. Rhee, MD, of Icahn School of Medicine at Mount Sinai, can be reached at drmichellerhee@gmail.com.
- Patricia B. Sierra, MD, of Sacramento Eye Consultants, can be reached at psierra@saceye.com.
- Timothy A. Soeken, MD, of Wilford Hall Eye Center, can be reached at timsoeken05@hotmail.com.
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