Successful outreach trips should involve education, not just surgery
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I made my first trip as a volunteer surgeon to San Pedro Sula, Honduras, in 1978.
A prestigious group of U.S. surgeons including my then senior partner William S. Harris, MD, Steve Shearing, MD, Guy Knolle, MD, and I, hosted by the “Clubes de Leones de Honduras” and supported by the Cavitron Corporation/Alcon, spent 5 days performing cataract/IOL surgery. The primary purpose of this trip was service, and we worked hard and long days to help as many in-need patients selected by the local Lions Club as possible. We returned the following year, but then I left practice in Dallas and returned to join the University of Minnesota department of ophthalmology faculty in 1980, and no further trips were made to Honduras by this group. While I found these two surgical trips to Honduras rewarding, I felt something was missing as we did not work closely with the local ophthalmologists, and we did not have a teaching mission.
Two years later, I was called by David Paton, MD, and invited to participate in a different type of international surgery program, Project Orbis. I traveled to Colombo, Sri Lanka, and spent an extraordinary and rewarding week working with the Orbis team seeing patients, operating and lecturing in the Orbis airplane. Our host was the government of Sri Lanka and the College of Ophthalmologists of Sri Lanka. In addition to patient care, the core mission was education of the local eye care providers including doctors and their support staff. This was the first year of the Orbis Flying Eye Hospital, and as an additional special memory, two current friends and colleagues, Steve Slade, MD, and Simon Holland, MD, were on the plane as Orbis fellows. My primary agenda, as requested by Dr. Paton, was to initiate teaching in corneal transplantation and help establish a reliable source of donor corneal tissue for the Project Orbis mission. Both were accomplished. The experience was memorable and rewarding, and I flew home to Minneapolis without the feeling that something was missing, like I felt after leaving Honduras in 1978 and 1979.
Since that time, I have performed eye surgery many times throughout the world but always in collaboration with the local ophthalmology societies and with the primary goal of sharing knowledge and experience with the local eye care providers.
In a previous commentary published in the Dec. 25, 2023, issue of Healio | OSN, I shared my thoughts on live surgery programs with education as a priority. These programs have both an educational and service goal, and every live surgery program must balance the educational mission with the ethics of patient care. Beneficence, nonmaleficence, individual autonomy and justice all come into play, and I shared my thoughts in this previous Lindstrom’s Perspective. Orbis International, in my opinion, is a virtuous example of superb eye surgery education and ethical patient care.
A few more thoughts. Working with one of my former fellows, Patricia Sierra, MD, who practices in Sacramento, California but was born in Tegucigalpa, Honduras, a group of us including Kevin Waltz, OD, MD, John Vukich, MD, Kevin Barber, MD, John Berdahl, MD, Mark Hansen, MD, Russell Swan, MD, and a few other giving colleagues adopted the residency training program at Hospital San Felipe in Honduras. Regular trips every year have created a sustainable educational and service program that has elevated the quality of resident training and patient care provided at this teaching hospital in a resource-challenged country. Interested surgeons can contact any of the surgeons listed above if they wish to join this laudable effort.
There are hundreds of opportunities to participate in international surgical programs. There is significant need here in America as well, where the ASCRS Foundation’s Operation Sight coordinates programs to treat those with unmet eye surgery needs in our local U.S. communities. At Minnesota Eye Consultants, we are in our third decade of performing no-cost surgery to those in need through the Vision Project funded by Unifeye Vision Partners and our Minnesota Eye Foundation.
There are many opportunities for the skilled eye surgeon to serve those in need globally and locally. The interested surgeon can contact any number of coordinating agencies, including the ASCRS Foundation, Orbis International, SEE International or the Himalayan Cataract Project, or any of the surgeons mentioned in the accompanying cover story or my commentary for guidance.
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