JS Online
Story by Kawanza Newson and Kristyna Wentz-Graff
May 4, 2008
Phnom Penh, Cambodia - The halls of Preah Ang Duong Hospital are filled with hundreds of people hoping that the doctors who have just arrived will treat their eye problems.
They are young. They are old. Some have bare feet.
Most traveled for hours, even days, just to be seen.
Among them is Loy Sry, a blind rice farmer who lost his vision 10 years ago. Loy can only see shadowy shapes and light, and he is afraid that doctors won't give him surgery. Or if they operate, the procedure won't restore his sight. Even worse, that he'll lose his land because his problem is inoperable.
"They will run out of patients, and I'll get other problems," said the 32-year-old, who walks hunched forward with his arms outspread to make sure nothing is in his way.
This December 2007 trip is the 100th journey for the ORBIS Flying Eye Hospital, but it is the first time the group of international doctors has been to Cambodia. The country, which is one of the poorest in Southeast Asia, is rife with eye disease and has a critical ophthalmologist shortage.
Most of its professionals, including eye doctors, were killed in the late 1970s during the Khmer Rouge's genocide, leaving few doctors to care for citizens and train more doctors.
Currently, there are only eight ophthalmologists and 40 eye doctors to provide care for the entire country. Most practice in urban areas, while 85% of the population lives in rural areas. They have limited access to eye care when they're infected or injured, usually during agricultural work.
Sharing knowledge
For the next two weeks, those doctors and others from nearby Laos and Myanmar will receive intensive training and ophthalmologic equipment to help improve treatment in the region.
They'll work alongside an international ORBIS medical team - including an Appleton ophthalmologist and a Marshfield nurse - who will teach them to perform eye surgery and manage at least six common ailments.
"The goal is to upgrade their skill set," said Brooke Johnson, spokeswoman for ORBIS, based in New York. "A lot of times we train the more senior doctors because they're already in a position to train others. The hope is that they'll train younger doctors and that the skills will trickle down."
Since 1982, ORBIS programs have helped more than 6.8 million people in 86 countries and trained more than 195,000 health care professionals, she said. Cambodia was the 75th country visited by the Flying Eye Hospital, one of several programs designed by the organization to prevent blindness worldwide.
A Boeing DC-10 was renovated to function as a fully operational surgical center.
Before the plane's arrival, Cambodian doctors scouted their practice areas for patients who could be treated by the ORBIS doctors. That's how Loy found out about it - a local doctor examined his eyes and told him to go to Phnom Penh to be considered for a corneal transplant.
Journey for sight
Loy made the 12-hour trip from Kratié Province to Phnom Penh with his brother Loy Srom, 28. They walked, took a bus and rode on the back of a small motorcycle to get here.
When the plane arrives, the siblings had been in Phnom Penh for eight days. It was a long trip, but Loy told an ORBIS interpreter that it was something he had to do. Today, Loy waits nervously in the darkened examination room, continuously rolling medical papers in his hand.
"Making the trip was important to me," he said. "I hope to have my life back. Not being able to see or help my family makes me feel dead at times . . . helpless."
Appleton ophthalmologist Michael Vrabec has volunteered with the ORBIS program since 1990, when he spent three weeks in Ibadan, Nigeria, as the only cornea surgeon. Since then, he's been on about 20 trips, including journeys to Bangladesh, Paraguay and Morocco.
"I have the same idea of trying to save sight worldwide," he said.
Vrabec said volunteering has greatly improved his skill level because the international cases he treats are always more difficult than what he sees in the U.S.
And he pushes the local doctors to immediately begin to use what they learn, typically allowing the local doctor to perform most of a surgery because "when the plane leaves, the plane is gone."
Over the years, Vrabec has learned to travel lightly. For this trip, he packed a small suitcase with a few shorts and T-shirts for himself; two large bags of medical supplies to donate to the local hospital; and a small blue insulated lunchbox with three corneas donated by the Lions Eye Bank of Wisconsin for transplantation. Each cornea costs about $2,400.
Vrabec, who is also an assistant clinical professor at the University of Wisconsin School of Medicine and Public Health, has performed thousands of corneal transplants and can quickly spot a case that can be used for training.
A reason found
As he performs Loy's examination, Vrabec is surrounded by a dozen local doctors who listen intently while he explains that Loy's corneas were infected and scarred, likely from his agricultural work.
The cornea is the clear surface at the front of the eye that protects it from germs, dust and other harmful materials. It also helps the eye focus. When the cornea becomes injured or infected, a person's vision is dramatically reduced.
Corneal transplantation is one of the most frequently performed human transplant procedures. Since 1961, more than 700,000 corneal transplants have been performed, according to the Lion's Eye Bank.
Recovery of the donor eye tissue takes place within hours of death and excision, and preservation of the cornea must take place within 18 hours of death. A corneal transplant typically is performed within three to five days after donation, though it can be done up to 14 days later if the donor cornea is stored properly.
Jerry Rabbach, community relations specialist for the Wisconsin eye bank, said 42,000 corneal transplants are performed in the U.S. each year.
Of the 1,011 eyes that were donated to the Wisconsin eye bank for transplantation last year, only 187 were transplanted outside the U.S., he said.
Vrabec, who sometimes travels to Madison to pick up corneas for his operations, tells the local doctors that Loy is an ideal candidate - he is young, blind in both eyes, has parents who depend on his work for survival and cannot afford to have the surgery otherwise.
Loy is then sent for an exam to make sure he can handle anesthesia and then to meet with more doctors who explain the procedure and give him a wristband displaying Vrabec's name.
A life changed
A few days later, Loy and other patients are transported from Preah Ang Duong Hospital by ambulance to the airport for their procedures aboard the plane.
Loy does not smile. His brows are furrowed as he listens to the talk around him and tries to understand what is going on. He knows that he will have surgery aboard an airplane, but he has never been on or seen an airplane up close before.
Once aboard, he is escorted into an exam room and a large "c" is written above the eye that will get the transplant.
Loy is one of the first patients in Cambodia to receive a corneal transplant and his procedure is broadcast live to local doctors on the plane.
"The second stitch is the most important stitch in determining whether or not we'll have astigmatism," Vrabec tells the crowd.
He also tells them to save the old cornea "just in case" and not to touch the tip of the needle during surgery because it will dull.
In about an hour, his transplant is over, and Loy is sent to the recovery room before heading back to the hospital.
The next day, his eye patch is removed at the hospital. Loy returns to the plane a day later for a follow-up exam and is able to count fingers that a doctor holds up for him while standing across the room.
He also finally sees the flying hospital.
"This plane is so big, I don't have any words to describe it," he says.
Since his surgery, Loy has a new appreciation of life. A month after his transplant, he returned to Preah Ang Duong Hospital to meet with ORBIS doctor Wenhua Li from the Shanxi Eye Hospital in China. During that visit, he told the doctor that he has been very careful about following the doctor's instructions and using his eye drops. He also said he's decided to change careers and to try to start his own family.
"I want to be a taxi driver now to make more money for my family and to find a girlfriend," he said.
Story by Kawanza Newson and Kristyna Wentz-Graff
May 4, 2008
Phnom Penh, Cambodia - The halls of Preah Ang Duong Hospital are filled with hundreds of people hoping that the doctors who have just arrived will treat their eye problems.
They are young. They are old. Some have bare feet.
Most traveled for hours, even days, just to be seen.
Among them is Loy Sry, a blind rice farmer who lost his vision 10 years ago. Loy can only see shadowy shapes and light, and he is afraid that doctors won't give him surgery. Or if they operate, the procedure won't restore his sight. Even worse, that he'll lose his land because his problem is inoperable.
"They will run out of patients, and I'll get other problems," said the 32-year-old, who walks hunched forward with his arms outspread to make sure nothing is in his way.
This December 2007 trip is the 100th journey for the ORBIS Flying Eye Hospital, but it is the first time the group of international doctors has been to Cambodia. The country, which is one of the poorest in Southeast Asia, is rife with eye disease and has a critical ophthalmologist shortage.
Most of its professionals, including eye doctors, were killed in the late 1970s during the Khmer Rouge's genocide, leaving few doctors to care for citizens and train more doctors.
Currently, there are only eight ophthalmologists and 40 eye doctors to provide care for the entire country. Most practice in urban areas, while 85% of the population lives in rural areas. They have limited access to eye care when they're infected or injured, usually during agricultural work.
Sharing knowledge
For the next two weeks, those doctors and others from nearby Laos and Myanmar will receive intensive training and ophthalmologic equipment to help improve treatment in the region.
They'll work alongside an international ORBIS medical team - including an Appleton ophthalmologist and a Marshfield nurse - who will teach them to perform eye surgery and manage at least six common ailments.
"The goal is to upgrade their skill set," said Brooke Johnson, spokeswoman for ORBIS, based in New York. "A lot of times we train the more senior doctors because they're already in a position to train others. The hope is that they'll train younger doctors and that the skills will trickle down."
Since 1982, ORBIS programs have helped more than 6.8 million people in 86 countries and trained more than 195,000 health care professionals, she said. Cambodia was the 75th country visited by the Flying Eye Hospital, one of several programs designed by the organization to prevent blindness worldwide.
A Boeing DC-10 was renovated to function as a fully operational surgical center.
Before the plane's arrival, Cambodian doctors scouted their practice areas for patients who could be treated by the ORBIS doctors. That's how Loy found out about it - a local doctor examined his eyes and told him to go to Phnom Penh to be considered for a corneal transplant.
Journey for sight
Loy made the 12-hour trip from Kratié Province to Phnom Penh with his brother Loy Srom, 28. They walked, took a bus and rode on the back of a small motorcycle to get here.
When the plane arrives, the siblings had been in Phnom Penh for eight days. It was a long trip, but Loy told an ORBIS interpreter that it was something he had to do. Today, Loy waits nervously in the darkened examination room, continuously rolling medical papers in his hand.
"Making the trip was important to me," he said. "I hope to have my life back. Not being able to see or help my family makes me feel dead at times . . . helpless."
Appleton ophthalmologist Michael Vrabec has volunteered with the ORBIS program since 1990, when he spent three weeks in Ibadan, Nigeria, as the only cornea surgeon. Since then, he's been on about 20 trips, including journeys to Bangladesh, Paraguay and Morocco.
"I have the same idea of trying to save sight worldwide," he said.
Vrabec said volunteering has greatly improved his skill level because the international cases he treats are always more difficult than what he sees in the U.S.
And he pushes the local doctors to immediately begin to use what they learn, typically allowing the local doctor to perform most of a surgery because "when the plane leaves, the plane is gone."
Over the years, Vrabec has learned to travel lightly. For this trip, he packed a small suitcase with a few shorts and T-shirts for himself; two large bags of medical supplies to donate to the local hospital; and a small blue insulated lunchbox with three corneas donated by the Lions Eye Bank of Wisconsin for transplantation. Each cornea costs about $2,400.
Vrabec, who is also an assistant clinical professor at the University of Wisconsin School of Medicine and Public Health, has performed thousands of corneal transplants and can quickly spot a case that can be used for training.
A reason found
As he performs Loy's examination, Vrabec is surrounded by a dozen local doctors who listen intently while he explains that Loy's corneas were infected and scarred, likely from his agricultural work.
The cornea is the clear surface at the front of the eye that protects it from germs, dust and other harmful materials. It also helps the eye focus. When the cornea becomes injured or infected, a person's vision is dramatically reduced.
Corneal transplantation is one of the most frequently performed human transplant procedures. Since 1961, more than 700,000 corneal transplants have been performed, according to the Lion's Eye Bank.
Recovery of the donor eye tissue takes place within hours of death and excision, and preservation of the cornea must take place within 18 hours of death. A corneal transplant typically is performed within three to five days after donation, though it can be done up to 14 days later if the donor cornea is stored properly.
Jerry Rabbach, community relations specialist for the Wisconsin eye bank, said 42,000 corneal transplants are performed in the U.S. each year.
Of the 1,011 eyes that were donated to the Wisconsin eye bank for transplantation last year, only 187 were transplanted outside the U.S., he said.
Vrabec, who sometimes travels to Madison to pick up corneas for his operations, tells the local doctors that Loy is an ideal candidate - he is young, blind in both eyes, has parents who depend on his work for survival and cannot afford to have the surgery otherwise.
Loy is then sent for an exam to make sure he can handle anesthesia and then to meet with more doctors who explain the procedure and give him a wristband displaying Vrabec's name.
A life changed
A few days later, Loy and other patients are transported from Preah Ang Duong Hospital by ambulance to the airport for their procedures aboard the plane.
Loy does not smile. His brows are furrowed as he listens to the talk around him and tries to understand what is going on. He knows that he will have surgery aboard an airplane, but he has never been on or seen an airplane up close before.
Once aboard, he is escorted into an exam room and a large "c" is written above the eye that will get the transplant.
Loy is one of the first patients in Cambodia to receive a corneal transplant and his procedure is broadcast live to local doctors on the plane.
"The second stitch is the most important stitch in determining whether or not we'll have astigmatism," Vrabec tells the crowd.
He also tells them to save the old cornea "just in case" and not to touch the tip of the needle during surgery because it will dull.
In about an hour, his transplant is over, and Loy is sent to the recovery room before heading back to the hospital.
The next day, his eye patch is removed at the hospital. Loy returns to the plane a day later for a follow-up exam and is able to count fingers that a doctor holds up for him while standing across the room.
He also finally sees the flying hospital.
"This plane is so big, I don't have any words to describe it," he says.
Since his surgery, Loy has a new appreciation of life. A month after his transplant, he returned to Preah Ang Duong Hospital to meet with ORBIS doctor Wenhua Li from the Shanxi Eye Hospital in China. During that visit, he told the doctor that he has been very careful about following the doctor's instructions and using his eye drops. He also said he's decided to change careers and to try to start his own family.
"I want to be a taxi driver now to make more money for my family and to find a girlfriend," he said.
No comments:
Post a Comment