Setting foot in Africa in June to help our Ghanaian brothers and sisters proved to be an impressionable experience that was both remarkably rewarding and profoundly educational. The Neatrour family (all 5) and Andrew (one of Kristin’s fellow medical school students), with the help of Unite for Sight (UFS) and Montero Medical Missions, teamed up to deliver vision to those needing provisions as simple as reading glasses or eye drops to providing improved sight through cataract or pterygium surgery. In 320lbs of our luggage, we hauled surgical supplies, including 100 IOLs (intraocular lens implants), surgical blades, and viscoelastic solution (used inside the eye in cataract surgery), as well as five live corneas for transplantation and instruments that help discern IOL power and diagnose glaucoma.
Preparation was key as we all worked for months to become Global Impact Fellows with Unite for Sight, an impressive 501(c)(3) nonprofit organization. After completing 70 plus educational modules each, we became proficient in topics including Cultural Competency, Ethics and Professionalism, Global Health, Community Eye Health, Social Entrepreneurship, Ghana Volunteer Training, and Travel Abroad Training. Generous donations from family, friends, co-workers, Community United Methodist Church members, Montero Medical Missions, and Medical Supply Rescue & Recycle helped us to meet our $10,000 goal to provide cataract surgery for 200 Ghanaians and glasses for 3,600 patients in need. Alcon, Allergan, and Bausch & Lomb were generous in donating eye drops and surgical supplies. Icare USA donated a tonometer for measuring IOPs (intraocular pressures) for glaucoma detection. Vision Share, in partnership with the Lions Medical Eye Bank and Research Center of Eastern Virginia, donated five live corneas (one of which was implanted while I was in Ghana). Accutome partnered with the Neatrour Family Foundation to donate an A-Scan ultrasound device designed to measure the correct IOL power to use in surgery. Additionally, 3600 pairs of reading glasses (250 lbs) were either donated or purchased, cleaned, sorted, and delivered to the partner optometrists in Ghana to be distributed to poverty stricken Ghanaians in the villages. All of these supplies fit in six large black canvas backpacks (50 lbs each)!
Day 1 and 2 took Leslie, Katie, and Greg on an overnight outreach mission with a local optometrist, ophthalmic nurse, and fellow volunteers to the Eastern Region villages of Akoase and Ayirebi where they screened 100-150 patients each day for cataracts, refractive errors, glaucoma, and retina conditions. They served as visual acuity testers and glasses/eye drop dispensers as the optometrists completed the visual exams and screened for eye surgery. The driver Bismarck helped with translation from the native “Twi” to English. The roads of red dirt and puddles (from the rainy season) led to the perfect storm when the Unite for Sight van stalled out in the middle of nowhere at night.You can just imagine Leslie and Katie standing outside of the security of the van in the dark of night on a remote dirt road in Africa surrounded by sounds of wildlife and abuzz with mosquitoes (potentially carrying malaria). Greg and four other men pushed the gas-flooded van out of the water while the women supervised. Thankfully, the men were able to start the van, which approached 200,000 miles on its odometer. That night was spent in the safe shelter of mosquito net tents on beds inside an 80 plus degree motel room.
While half the team traveled, the other half (Kristin, Andrew and I) joined Dr. Baah of the Save the Nation’s Sight Clinic on that first day. We delivered the Accutome A-scan and trained the staff on its use. The ultrasound is important in measuring the length of the eye to choose the correct IOL power to see distance in one eye and near in the other. It was put to use in the patients that had cataract surgery that afternoon where I performed my 1st SICS (small incision cataract surgery). This manual technique dominates in the developing world due to the quick recovery in vision and low cost. The incision is large enough to deliver the nucleus out of the eye, but still self-healing so no sutures are needed. This was a technique I had never learned to do until now – in my 25 years of performing cataract surgery! Day 2 took us to Dr. Clarke’s Crystal Eye Clinic where Kristin and Andrew began their diabetes study on 47 cataract patients, which continued over the next four days. I performed more SICS cataract procedures and Dr. Clarke, a corneal transplant to a patient who had a corneal scar from a severe infection. I saw something rare that day: a Ghanaian with complete 3rd nerve palsy in one eye – a fully drooping eyelid, turned-out eye with limited movement, and a dilated pupil. This patient was referred to the University Hospital for imaging to decipher causes (possibly caused by a brain tumor).
Day 3 united our entire team as we traveled on an outreach in the Volta Region to the small village of Juapong where our team saw 104 patients. The visual acuity team hung the eye charts on the side of the van while the patients sat under a tree for protection from the hot sun and the occasional rain. The rest of the team found refuge in a small building where I helped to conduct a study with the iCare tonometer – a piece of equipment that detects glaucoma by bouncing a small plastic and gold rod off the cornea without the need for anesthetic drops. Ernest, our optometrist, and I found it accurate and he accepted it as his new preferred way to measure intraocular pressure. I named him the “iCare master“ and we shared laughs! We saw seven patients needing cataract surgery, one with ectropion with the lower lids hanging out, a droopy eyelid in a 1 ½ – year old, a corneal scar from birth in a 6-month old, bilateral cataracts in a 1-month old, and 20 patients with glaucoma (two of which were end-stage with only hand motion vision). Eye drops (ranging from meds for glaucoma to those treating infection) and reading glasses were dispensed (the cost of which were only the equivalent of US $.50 – $2 each to the needy patient). Patients needing a consultation in the clinic or requiring surgery were given a date and the community coordination team arranged patient transportation.
Day 4 took the entire team to the Crystal Eye Clinic to observe as Dr. Clarke and I performed more cataract and pterygium surgery. The teamwork of Dr. Clarke’s staff in the clinic and operating room was noteworthy and very efficient. Some days Dr Clarke works until 9 or 10pm and performs surgery on 50 plus eyes! Every volunteer was given the opportunity to observe the surgery up close. Greg enjoyed passing the tape to Dr. Clarke to patch the operated eye. Partnering with UFS has allowed Dr. Clarke to grow his cataract surgery volume 13 fold over the past five years!
Day 5 took the outreach half of our team to a Christian school to educate and screen students ranging in age from 3 yrs old to 18 yrs old. The 600 or so students all wore uniforms, were remarkably behaved, and greatly appreciated our presence. The team offered an educational 45 minute talk, screened ~100 students (identified at risk by teachers), and distributed 100 coloring books and crayons to children ranging in age from pre-school to 1st grade. The coloring books, which focused on health-related topics in English, were generously donated by one of Kristin’s contacts. The children enjoyed performing dances and singing songs for the volunteers. That day Kristin and Andrew completed their diabetes study at the Crystal Eye Clinic, and I ran Dr. Baah’s Save the Nations Sight Clinic since Dr. Baah scooted to the airport to pick up a visiting doctor. Eye conditions seen that day included dry eyes, refractive errors, and glaucoma (newly diagnosed in a 28 year old with normal IOPs but with severe visual field loss). The next touching story I experienced was a one-eyed cataract patient (the other eye was blind with only light perception vision after a corneal transplant in Egypt in the 1970’s) who was carried on his son’s back up to the 2nd floor theater (operating room) and then back down because of his difficulty in walking. This gentleman will now be able to care for himself and not be so dependent on others because of the cataract surgery performed that day on his one remaining functional eye.
The friendships made with our gracious hosts- Dr. Clarke, Dr. Baah, Jerome, Ernest, John, Bismarck, and Margaret – and fellow volunteers (15 or more from the East Coast to the West Coast of the US who stayed at the Telecentre Bed & Breakfast) will last a lifetime! We return with a renewed enthusiasm, dedication, and passion to help our fellow man throughout the world. I encourage you to join our team to help the world see!
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