Photos from an Outreach Microsurgical Eye Clinic at a Himalayan Cataract Project supported Solu Community Eye Centre located in Phaplu, Nepal.
Himalayan Cataract Project Co-Directors Dr. Geoff Tabin and Dr. Sanduk Ruit and a team from the Tilganga Institute of Ophthalmology (TIO) managed an outreach event at the Dolakha Lions Community Eye Center (DLEC), located in the mountainous district of Janakpur, Nepal. This OMEC was conducted by Tilganga Institute of Opthalmology with the support of Himalayan Cataract Project.
Prior to the OMEC, a team from DLEC conducted eight screening eye camps in the different areas examining a total of 1,751 patients and selecting 174 for cataract surgery. All patients were asked to put antibiotic eye drops in both eyes a day before their scheduled surgery.
After the surgery, patients were for 1 to 2 days for follow-up. On the first day, dressing was done and medicine was used frequently as per doctor’s prescription. Most patients were discharged on the second day after taking post-operative visual acuity test and after receiving instructions on how to care of their eyes. A few patients with complicated cases were kept till the third day for observation and treatment.
I am happy to report that we got 2011 off to a great start on our quest to restore sight to the people of the Himalayas!
Between January 17 - 19th, Dr. Bajimaya from Tilganga Institute of Ophthalmology (TIO) conducted an OMEC in Manthali a village development committee in Ramechhap District in northeastern Nepal. As a result, 1597 people were screened and a total of 188 surgeries performed.
In February, Hetauda Community Eye Hospital organized eye screening programs on rural and underprivileged villages of Makawanpur district. Two screening camp were held on Epa Village Development Committee (VDC) and in Bharta VDC. Both of screening were the first health camp ever held in these villages.
208 patient were examined in Epa VDC screening camp and among them 27 cataracts were found. Similarly one 148 patients were screened in Bharta VDC and 12 cataracts were found. With the support of the Himalayan Cataract Project, Hetauda Community Eye Hospital provided free of cost surgery to all cataract patients at the base hospital. All patients returned happily after undergoing the sight-restoring procedure.
Currently, TIO's Dr. Govinda is leading a four-day OMEC at the Jagatguru Kripalu Charity Hospital in Uttar Pradesh in Northearn India. It is anticipated that at least 1800 people will be screened and an estimated 600 surgeries performed.
On behalf of the Himalayan Cataract Project, I would like to thank everyone for your continued interest in our project. It is only with your generous support that we are able to bring high quality eye care to the remotest areas of the Himalayas.
2010 has been a busy year for our project. With your help, a total of 24 Eye Camps were conducted in the Nepal, Tibet, China, Bhutan, and Northern India. A total of 26,062 people were screened and out of them 5,176 received sight-restoring surgeries.
In addition, ophthalmologists and ophthalmic nurses from different countries were able to participate in these Remote Eye Camps to expand their skills in high volume cataract surgery.
I want to take this opportunity to express our sincere gratitude for your generous contributions. It is only with your continued support that we can continue the fight against curable and preventable blindness.
Happy Holidays and Best Wishes for the year 2011.
P.S. I hope you enjoy reading our 2009 Annual Report and our Best of 2010 highlights.
Lunana is located on the bank of the Pho Chu River and it is the most remote region in Bhutan. It takes ten days walk from the nearest road and eight days from the district Headquarters. Lunana is made up of dispersed settlement with 150 households. Cold and harsh climate pervades throughout the year, with altitudes ranging from 7000 to over 8000 feet above sea level and mule tracks are the only access.
Lunana’s facilities, which include a school, a health center, and a livestock extension center, remain open from June to September and close by mid October due to heavy snowfall. Most of the people also migrate to lower nearby districts in search of manual work and also for barter trade with their yak products with necessary items like chilly, rice and others.
Before setting out for the outreach camp (OMEC), the team had to make additional preparations due to weather conditions as well as the geographical location of Lunana. Prior to the their departure, they made sure all the drugs and non-drugs items including the operating microscope were packed properly to ensure that they were small, portable and most importantly waterproof.
The ophthalmic team that set out for the OMEC consisted of one ophthalmologist and 3 ophthalmic technicians. The team left on the 10th August. Traveling in monsoon season brings many problems due to incessant rains leading to landslides, washed away bridges, falling boulders, and so on. After a day of travel, the team spent a day in the village of Damji where they provided eye care services to more than 100 patients.
On the third day of the journey, the team proceeded to halt at the base of mount Kangla Karchu to enable the crossing of the pass the following day. From there on, there was no downhill journey and the team climbed up hills after hills at high altitude. Traveling through incessant rains and winds in muddy and slippery stones took a toll on the travelers as well as the horses carrying the loads.
Late that evening the team arrived at a campsite where tents were pitched and arrangements made for the evening. That night, the ophthalmologist developed severe chest pain, and breathlessness, giddiness, headache nausea and vomiting and his condition further deteriorated the next day. The team decided to halt there for one day to give him time for acclimatization and at the same time stabilize his condition.
That evening, the doctor also showed sign of dehydration and general weakness. Due to difficult terrains, lack of communication, and adequate medical aids, a decision was made to transfer him back that night. While an attempt was made to travel on horse, it was not possible due to poor visibility, lack of strength to ride on horse and due to poor trail condition. The return mission was abandoned.
With intensive medications over the night and nourishing porridge, and glucose water, his condition showed improvement by sunrise. Weighing the pros and cons, he determined to proceed further. However, much of the remaining trip had to be made on horse. Upon the arrival of the team members and the medical loads, preparations were done for conducting the clinics. The operation theatre was set up with plastic sheets and fumigation.
More than 100 patients received treatment in Lunana and all school children were thoroughly evaluated for any ophthalmic problems. Those requiring vision restoring surgery were listed and received counseling while preoperative preparations were being done. A total of 18 patients received. All operations went successfully and the post-operative period was uneventful. Medications were explained and handed over to the patients with detailed instructions.
One of the aims of the trip was to follow-up on a corneal transplant patient. She had permanently lost her right eye years back from corneal trauma and ulceration. It had taken her relatives more than 10 days to carry her from Lunana to Jigme Dorji Wangchuck National Referral Hospital in Thimphu, Bhutan. Due to lack of cornea, she had to stay in the hospital for more than two months before her operation. She regained her vision and she is happily tending to yaks now. At the follow-up, she was all smiles and with deep gratitude. She was very careful and understood the importance of timely medications and follow-ups. She had functional vision and her transplant had remained clear. Her medicines were refilled and she was advised to return to the hospital for a detailed assessment.
The team’s return journey proved to be very challenging. With one bridge washed away a detour had to be made to cross a lone log bridge. Climbing the slippery cliff and reaching the log bridge proved to be very demanding and at times life threatening endeavor. After facing many difficult situations and overcoming each, the team, all returned safe and sound.
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