reflections: THE HUMAN SIDE OF OPTOMETRY
Third-World Reminders
This O.D. learns that one person can make a difference.
BY MARK HARDER, O.D.

I just returned from a medical mission in El Salvador, where I was part of a group that saw approximately 6,100 patients over a two-week period. Our 35-member team, including four optometrists and four ophthalmologists, provided these patients with everything from reading glasses to pterygium surgery to cataract surgery. Before the project, one of our team went to villages to prescreen patients, giving them tickets for specific days at the clinic. Three hundred and fifty lined up for the morning session. The daunting workload came as no surprise to me, for it was my 15th such project in a Third World country. But the experience did remind me of some old lessons.

Appreciating the basics

I was reminded how to spell diarrhea. That malady is always a risk in Third World countries where health risks are greater in general; fever and malaria were also dangers.

I was reminded of simple pleasures. I enjoyed the sunrise over the bay, a cool breeze and a cold beer at the end of the day. Things I take for granted at home gain a new richness in the Third World.

I was reminded that life isn't fair. In the past 20 years, El Salvador has suffered through a civil war, two major earthquakes and a severe hurricane -- all in a country of only five million. Salvadorans have had more than their share of misery.

Putting a face on misery

Being a part of an ophthalmic mission, however, you put a face on this misery. For me this face belonged to a 15-year-old girl. She had a 3-D change in her myopia and I was able to get her a good pair of glasses. Unfortunately, when we examined her retina, we found the beginning of retinitis pigmentosa (RP). Because of the lack of available health care, this was possibly the last time she would see a doctor and the news was tragic. Resources are limited and it's difficult being unable to help a keratoconic patient or to give a cosmetic contact lens to a patient who has a badly scarred cornea.

Miracles happen

On the other hand, I was reminded that miracles still occur. For example, a woman brought in her five-year-old granddaughter, Jacquelin. The little girl's registration paper (number 4932, indicating that she was the 4932nd patient we had seen on this project!) said that she "no see good" and that her head hurt. We used a Nikon Retinomax K Plus and confirmed with retinoscopy and ophthalmoscopy that she was a -11.00D myope.

I knew that glasses would change Jacquelin's life. Normally, I would have sent her to dispensing, where another team member would pick glasses for her, but I was a little depressed from the RP patient the day before, so I decided to give Jacquelin her glasses myself. I put a pair of -9.50D glasses on her and knew by the smile on her face that she was seeing the world for the first time. The encounter took all of 10 minutes.

And then there was the 20-year-old who had muscle surgery to correct his 70D esotropia. When I last saw him, he was going to his first dance. Another woman had been attacked with a machete years earlier, leaving a cicraticial scar that dragged down her lower lid. An M.D. on the project was an oculoplastic surgeon who restored this woman's face.

I am often told that it's so good of participants to go on these projects, but I know that I always receive more than I give.

DO YOU HAVE A MEMORABLE EXPERIENCE YOU'D LIKE TO SHARE? DISCUSS YOUR STORY WITH RENÉ LUTHE, SENIOR ASSOCIATE EDITOR OF OPTOMETRIC MANAGEMENT AT (215) 643-8132 OR LUTHER@BOUCHER1.COM.