Over Dinner

I had a great conversation with Dr. Seth over dinner. 

Seth is one of the 95 or so ophthalmologists in Ghana . has been our gracious host as we have been working with his team in Kumasi and surrounding regions. Unfortunately, due to scheduling conflicts, the other volunteers and I haven’t been able to have much time working with him. But over dinner we talked a little about the accessibility of eye care in Ghana. Of the total ophthalmologist in Ghana about have practices in Ghana, about 50 of them work in and around Accra, the capital city. Of the remaining about 25 or so live in and around Kumasi, the second largest city in Ghana. The rest, a number somewhere around 25 or so are scattered across the rest of Ghana. This lack of skilled personal according to Dr. Seth leave many regions without access to modern eye care.

These first couple of days in Kumasi have been pretty slow. Most of the areas we are seeing have been seen in recent months by other eye clinics. Due to this we have had a low patient load. I’m not going to lie. It feels like we’re not accomplishing much… at least that part of the thoughts that have been going through my head. However these thoughts of feeling like I haven’t been much of a help in curing blindness or helping improve the healthcare infrastructure of Ghana, are strongly juxtaposed to this singular thought. We are winning the fight at least in this small region around Kumasi. I have been talking with Josiah, the optometrist that the group I’m with have been shadowing and he has explained more than once that the lack of strong attendance at our outreach has been due to other clinics visiting the same region recently.

This victory in the Kumasi presents a new problem. A better problem in my mind. How do the optometrists in and around Kumasi work to coordinate their outreaches so that the time and resources spent by each clinic are used wisely. This is something that I have been thinking quite a bit about. It is easy to fall into a pattern of behavior and to lose the guiding star of your practice or life. In Kumasi it seems like modern eye care is accessible and affordable. The question is how do we connect the more rural areas to modern health care and eye care?

 

I think the answer may be in the book, Second Suns written by David Relin, that I have been reading about Dr. Geoffrey Tabin and Dr. Sanduk Ruit, the founders of the Himalayan Cataract Project and pioneers in Small Incision Cataract Surgery or SICS. The first SCIS I watch was at the St. Thomas Eye Hospital. After a several days on outreach in the Cape Coast area, we were bused back into Accra to watch surgeries. The cases were fascinating. I watched as cloudy damaged lenses were replaced with Intraocular lenses. The blind were literally given back their eyes. And to make it more amazing the surgeries only took around 7 minutes barring complications or power outages.

In the book Second Suns, highlights unity and growth of eye care of Nepal’s poor and the impoverished communities of surrounding regions. The book highlights the difficulties of expanding care and building a world class institution while underfunded and in subpar conditions.

It turns out that Dr. Seth has actually met Geoff Tabin. Tabin comes to meet with the ophthalmologists of Ghana yearly and teaches new techniques and preforms surgical. He seems to agree with the view of the author of Second Suns that Dr. Tabin has a ton of energy and passion. The Himalayan Cataract Project built a world class training hospital, build a spider web of interconnected hospitals that provide world class care. I understand that each doctor approached the problem different, but statistically the Himalayan process for solving preventable blindness works and turns the tide.