Eyes in the skies
 
One man's vision has led to the creation of an international eye clinic aboard a converted DC-10 that is treating six million blind people and educating doctors in 70 developing countries.

Published: The Globe and Mail, August 16, 1997 FOCUS
By Deborah Jones/Vancouver

    GARTH Taylor first heard of Orbis International 15 years ago when he received a call from his native Jamaica asking him what he knew about a new flying eye clinic committed to curing blindness in developing countries. At the time, says the Cornwall, Ont., ophthalmologist, he'd never heard of Orbis. But his investigation led him to the most rewarding experience of his life.

    Dr. Taylor ended up joining Orbis. As a volunteer surgeon, he has made 50 trips to such places as Syria, China, Uzbekistan and Burma aboard its high-tech mobile surgical suite and lecture theatre, all housed in a DC-10 aircraft.

    Orbis is a non-profit health agency that evolved from a vision that Houston ophthalmologist David Paton had more than 20 years ago. Since then, it has conducted more than 350 training programs involving more than 35,000 doctors and nurses. Volunteer surgeons such as Dr. Taylor have operated on 20,000 patients, and the organization says its programs have helped local doctors prevent or cure blindness in about six million people in 70 countries.

    "It's a wonderful organization," says Dr. Taylor, who spends up to 14 weeks a year volunteering in the Third World and has recruited other Canadians to come on board Orbis, both as volunteer surgeons and staff members.
The World Health Organization estimates that there are 38 million blind people and another 110 million with visual impairments; 90 per cent are in the Third World. In two-thirds of the cases blindness could have been prevented by proper medical care, or cured through such treatment as surgical removal of cataracts, the most common cause of blindness.

    That's one of the reasons Orbis sends a DC-10, with its 18-member medical team, to remote locations for a week or two to perform four or five operations a day. But the main mission of Orbis is to transfer First World surgical skills to the Third World. "Orbis doesn't go to get rid of all blindness; it's developmental," says Dr. Taylor, "We teach them to do the surgery, or we teach them to teach others in their country."

    Third World doctors and nurses often can't afford to study abroad. If they can acquire training, they are prevented from getting hands-on clinical experience in develped nations because of strict licencing laws.

    Orbis teaches eye doctors and nurses around the world the latest research and surgical techniques, supervised by specialists with university teaching appointments in the U.S. and Canada.

    The passenger cabin of the DC-10 is a lecture theatre that seats 52 doctors and nurses. The audience watches each operation and can ask questions of surgeons in the on-board operating room, using advanced audio-visual equipment that includes 12 cameras surrounding the operating table. If necessary, hundreds more observers can be accommodated in an adjoining building with interactive AV equipment. Meanwhile, local doctors help the visiting surgeons perform operations, from cataract removal to retina transplants.

    While the Orbis DC-10 is equipped with the latest technology, it also carries older equipment so that Third World doctors can be trained on whatever is available in their country.

    Converting an aircraft into a hospital isn't easy. The DC-10 has to meet stringent North American standards for flight safety while in transit, and on the ground must meet North American standards for a hospital operating suite. It takes nine hours to convert the aircraft into a hospital every time it lands. All 18 crew members, from pilots to surgeons to nurses and technicians, pitch in to set up ramps, ensure security (in many countries, soldiers with machine guns patrol the tarmac around the plane) and sterilize the operating areas. "I have done everything except fly the plane," says Dr. Taylor. "I've cleaned toilets, done surgery and washed the plane."

    In Third World countries the plane must provide power (with its own generator), clean water (through its filtration and sterilization system) and oxygen (with its converter). It also has a satellite dish on one wing so the crew can keep in touch with anyone in the world.

    They must also win the trust of governments in the countries they visit. The caution shown by Jamaica, in asking a native-son ophthalmologist to check out Orbis, is typical. The success of the medical training also depends on co-operation by host governments.

    Ottawa retina surgeon Dr. Brian Leonard, who teaches at the University of Ottawa Eye Institute, has been with Orbis on 40 volunteer missions. He says the organization has such a high profile that heads of state turn out to meet the crew. "When this big beautiful DC-10 flies in, it generates attention and public interest."

    The work, while gratifying, can be discouraging. Parts of Africa are especially difficult, says Dr. Leonard. "In some areas when we come back to follow up we find the infrastructure gone, the technical and nursing staff dead from AIDS and that the specialist surgeons we trained have moved to Saudi Arabia for better salaries. Plus an instrument we donated has been lost or stolen, or is being used as a toaster."  
Deborah Jones is a contributing editor to Report on Business Magazine and Chatelaine.
Copyright Deborah Jones 1997
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Man’s vision created airborne international eye clinic
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