August 15, 2002
4 min read

Surgery mission provides teaching as well as care

Through the World Eye Mission, a physician instructed residents in pediatric ophthalmology and provided surgical training.

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TORONTO — The World Eye Mission is providing training to resident doctors as well as ophthalmic care in its mission trips to Central America.

“The mission had a dual purpose: to teach, in a visiting professor role, the residents and trainees and to provide some degree of service by seeing patients and performing surgery,” said Alex V. Levin, MD, MHSC, FRCSC, a Canadian pediatric ophthalmologist who traveled to South America through the organization.

According to Dr. Levin, the trip was a beneficial learning experience for both him and his Guatemalan hosts.

“It was a fascinating and rewarding experience — a good example of the ‘teach a person to fish’ philosophy. We were able to provide education and hands-on, didactic experience, which these doctors and residents can carry on in their careers to improve care of the patients in their home countries,” he said.

Guatemalan ophthalmology

Dr. Levin was pleasantly surprised by the quality of ophthalmic care given to patients in Guatemala City, where he was assigned for 1 week.

“The quality of eye care in Guatemala is actually remarkably good but can benefit from external influence,” he said. “I think the doctors there are doing an excellent job but can gain from ongoing continuing medical education, which essentially this program provides — as opposed to some countries where the level of care really is rudimentary. What we did was augment their skills.”

Even though Guatemala is a small country, it is one of the largest hubs of ophthalmic training in Central America, Dr. Levin said.

“Guatemala City in particular does all the ophthalmology residency training for Central America. As a result, the extension of this training and learning reaches beyond the borders of Guatemala to El Salvador, Honduras, Costa Rica and other countries that send their residents there,” Dr. Levin said.

While in Guatemala City, Dr. Levin was introduced to a new program that helped extend care to people of a lower socioeconomic status.

“We worked in pediatric glaucoma, pediatric cataract and strabismus,” he said. “The main contact there for the mission was Mariano Yee, MD, who has a fantastic role-model program in which he works in a private office setting with his brother and his optometrist wife, where they see patients and provide care.

“They divert part of the income from that private practice to fund a public practice within the same building so that public patients have the benefit of being cared for by the same doctors in essentially the same clinic and operating room. This is a novel and model way of reaching out to the poor — they are getting the best of care, but for free,” Dr. Levin said.

The mission

According to Dr. Levin, his goal in Guatemala was to both instruct local resident trainees and staff ophthalmologists to provide hands-on care.

“This was a mission to teach them how to do what they need to do to deal with disease. I gave lectures almost every night to the residents on various elements of pediatric ophthalmology, as well as some talks on ophthalmology ethics. They don’t receive any formal ethics teaching [there], so this was new for them.

“We also discussed resource allocation, which was particularly poignant for them in terms of how to determine who is going to receive the care, the rich or the poor, when the poor are so numerous,” he said.

Dr. Levin also performed some surgical procedures during his stay.

“I did some strabismus surgery and some cataract surgery while I was there,” he said. “Clearly they don’t have the same facilities as we do. But we try to give them help that allows them to best use what’s available to them.”

World Eye Mission

The World Eye Mission is a nonprofit organization dedicated to bringing care and training to doctors and patients in countries that do not have the resources to afford it.

“I was contacted by the World Eye Mission,” Dr. Levin said. “They were looking for someone in pediatric ophthalmology to work with them. [The mission] has worked in several countries — Haiti, Dominican Republic, Bulgaria, Venezuela and Guatemala — to use a visiting-professor type of approach to Third-World care. This is different from the prevention type of approach or from the people who go and do 100 cataracts in a week.”

Dr. Levin said he was impressed with the commitment of the mission and its founder, Dr. Jeevak Lal, MD. He specifically noted the dedication of the Guatemalan physicians.

“I think the most important thing I taught them was the management of pediatric cataracts and techniques to improve surgical outcomes in pediatric cataracts. The most important element to me was the model of care Dr. Yee was providing; second was the remarkable enthusiasm and devotion these people have for improving the care they deliver.

“I also think it’s important to note that they have some incredibly bright residents who are going out to do good things. The World Eye Mission is not a quick fix, and surgeons don’t just hop in, do a few things and then leave. Sustainability is the focus of this program,” Dr. Levin said.

For Your Information:
  • Alex V. Levin, MD, MHSC, FRCSC can be reached at the department of ophthalmology, M158, Hospital for Sick Children, 555 University Ave., Toronto, Ontario, Canada, M5G1X8, (416) 813-1500; fax: (416) 813-6261; email:
  • The World Eye Mission can be reached at 1306 N. Eaton St., Albion, MI 49224; (517) 629-5561; fax: (517) 629-4042; e-mail: