Disclosures: Alter reports no relevant financial disclosures.
January 15, 2022
2 min read

BLOG: Building eye care capacity in Haiti, part three

Disclosures: Alter reports no relevant financial disclosures.
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When I started work to help the residency at HUEH, I received many warnings suggesting I was wasting effort and that the problems were too pervasive to help.

There have been many ups and downs along the way, but progress can be made with a great team of dedicated professionals and open communication with your partners. Fortunately, I made two trips to Haiti in 2020 before the COVID outbreak, and we returned for three additional trips in early 2021 after being vaccinated. We were able to start our retinopathy of prematurity fellowship with Dr. Shakespeare Saintil, who is now screening and treating infants.

Daniel C. Alter

Now the residency is working fairly well without our frequent visits. We are not done yet, but we hope our success will be an inspiration to others in Haiti and other developing countries. The medical students and interns see the improvements, and ophthalmology is the most competitive residency at HUEH. Three of the top five ranked interns chose ophthalmology. Historically, there was little interest in ophthalmology as the cost barrier to entry and inability to be trained without equipment were negatives.

If there was one suggestion I would make to anyone trying to enhance or build surgical skills for residents in a setting that struggles with attending coverage and case load, I would say a microscope for wet lab practice and video capabilities in the OR so junior residents and nurses can be fully engaged in surgery. Practice with simulation eyes like those made by Phillips Studio can be used to greatly enhance the new surgeons’ skills. This is even more important in residencies struggling with low cataract numbers.

People often ask me how to get involved. The simple answer is to donate your time, money, supplies or equipment. Often, a balanced combination is best when supporting a specific project because there are likely needs in all those areas. Almost any resource-limited place you visit on one of these trips will have a great need for any materials and supplies, so one should always bring as much as possible. Ask well before your trip what the most important supplies are that you can bring. Your local industry reps can be helpful with supplies. At FOCUS we strive to increase local capacity during our trips, so the emphasis is on skills transfer locally. However, on our trips to Port-au-Prince, we often have phaco surgeons join us and work at a nearby charity clinic that is well equipped. This is a great option for a first-time visitor. In addition to FOCUS, organizations such as SEE International, Himalayan Cataract Project and Orbis International will have seasoned global ophthalmologists to travel with and well-planned mission trips.

Sometimes the most effective way to help is to donate to an organization like FOCUS or other eye care organizations that foster programs that increase sustainable solutions in the developing world. After all, it is resources that limit capacity building. In many cases, the money generated by half a week of work when donated to the right program might have a larger impact than going on a once-a-year mission trip to do cataract surgery in a remote location.

For more information on FOCUS, visit us on the web at 1focus.org.