Ophthalmic Outreach

Sustainability key to long-term outreach projects

In addition to offering their medical services in Nicaragua, a group of physician volunteers provides vital equipment to hospitals.
John A. Hovanesian, MD
John A. Hovanesian

Introduction

Surgeons making volunteer visits to a developing country always do some good, but the amount of good depends not just on the work they perform during their visit but on what knowledge, skills and supplies they leave behind. As we learn in this article about Dr. Jonathan Walker’s project in Nicaragua, the most effective volunteer surgical missions concentrate just as much at building capacity in the developing country as on performing surgery during the visit.

– John A. Hovanesian, MD
OSN Ophthalmic Outreach Editor

Delivering eye care to those in need around the world can be a richly rewarding experience, one that can change lives — for the patients and the physicians.

However, maintaining that level of care after ophthalmologists return to their practices is important to sustaining affordable ophthalmic services worldwide, Jonathan D. Walker, MD, said.

Patients line up
Patients line up for evaluation at CENAO.

Images: George D

In a telephone interview with Ocular Surgery News, Dr. Walker said fostering sustainable medical care in developing nations is key to meeting long-term ophthalmic needs, beyond those met during brief surgical missions.

“I think the standard mission story is, the doctors pack everything up, they go to some faraway place, they do a bunch of surgeries, everyone feels like they are Alan Alda in M*A*S*H and it’s really cool, and you do have a great time and you meet great folks,” Dr. Walker said. “But then you come back home, and you’ve helped a bunch of people, but you leave no improvement in the system.”

Dr. Walker — along with John T. Pajka, MD, Mark E. Drabkin, MD, and Richard M. Feist, MD, — volunteers at the Centro Nacional de Oftalmologia (CENAO) in Managua, Nicaragua. He and fellow volunteers call the disconnect between providing services and sustainability a logjam that can be freed by providing new and appropriate equipment to hospitals.

“It can make an exponential difference in terms of what physicians there can do,” Dr. Walker said. “So in addition to doing a bunch of surgeries, the goal is to go down there and leave something they need, so they can treat more patients on their own and also be better able to teach the doctors in training.”

CENAO

Dr. Walker and volunteer colleagues bring equipment and assistance to CENAO in an effort to support sustainable health care in the region. CENAO, the only teaching and charity hospital in Nicaragua, serves some of the poorest people in the region who might not otherwise receive health care, Dr. Walker said.

Patients await surgery
Patients await surgery at CENAO.

He was introduced to CENAO by Dr. Pajka about 5 years ago. Since then, Dr. Walker has traveled to Nicaragua many times, gathering grants and donations for the hospital. He said physicians at CENAO are experienced at performing ocular surgery but often do not have the proper tools to perform procedures.

“From meeting the doctors in Nicaragua, it is apparent that they have devoted themselves to helping the poor and teaching new doctors. Unfortunately, neither the government nor their impoverished patients can provide revenue to pay for the equipment they need,” Dr. Walker said.

Ways to assist

Donations to CENAO have included operating microscopes, surgical machines, lasers, slit lamps and even simple things such as ophthalmology textbooks in Spanish, Dr. Walker said.

More help is always needed in achieving sustainable care, not only at the hospital in Nicaragua but also in other outreach programs and missions around the world, he said. There are numerous ways that physicians can take part in achieving lasting outreach work — many of which do not involve traveling to another country and performing surgery.

Doctors use the microscope donated by John T. Pajka, MD
Doctors use the microscope donated by John T. Pajka, MD.

Being creative about gathering funds or equipment for outreach programs is important to try to make these programs self-sustaining, Dr. Walker said. He suggested informing stateside patients and working with church and service groups such as Lions Club International to encourage and coordinate donations. For instance, Lions Club members near his Fort Wayne, Ind., practice have donated money and transportation and even created custom crates to send equipment to developing countries.

“These guys just love doing that in their barn, and they bring these incredibly packed things, and then people help with loading and shipping the stuff. It’s fun,” he said.

Helping out

By donating equipment to the staff at hospitals in developing nations, physicians are helping provide universal and sustainable eye care in those countries, Dr. Walker said, adding that not all ophthalmologists can leave their busy practices, professorships or personal lives to participate in outreach around the globe.

For those physicians, giving funds or equipment may be the best option for volunteering while staying close to home.

“Doctors who are uncomfortable with operating on missions or don’t think they have the time … you can contact someone who does go on a mission and ask them what they need, and buy something for $50 or $100 or $5,000 … and without leaving your office, and you can get a dramatic return on the investment,” Dr. Walker said. “If someone can travel but does not have the inclination or wherewithal to do a full surgical mission, then simply visiting a facility to learn about their needs can be a much easier and shorter trip. The knowledge gained can then be used to help them from back in the States. For instance, physicians routinely interface with representatives from the manufacturers and are well-positioned to ask for help. … Even a tiny intervention in a country far away can make a big difference.” – by Erin L. Boyle

  • Jonathan D. Walker, MD, can be reached at Allen County Retinal Surgeons, 7900 W. Jefferson Blvd., No. 300, Fort Wayne, IN 46804; 260-436-2181; fax: 260-436-2567; e-mail: jonwalker22@gmail.com. For more information about CENAO, contact Dr. Walker.
John A. Hovanesian, MD
John A. Hovanesian

Introduction

Surgeons making volunteer visits to a developing country always do some good, but the amount of good depends not just on the work they perform during their visit but on what knowledge, skills and supplies they leave behind. As we learn in this article about Dr. Jonathan Walker’s project in Nicaragua, the most effective volunteer surgical missions concentrate just as much at building capacity in the developing country as on performing surgery during the visit.

– John A. Hovanesian, MD
OSN Ophthalmic Outreach Editor

Delivering eye care to those in need around the world can be a richly rewarding experience, one that can change lives — for the patients and the physicians.

However, maintaining that level of care after ophthalmologists return to their practices is important to sustaining affordable ophthalmic services worldwide, Jonathan D. Walker, MD, said.

Patients line up
Patients line up for evaluation at CENAO.

Images: George D

In a telephone interview with Ocular Surgery News, Dr. Walker said fostering sustainable medical care in developing nations is key to meeting long-term ophthalmic needs, beyond those met during brief surgical missions.

“I think the standard mission story is, the doctors pack everything up, they go to some faraway place, they do a bunch of surgeries, everyone feels like they are Alan Alda in M*A*S*H and it’s really cool, and you do have a great time and you meet great folks,” Dr. Walker said. “But then you come back home, and you’ve helped a bunch of people, but you leave no improvement in the system.”

Dr. Walker — along with John T. Pajka, MD, Mark E. Drabkin, MD, and Richard M. Feist, MD, — volunteers at the Centro Nacional de Oftalmologia (CENAO) in Managua, Nicaragua. He and fellow volunteers call the disconnect between providing services and sustainability a logjam that can be freed by providing new and appropriate equipment to hospitals.

“It can make an exponential difference in terms of what physicians there can do,” Dr. Walker said. “So in addition to doing a bunch of surgeries, the goal is to go down there and leave something they need, so they can treat more patients on their own and also be better able to teach the doctors in training.”

CENAO

Dr. Walker and volunteer colleagues bring equipment and assistance to CENAO in an effort to support sustainable health care in the region. CENAO, the only teaching and charity hospital in Nicaragua, serves some of the poorest people in the region who might not otherwise receive health care, Dr. Walker said.

Patients await surgery
Patients await surgery at CENAO.

He was introduced to CENAO by Dr. Pajka about 5 years ago. Since then, Dr. Walker has traveled to Nicaragua many times, gathering grants and donations for the hospital. He said physicians at CENAO are experienced at performing ocular surgery but often do not have the proper tools to perform procedures.

“From meeting the doctors in Nicaragua, it is apparent that they have devoted themselves to helping the poor and teaching new doctors. Unfortunately, neither the government nor their impoverished patients can provide revenue to pay for the equipment they need,” Dr. Walker said.

Ways to assist

Donations to CENAO have included operating microscopes, surgical machines, lasers, slit lamps and even simple things such as ophthalmology textbooks in Spanish, Dr. Walker said.

More help is always needed in achieving sustainable care, not only at the hospital in Nicaragua but also in other outreach programs and missions around the world, he said. There are numerous ways that physicians can take part in achieving lasting outreach work — many of which do not involve traveling to another country and performing surgery.

Doctors use the microscope donated by John T. Pajka, MD
Doctors use the microscope donated by John T. Pajka, MD.

Being creative about gathering funds or equipment for outreach programs is important to try to make these programs self-sustaining, Dr. Walker said. He suggested informing stateside patients and working with church and service groups such as Lions Club International to encourage and coordinate donations. For instance, Lions Club members near his Fort Wayne, Ind., practice have donated money and transportation and even created custom crates to send equipment to developing countries.

“These guys just love doing that in their barn, and they bring these incredibly packed things, and then people help with loading and shipping the stuff. It’s fun,” he said.

Helping out

By donating equipment to the staff at hospitals in developing nations, physicians are helping provide universal and sustainable eye care in those countries, Dr. Walker said, adding that not all ophthalmologists can leave their busy practices, professorships or personal lives to participate in outreach around the globe.

For those physicians, giving funds or equipment may be the best option for volunteering while staying close to home.

“Doctors who are uncomfortable with operating on missions or don’t think they have the time … you can contact someone who does go on a mission and ask them what they need, and buy something for $50 or $100 or $5,000 … and without leaving your office, and you can get a dramatic return on the investment,” Dr. Walker said. “If someone can travel but does not have the inclination or wherewithal to do a full surgical mission, then simply visiting a facility to learn about their needs can be a much easier and shorter trip. The knowledge gained can then be used to help them from back in the States. For instance, physicians routinely interface with representatives from the manufacturers and are well-positioned to ask for help. … Even a tiny intervention in a country far away can make a big difference.” – by Erin L. Boyle

  • Jonathan D. Walker, MD, can be reached at Allen County Retinal Surgeons, 7900 W. Jefferson Blvd., No. 300, Fort Wayne, IN 46804; 260-436-2181; fax: 260-436-2567; e-mail: jonwalker22@gmail.com. For more information about CENAO, contact Dr. Walker.