John A. Hovanesian
When P. Jeffrey Colquhoun, MD, arrives at the Zimba Eye
Clinic in Zambia, he is greeted by the many individuals waiting outside the
clinic for ophthalmologic care.
“The day we arrive, there will be a line of a
couple hundred people circling around the clinic who are hoping to get in that
day,” Dr. Colquhoun said. “Sometimes it takes a couple of days before
they get in.”
While people wait for surgical care, they camp outside
the clinic, sleeping on concrete, he said. After surgery, they sometimes embark
on a 2- or 3-day journey home.
“For a lot of folks, it’s a week out of their
lives to get eye care. It’s really a phenomenal investment of time
compared to what we’re used to here in the U.S. [We have] a short drive to
the ambulatory surgery center, 15 minutes of surgery, home an hour later, out
to lunch, and it’s barely a blip in your day’s schedule to get
cataract surgery,” Dr. Colquhoun said.
Volunteering at the Zimba Eye Clinic has been a
continuation of Dr. Colquhoun’s outreach work since he graduated from
medical school more than 25 years ago. He said he wanted to give back after
earning a medical degree in ophthalmology. He has worked with numerous
volunteer organizations and Christian missions as part of his faith and a
personal and spiritual mission to help others.
|Placement of an IOP amniotic graft post
pterygium at the Zimba Eye Clinic.
Image: Colquhoun PJ
“It’s a good thing to get out of our comfort
zone every now and then,” Dr. Colquhoun said. “We kind of rise to a
higher cause and learn a lot about ourselves and about our maker when
we’re not in our comfort zone. There’s a lot of personal, spiritual
growth when I’m on a mission trip, and I also feel I’m walking the
walk that I should be when I’m thinking not just of myself, but of
There is a great need for ophthalmic outreach work in
Zambia, according to Dr. Colquhoun. The country is facing a shortage of
physicians to meet the rising need for ocular care. Several years ago, it was
estimated there were only eight to 10 ophthalmologists to care for the
country’s 12 million residents, he said. Zambia compares in size with the
state of Texas, which has nearly 1,000 ophthalmologists, he said.
In a 2-week period, surgeons screen 500 to 700 people,
performing surgery in 100 to 200 cases. The most common eye condition that Dr.
Colquhoun and colleagues treat at the clinic is cataracts, which accounts for
about 75% of all surgeries, with trachoma the next most common. He and
colleagues also perform lid repairs, glaucoma procedures, pterygium excisions,
and removal of squamous cell carcinoma and other tumors.
In addition to the other ocular conditions seen at the
clinic in Zambia, the ocular manifestations of AIDS/HIV are also prevalent
concerns there, Dr. Colquhoun said, adding that Zambia has one of the highest
rates of AIDS/HIV in the world, at about 17%.
At the Zimba Eye Clinic, he and colleagues have treated
a variety of AIDS/HIV-related eye issues, including conjunctival tumors,
squamous cell carcinoma and cytomegalovirus retinitis. The AIDS/HIV epidemic
has decimated certain age groups in Zambia, where the average life expectancy
is 37 years.
“You don’t see that many older people, and
it’s largely because of AIDS,” he said. “We see a lot of kids
with grandparents — the grandparents escaped the HIV epidemic, but we see
a grandparent, relative or sometimes an older sibling taking care of a younger
sibling because one or both parents have died from AIDS.”
The international push to address the rising AIDS/HIV
rate in Africa and in Zambia, specifically, has helped to reduce the rate from
20%, Dr. Colquhoun said. One of his first trips to Zambia was with Rick Little,
co-founder of the outreach organization Friends of Zambia. That trip, a
“Seeing is Believing” trip, highlighted the overwhelming need for eye
care in the country.
Subsequent to that trip, the Bill and Melinda Gates
Foundation, several pharmaceutical companies, the U.S. government and others
have supported the initiative to supply antiviral medications to the country.
“That brought light to a dark situation,” Dr.
Many hats of volunteerism
Friends of Zambia is one of several groups that Dr.
Colquhoun volunteers for in Zambia. His initial outreach work was with Medical
Ministry International, mainly in the Caribbean. That group, based in the
Dominican Republic under director Willie Hunter and physician Juan Battle, MD,
is one of the largest short-term mission project organizations in the world, he
His work now with the Zimba Eye Clinic, through
International Vision Volunteers, is somewhat different.
“This modern clinic built in 2003 is visited by
about six teams typically for two weeks each visit during each year. The
equipment was donated largely by Alcon, including a Legacy phacoemulsification
machine, mechanical vitrectomy, YAG laser, and slit lamp. There’s a local
staff that remain at the clinic. There’s a business director and a
clinical officer, who acts like a physician assistant, screens, sees patients,
and performs minor surgical procedures,” he said. “Also, the director
will market an upcoming team’s member names and dates up and down the
highways on signs. Apparently, that’s the most effective way for people to
see when an eye team is coming.”
The balance between outreach work, private practice and
his personal life has been challenging, but the rewards have been worth the
struggle, he said.
“It’s not perfect. Things get out of bounds
with my practice and family life here, but it’s something that takes a
limited amount of time and energy that bears its own rewards,” Dr.
Colquhoun said. “My observation is that anyone who goes once has a
compelling urge to go again on a mission trip.” – by Erin L. Boyle
- P. Jeffrey Colquhoun, MD, can be reached at Southwest Michigan Eye
Center, 3600 Capital Ave. SW, Suite 203, Battle Creek, MI 49015; 800-274-6699;
fax: 269-979-6381; e-mail: firstname.lastname@example.org; Web site: