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Initiative
Eyes in the Sky
On its silver jubilee, the Flying Eye Hospital of ORBIS landed
in Mumbai. Express Healthcare writes about the unique teaching and medical
technique of the organisation
 To
be trained aboard a plane in the latest in ophthalmology sounds like a world
of fun. Well, that is exactly what ORBIS's Flying Eye Hospital (FEH) does. It
flies a McDonnell Douglas DC-10 jet to 80 countries to treat ophthalmic cases
and train ophthalmologic surgeons, optometrists, biomedical engineers and nurses.
So far, it has treated over four million people and trained over one lakh professionals.
According to the World Health Organisation, 37 million people worldwide are
blind — 28 million unnecessarily. A cure is often simple and inexpensive,
but in the world's poorest countries, even basic medical help is frequently
out of reach. This is where ORBIS International steps in. The organisation strives
to eliminate avoidable blindness and restore sight in the developing world,
where at least 90 per cent of the blind and visually impaired live.
Dr David Paton, a Houston-based ophthalmologist, first conceived the idea of
an airborne teaching eye hospital. ORBIS launched the FEH to prevent and treat
avoidable blindness in 1982.
Targeting the largest chunk of global blindness, over 12 million blind Indian
people, the unique teaching technique of ORBIS is helping treat blindness in
the remotest corners of the country. An estimated 75 per cent of India's 12
million blind people suffer from avoidable blindness because of the country's
limited eye care infrastructure that has only one eye surgeon per 1,00,000 people.
Destination Mumbai
An eye surgery in progress in the Flying Eye Hospital |
In its 16th visit to India, the FEH landed in Mumbai for two
weeks (March 30 to April 10) training over 120 ophthalmologists, 50 optometrists,
six biomedical engineers and 12 nurses participating in skills exchange, surgeries
and lectures. During this programme, 154 patients were examined and 32 patients
received surgical treatment on board at the FEH.
According to Dr GV Rao, Country Director, ORBIS India, "The
topics in training this time were public policy and biomedical engineering,
and for the first time, optometry. Special emphasis was laid on paediatric glaucoma,
paediatric ocuplasty, orbital disorders, paediatric retina diseases, paediatric
strabismus and corneal diseases and ocuplasties."
This was also the first time the EYESI Virtual Reality Simulator
came to India. The $10,000 EYESI is a virtual reality training system for ophthalmic
surgery that uses advanced computer technology to simulate the feel of real
surgery, making it possible for surgeons at all levels to acquire new skills
and to perfect the techniques in preparation for surgery on the human eye. Completion
of an EYESI course is recognised with CME credit from the University of Indiana,
US.
ORBIS has also harnessed the reach of the Internet and established a website,
a telemedicine initiative that connects doctors in India with ORBIS volunteer
ophthalmologists who provide one-on-one mentoring and case-by-case patient consultations.
- Since ORBIS conducted its first sight-saving
mission in 1982.
- More than 900 sight-saving training programmes
have been carried out in 85 countries.
- More than 450 volunteer faculty (ophthalmologists,
nurses and biomedical engineers) from five continents have participated
in ORBIS programmes.
- More than 1,20,000 healthcare professionals
have received training from ORBIS.
- More than 3 million patients have received
direct treatment from ORBIS and ORBIS-supported programmes.
- More than 27 million patients are estimated
to have benefited through ORBIS medical training programmes.
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Partnership Programme
 The
training programme is a unique partnership between ORBIS and FedEx. The first
such programme in India, was held in Hyderabad when FEH landed in 1988. So far,
it has come to cities like Delhi, Chennai and Kolkata.
A permanent office was set up only in 2000 in Delhi. In partnership with the
Government of India, a national paediatric eye care programme has been launched
in seven Indian states. ORBIS has already established nine child-friendly paediatric
care centres and another 11 are under way.
"In Maharashtra, more than 4,00,000 children have been screened by four
paediatric eye care centres since 2004. By 2010, we plan to set up more than
50 centres across the country," says Dr Rao, adding, "Our focus is
capacity building of local doctors, identifying difficult cases and making treatment
affordable. So far, we have screened over 10 lakh patients, conducted over 50,000
surgeries and trained over 4,000 doctors."
Says Oliver Foot, ORBIS President and Executive Director, "Our consolidated
support, through the FEH and continuous in-country presence, will result in
a greater number of skilled professionals, who in turn will be able to treat
those hoping to preserve or regain their sight."
Prior to the start of a FEH programme, local doctors pre-select patients whose
conditions are relevant to that particular training programme. Selected patients
are then screened by ORBIS volunteer faculty members once they arrive at the
programme site. Patients given priority are bilaterally blind, cannot afford
to have the surgery otherwise, and represent good teaching cases. Local doctors
maintain oversight of patients before, during and after surgery.
By training local doctors and healthcare workers, who in turn train their colleagues,
ORBIS is strengthening the capabilities of local healthcare communities to prevent
and treat blindness. "The focus of the programme is paediatric ophthalmology
as it is a highly specialised arena. More than 3,20,000 children in India suffer
from avoidable blindness," says Dr Rao.
- In partnership with Shri Ganpati Nethralaya,
this programme aims to reduce childhood blindness in the Marathwada
region of Maharashtra by providing quality eye care services. Doctors,
teachers and primary healthcare workers will all receive hands-on training.
- In partnership with Lions Nab Eye Hospital,
this programme aims to reduce the burden of avoidable childhood blindness
in Southern Maharashtra.
- A paediatric ophthalmology unit will be
established with an outreach component and a team will be trained at
Aravind Eye Hospital to increase the productivity of the hospital.The
partnership with Bangalore’s West Lion's Eye Hospital is focused
on combating childhood blindness in Karnataka. A fully-equipped paediatric
department will be established and training will be initiated for clinical
and non-clinical staff. A vision centre will be set up, mothers and
caretakers will be educated in primary eye care, and people will be
informed about eye care issues through media and educational efforts.
- An initiative in partnership with Little
Flower Hospital in Angamaly, Kerala, the goal of the Kerala Childhood
Blindness Project is to reduce avoidable childhood blindness in the
state by providing paediatric eye care services.
- n "In FY 06, we'll begin to set up
a well-equipped paediatric department as well as begin training clinical
and non-clinical staff,"says Dr Rao. This one-year project will
be implemented in partnership with Kalinga Eye Hospital (KEH) in central
Orissa. The goal is to support the increase of surgical cases, expand
infrastructure, and convert KEH into a tertiary referral centre. Both
adult and paediatric cataract surgeries will be performed, and doctors,
paramedics, teachers and primary healthcare workers will receive training.
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The In-flight Classroom
 "More
than 3,20,000 children in India suffer from avoidable
blindness"
- Dr GV Rao
Country Director
ORBIS India
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The aircraft has operation theatres, patient waiting space,
a consultation room, a technical support area and a training room. The team
of experts consists of ophthalmologists, nurses, orthoptist, eye banking personnel
and biomedical engineers from various nationalities.
In the 48-seat classroom, doctors gather for lectures, discussions and live
broadcasts of surgical procedures being performed in the FEH operating room.
"If needed, surgeries are also broadcasted to an additional classroom outside
the aircraft," says Dr Rao. Large numbers of trainees can observe the surgeries
and ask questions of the operating surgeons via a two-way audio-visual system.
Upon the FEH's departure, videos of the surgical demonstrations are left with
local institutions to be used in further training. As part of ORBIS's commitment
to ongoing quality care, an ORBIS ophthalmologist returns to the host country
within two months of each programme to examine patients and review cases with
local doctors.
Hands Across the World
This FEH programme has brought together eye specialists from around the world
for an intensive skills exchange. Besides the training programme, ORBIS International
works in long-term national blindness prevention programmes in countries like
Bangladesh, China, Ethiopia, India and Vietnam.
The FEH was made possible with support from hospitals like Aditya Jyot Eye Hospital,
Lotus Eye Hospital, HV Desai Eye Hospital, PD Hinduja Hospital, LTMG Hospital
and associations like Maharashtra Eye Bank and Eye Hospital and Maharashtra
State Ophthalmic Society. In January, an ORBIS study among parents in Maharashtra
found a low level of awareness about child blindness. The study showed that
while 20 per cent of the children surveyed suffered from some form of eye disease,
more than 50 per cent of parents were unaware about this.
In a country where 30 per cent of childhood blindness is preventable, the noble
efforts of ORBIS would definitely make some impact in reducing the huge burden
of blindness.
healthcare@expressindia.com
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