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global health

This Flying Hospital Trains Doctors to Fight Blindness Around the World

The majority of blindness cases are in the developing world a lot of them could be prevented or treated.

Clara Hogan

Orbis International

Outside of America, where eye exams are a yearly routine (albeit crazy expensive if you're not covered), eye care is rare and limited for millions. In fact, the number of people suffering from blindness is growing so rapidly, it’s on track to be one of the most pressing global health threats in the next few decades, according to the World Health Organization.

One of the medical facilities targeting the growing epidemic is actually equipped with wings. The world’s only “Flying Eye Hospital” is an MD-10 cargo plane donated by FedEx, tricked out with state-of-the-art equipment and technology. The plane travels to countries with the highest needs, bringing sight back to patients and training local doctors on the technical skills required for eye procedures and screenings.

The global operation is run by Orbis International, a nonprofit that fights blindness in low-income countries, where the majority of eye conditions take place. Out of the 253 million blind or visually impaired people globally, a full 90 percent are in the developing world, and 4 out of 5 of those cases would be completely treatable or preventable with access to appropriate healthcare, the WHO says. Most alarming, that overall number is expected to triple by 2050.

“It’s going to be an absolute tsunami—the definition of an epidemic—and we need more doctors to be able to tackle it,” says Antonio Jaramillo, Orbis’ head ophthalmologist. “Losing your eyesight is an economic catastrophe in these countries. For children, it may mean not being able to attend school. For adults, it likely means you can’t work, which can send your entire family into poverty.”

Orbis International

Orbis has run the flying hospital since 1982, but it’s evolved and been updated over the years. The plane (and equipment) they use today is new, debuting last year. The aircraft recently landed at Moffett Federal Airfield in San Francisco to restock on supplies, where I stepped aboard for a tour.

From the outside, the plane looks like any normal airliner. When you enter, though, instead of rows of tightly packed chairs and overhead luggage bins, there’s a spacious medical facility. I’m told that the whole enterprise is completely self-sustaining, providing its own hospital-grade oxygen, water purification system, and generators to power equipment.

There’s a patient screening area, complete with teddy bears waiting for pediatric patients, as well as an operating room equipped with 3D technology that allows surgeries to be broadcast live to the 46-seat classroom in the front of the plane where local doctors watch on virtual-reality headsets and ask questions through two-way communication. That feed is also broadcast through a tool called Cybersight to partner hospitals around the world with the use of Google Cardboard.

“We might have a couple of doctors in the operating room and a few dozen in the classroom up front, but we can also bring in an audience from 50 countries at the same time that get a very similar experience,” Jaramillo says.

Every year, more than 400 medical volunteers—including many of the top ophthalmologists in the world—travel with Orbis on the plane, treating patients and teaching local trainees how to screen for and treat commonly cured diseases such as cataracts, glaucoma, strabismus, as well as diabetes-related eye conditions.

In fact, diabetes is a driving reason behind the projected growth in blindness; the number of people with the disease has grown from 108 million in 1980 to 422 million in 2014. That’s a trend that’s expected to continue, most rapidly in low-income countries. Blindness among children is another large focus. An estimated 19 million children are vision impaired, and for them, their conditions are time-critical because they affect the brain's ability to develop properly and, if left untreated, can become incurable later in life.

Pravin Dugel, an Arizona-based retinal surgeon, has been closely involved with Orbis after he took his first trip to Thailand with them 15 years ago. Dugel, a refugee from Nepal, also had the opportunity to return to his home country several years before the 2015 earthquake and use his connections after the disaster to help with relief efforts. He’s stayed loyal because of the company’s dedication to building networks, above all. “We don’t just drop in and leave,” he says. “We train local doctors, nurses, anesthesiologists, even people who repair machinery, and create ongoing partnerships with hospitals and countries.”

Orbis International

The team recently went to Cameroon, a country with only 73 ophthalmologists for 23 million people. Trips are planned 12 to 18 months in advance and are just one aspect of a partnership. The first day or two of a trip can be the hardest, Dugel says, as visiting doctors head into local clinics and witness the enormity of the situation on the ground.

“You see long lines of hundreds of patients, these are often people who have traveled for days and sold many of their possessions to get there with young kids in hopes you can fix their eyes or their children’s eyes,” Dugel says. He says the most difficult part is that for the majority of the people they see, their disease is already so advanced that it’s impossible to fix.

The rest of the trip, when procedures get underway both on the plane and in local hospitals, is typically more hope-filled. “The plane is packed from 8 am to 8 pm—the local doctors and staff are so hungry for knowledge and to provide better care,” he says. “At the same time, you’ll see children or families ecstatic to have their eyesight back. It’s enlightening and invigorating.”

In one particularly memorable incident, Dugel recalls meeting a woman, blind in both eyes, who came to him for an exam. He learned that when the woman’s husband died, she began to work as a maid to provide for her two children but lost her job when she became blind from diabetes. Unable to work, she was forced to give her children away and left to beg on the streets. After examining her, Dugel noticed blood in her eye—a condition that requires one of the simplest procedures to fix. After about 15–20 minutes, she was able to see again.

“I last heard that she was off the streets and working as a maid again, though still unable to find her children,” Dugel says. “You can’t help but think, none of that pain and suffering had to happen, it could all have been prevented.”

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