Tibetans wearing sunglasses after eye surgery at the Nakchu eye camp in Tibet

Thank you to Mountain Equipment Co-op for the recent donation of both children’s and adult’s sunglasses for Seva’s eye care programs in Tibet.

This generous donation of $5209-worth of high-quality sunglasses will be very much appreciated by patients in Tibet who have received cataract surgery.

Tibet has one of the highest rates of blindness in the world, mainly due to cataracts. Each year, Seva conducts thousands of sight-restoring cataract surgeries in Tibet.

This photo shows patients at a Seva eye camp in Nagchu on the Tibetan plateau wearing glasses after surgery. The sunglasses not only protect their sensitive eyes from the  strong UV light, but also help to shield their eyes from dust and rubbing as they are healing.

Thank you, MEC! The glasses will be taken to Tibet this fall.

For more information about Seva’s work in Tibet, visit our website.

The Seva-supported Kham Eye Center in Dartsedo will officially open in October 2010 but is already treating patients and performing cataract surgeries.

This blind Tibetan man is one of the first patients at the new Kham Eye Center in Dartsedo. He will receive cataract surgery to restore his sight.

The region has one of the highest rates of preventable and treatable blindness in the world and the need for care is huge. The high prevalence of age related cataract blindness among Tibetans is perhaps due to high altitude ultraviolet light exposure. According to a study in the British Journal of Ophthalmology, blindness and visual impairment in the Tibet Autonomous Region are significant public health problems, with the most elderly having rates of blindness between 12% and 33%. Women in Tibet bear two thirds of the burden of blindness.The Kham Eye Centre is the first dedicated eye hospital on the Tibetan plateau.

Kham Eye Center is the brainchild of Dr. Dorjee, chief ophthalmologist and director of Kandze Prefecture People’s Hospital. Dr. Dorjee is an extremely dedicated and compassionate eye surgeon. When the devastating earthquake struck the Yushu area in April, Dr. Dorjee was in the region conducting surgical eye camps. He and his medical team rushed to the earthquake zone to offer emergency assistance and, in the first day alone, treated 800 earthquake victims.

Blind patients arriving at the Kham Eye Center in Dartsedo for eye surgery

The Kham Eye Center is a non-profit eye care institution specializing in clinical services, research, teaching and prevention and treatment of eye disease. Seva is funding the human resource development, technical and managerial mentorship, and provision of ophthalmic equipment instruments and supplies.

The goals of the Kham Eye Center are:

1. to conduct a minimum of 14,000 cataract sight restoring surgeries over the next 5 years;
2. to establish 10 vision centers by 2010;
3. to train 10 eye doctors and 10 county level nurses;
4. to establish the Center as a standard national eye hospital, using state-of-the-art technology;
5. to become the model eye care program in the Kham region;
6. to become an eye care training center;
7. and to develop as a community ophthalmology center.

“Hundreds of thousands of cataract operations are impressive, but to change one person’s life with sight-restoring surgery is magnificent. That is the reason we do it.”
Dr. Peter Nash, ophthalmologist, Seva board member and legacy donor

Here is one story of a life changed through the gift of sight.

Tsering Dolma, age 72, has been a widow for many years. Although she has a son, he works far away so she lives alone. In her village in Tibet, she is the loneliest woman because all the other older women have some family members living with them.

Since 2008, Tsering Dolma’s vision deteriorated from cataracts, but she had no idea of the reason for this, which caused many problems in her life.

One day in the summer of 2009, Tsering Dolma was leaving her house to attend a village council meeting, and she fell down the stairs because her right eye was blind and her left eye had blurry vision. The fall seriously injured her knees, and she ended up bedridden for a month.

The following winter, it snowed a lot in her village and the streets were very slippery. Tsering was afraid of having another fall, so she decided to stay at home until it stopped snowing and the snow on the ground melted. The snow, however, didn’t melt that quickly. She was stuck in her house for seven days. She recalled, “During the seven days, I felt like a prisoner because I had nobody to talk to and I was completely isolated.” Tsering often believed that she had basic good health, but without eyesight she was powerless.

In January 2010, her son brought her to the Seva-supported eye hospital in Lhasa and Tsering’s sight was successfully restored. Tsering never expected that she would be able to see again and she was thankful that it actually happened to her.  On leaving Lhasa to return to her village 1,700 kilometers away, she said she hoped to work in her barley field, visit her neighbors every day, and to travel to visit her son several times every few months. She smiled and said, “I won’t be a prisoner ever again, and I will be enjoying my life as much as I can!”

Cataract, the clouding of the lens of the eye, occurs with age. Blindness due to cataract occurs with poverty.

In Canada, almost no one becomes blind from cataract. Cataract is diagnosed early when impairment is minimal, and treated surgically, almost always restoring near-normal sight.

In low-income countries, almost everyone with cataract becomes blind. Cataract is diagnosed late when impairment is severe. When possible, cataract surgery occurs, almost always restoring near normal vision.

This teenage girl from Nepal is blind from mature bilateral cataracts. Photo from Seva Canada.

The difference between cataract in high and low income countries is not the condition or its treatment. All populations develop cataract with age. All countries offer similar high quality cataract surgery. Therefore, the difference is timing.

In Canada, cataract surgical services catch people up-stream as they age, before they become blind. In low-income countries, cataract surgical services work down-stream in the deep accumulated pool of older cataract blind.

The problem in most low-income countries is that they developed their cataract surgical service after their population aged beyond 50 years, and 5-10% of them became blind. Their cataract surgical services face this accumulated mass of cases. Meanwhile, the population ages and more and more cases pour in.

In most low income countries, there are five times as many in the pool of blind people needing surgery as the number of people who become blind every year. Even with a large investment in cataract surgical services it takes a decade or more to deal with the backlog, while meeting annual incoming needs.

Seva programs are situated where the backlog is greatest and services are least. As a result, their cataract surgical services require substantial expansion, far beyond those expected by people living in a high income country such as Canada, where cataract blindness is seldom, if ever, found.

Ken Bassett MD PhD is the Program Director for Seva Canada and Director of the BC Centre for Epidemiologic and International Ophthalmology.

This young Indian woman is blind from cataracts. Photo by Dr. Martin Spencer for Seva Canada

Here is the same Indian woman after having her sight restored in one eye through cataract surgery. Photo by Dr. Martin Spencer for Seva Canada

From The Globe and Mail, January 27, 2010 by Leslie Beck

Women who took 1,000 mg of vitamin C daily were 25 per cent more likely to develop cataracts

If you want to preserve your vision as you age, you might consider tossing your vitamin C supplement. According to a study published in the February issue of the American Journal of Clinical Nutrition, high-dose vitamin C supplements – 1,000 milligrams daily – can increase the risk of developing cataracts.

Researchers followed 25,593 women, aged 49 to 83, for eight years and found that those who took 1,000 mg of vitamin C daily were 25 per cent more likely to develop cataracts than those who did not use supplements.

Among women 65 and older, vitamin C use increased the risk of cataract by 38 per cent. Taking vitamin C in combination with hormone replacement therapy or corticosteroid medication was associated with an even greater risk.

However, getting too little vitamin C may also contribute to cataracts, since vitamin C is a potent antioxidant, protecting from free radicals. Previous research has linked higher blood levels and dietary intakes of vitamin C with a lower risk of cataracts.

The new study showed that multivitamins containing a small amount of vitamin C (60 mg) did not increase cataract risk.

A cataract is a clouding of the lens of the eye, which focuses light onto the retina at the back of the eye. When the lens is cloudy, the light is obstructed, affecting vision.

It’s thought that free radicals play a role in cataract development by damaging proteins in the lens. Free radicals are produced naturally when we breathe, but ultraviolet light, cigarette smoking and the consumption of alcohol are other sources.

People can develop cataracts in their 40s and 50s, but they’re most common after age 65. Family history, diabetes, exposure to sunlight, smoking and alcohol consumption also increase the risk.

This isn’t the first study to suggest that high-dose vitamin C supplements may harm your eyes. An earlier, 12-year study of 47,000 U.S. women revealed that long-term vitamin C users aged 60 and older were more likely to have surgery to remove cataracts and were twice as likely to develop cataracts.

It may seem paradoxical that vitamin C, a powerful antioxidant, contributes to cataract. Scientists believe that, under certain conditions, vitamin C can also act as a “pro-oxidant.” In other words, the nutrient has antioxidant activity when it reacts with free radicals, but it can also react with other compounds in cells, which leads to the formation of free radicals.

In this study, taking 1,000 mg of vitamin C daily increased the risk of cataract. But the risk was even higher in older women, those using hormone replacement therapy, and those taking corticosteroids (used to treat many conditions including allergy, asthma, arthritis, and inflammatory bowel disease). It’s thought that the combination of these factors may increase inflammation in the body and free radical production.

These findings should not be translated to vitamin C from foods. Eating at least seven daily servings of fruit and vegetables – about 3.5 cups worth – is an important way to meet daily vitamin C requirements. Women and men require 75 and 90 mg respectively; smokers need an additional 35 mg a day because smoking creates free-radical damage.

When it comes to nutrition, evidence suggests the following strategies may shield your eyes from cataracts.

Control your weight

People who are overweight, even moderately, have a higher risk of cataracts. Excess body fat around the abdomen may contribute to cataract formation by increasing inflammation in the body. Carrying excess weight also increases the risk of type 2 diabetes, a condition strongly related to early cataract formation.

Choose low-glycemic carbs

A diet of predominantly high-glycemic carbohydrates (e.g. white bread, white rice, sugary foods) is thought to increase the risk of developing cataracts by elevating blood glucose. Prolonged high blood glucose levels in the lens may increase cataract risk by causing free radical damage to lens proteins.

Choose foods that have a low glycemic index such as whole-grain breads, brown rice, pasta, steel-cut oats, legumes, nuts, citrus fruit, yogurt, milk and soy beverages.

Boost omega-3s

A handful of studies suggest omega-3s from fish oil, called DHA and EPA, protect from cataracts by helping fight inflammation in the body.

To increase your intake of omega-3 fatty acids, eat oily fish such as salmon, trout, sardines and herring at least twice a week. If you don’t like fish, consider taking a fish oil capsule that supplies 500 to 600 mg of DHA and EPA (combined).

Increase fruits and vegetables

These foods contain two natural compounds called lutein and zeaxanthin. Once consumed, they make their way to the eyes where they act as antioxidants and protect the lens from oxidative damage. Studies show that people who consume the most lutein have a 20-per-cent to 50-per-cent lower risk of developing cataracts or having cataract surgery compared to those who consume the least. Scientists speculate that an intake of six to 15 mg of lutein plus zeaxanthin per day is optimal for eye health. The best sources include kale, Swiss chard, collard greens, green peas, broccoli, romaine lettuce, Brussels sprouts, nectarines and oranges.

Reduce sodium

Research suggests that a high-sodium diet can increase the risk of cataracts by as much as twofold. Adults require 1,200 to 1,500 mg of sodium a day, half the amount most of us consume. The daily upper limit is 2,300 mg a day. Read nutrition labels and limit your intake of salty snacks and processed meats. Rely less on convenience foods and cook most of your own meals.

Limit or avoid alcohol

Studies show that compared to non-drinkers, daily drinkers have a significantly higher likelihood of cataracts. Alcohol increases free radicals that damage proteins in the lens and may also affect absorption of nutrients.

Leslie Beck is a Toronto-based dietitian at the Medcan Clinic.  Her website is lesliebeck.com.

Cataract scare opened Burnaby woman’s eyes to world

Burnaby woman, 28, realized how lucky she was to have access to good treatment

By Elaine O’Connor, The Province January 21, 2010

After a series of medical treatments, Burnaby’s Karin DuBois was shocked to be diagnosed with cataracts.

She was only in her 20s.

Thankfully, doctors assured her that the risk of losing her sight was small.

“They told me it’s such a simple surgery and that the chances of success are so high that it’s not even a concern — the chances of me going blind are very slim,” the 28-year-old recalled.

That’s far from the case for millions in the developing world.

Ninety per cent of the world’s 45 million blind live in impoverished countries; two-thirds are female.

Most of these cases are preventable. The most common cause of blindness is cataracts, which could be removed with a simple 15-minute, $50 surgery. But women and girls are only half as likely as men to get treated.

That’s one of the surprising statistics DuBois learned while creating an awareness video recently for SEVA Canada.

The Vancouver-based registered charity funds eye-care clinics and trains doctors to perform cataract surgeries in seven developing countries: Tanzania, India, Guatemala, Cambodia, Nepal and Tibet.

DuBois’ video earned her second place in SEVA’s national Her Sight Is Worth It video contest. The winners were announced Wednesday.

The B.C. Institute of Technology grad and Global B.C. assistant director said she wanted to create the video as a way of giving back.

“I’m lucky enough to live in Canada, where medical access is available. If I was in India or elsewhere, my chances of being permanently blind would be so much greater,” she said.

First-place winner Derick Groves of Victoria admitted he had little knowledge of the issue before entering the contest.

“It’s one of the things you don’t really think about,” said the 33-year-old film-school grad.

“It is a little surprising to see the percentage of women that make up the total number of blind and how little care they get.”

Third place went to Ontario-native Rhonda Kara Hanah, who temporarily lost sight in one eye after contracting an infection in Mexico.

SEVA launched the contest last fall, calling on Canadians 13 and older to submit three-minute movies about blindness in women and girls in the developing world.

The contest, sponsored by GAP Adventures and the Planterra Foundation, came with a unique reward: The group is restoring the sight of one woman and girl in the names of each of the three winners.

Penny Lyons, SEVA Canada’s executive director, said the entries served to highlight the “direct link between poverty and blindness.”

“As soon as you restore someone’s sight,” Lyons explained, “they can go to school or work, so by treating blindness in women, you are reducing poverty effectively and inexpensively, especially as it’s been very clearly documented that women are the key to sustainability in their families, communities and nations.”

The films, online at www.seva.ca/contest.htm, will be screened in 12 Canadian cities as part of the World Community Film Festival, which comes to Vancouver on Jan. 31.

eoconnor@theprovince.com
© Copyright (c) The Province

Dr. Martin Spencer, a Canadian ophthalmologist from Vancouver Island, has been selected as a 2009 Global Hero by Verge Magazine.  To read the feature by Verge Magazine about Dr. Spencer and his work, click here.

A long-time Seva board member, Dr. Spencer has transformed the way cataract surgery is done in the developing world.

Dr. Martin Spencer has volunteered overseas with Seva regularly for many years and has both preformed surgery and trained eye care specialists in India, Nepal, Tibet, Malawi, Guatemala and Cambodia. He was one of the first doctors in the world to travel to India, Nepal and Tibet to set up eye camps in remote areas. As a volunteer, he receives no funds and pays for the trips himself. He has voluntarily operated on thousands of cataract patients, transforming their lives by restoring their sight.

Dr. Spencer’s contributions go much further than providing cataract surgery to the blind. He also pioneered a modern cataract surgical technique that can be used in rough situations, such as remote mobile eye camps.

His expert program advice to Seva Canada led to the creation of a manufacturing unit in India called Aurolab, which today provides millions of intraocular lens implants annually for cataract patients, as well as surgical sutures and other sight saving products. The creation of Aurolab brought the cost of intraocular lenses down from $250 per lens to around $5, making it affordable in poorer countries and transforming the way cataract surgery is done in the developing world.

Dr. Spencer has designed several instruments for cataract surgery as well as two intraocular lenses. He has published and lectured extensively on topics related to cataract surgery, particularly in developing countries.

Marty is the recipient of many previous awards including the Lewis Perinbam Award in International Development (1997), the American Academy of Ophthalmology Achievement Award (1999) and the Achievement Award of the International Agency for the Prevention of Blindness (2004). Dr. Spencer got his medical degree in Chicago and his residency in Ophthalmology at the University of Western Ontario.  He is currently works in the Nanaimo area of Vancouver Island specializing in cataract and intraocular lens surgery.

Congratulations, Marty!

Today The Province ran a lengthy article on Seva Canada’s sight programs. Our thanks to Elaine O’Connor for the following great story:

It’s eye camp season again in Tibet. Each day hundreds of blind Tibetans are being screened by Seva for eye problems and scores of people blinded by cataracts are receiving sight-restoring surgery.

Tibetan patients queuing at a Seva cataract surgical eye camp

Seva Canada has been working for over 27 years to restore sight and prevent blindness in the developing world. We’ve been working in Tibet since 1995, where we are the dominant eye-care provider, doing two-thirds of all cataract surgeries.

Worldwide 45 million people are blind, but people don’t go blind by the millions. They go blind one personal tragedy at a time. Here is one story about someone who was blind and had her sight restored by Seva thanks to the generosity of Seva’s donors.

Patients at the Seva eye camp in Chamdo, Tibet

Last autumn in Chamdo, Tibet, a little 7-year-old boy led his blind mother by the hand to a Seva surgical eye camp. Dekyi is a 48-year-old single mother with 6 children depending on her.

Dekyi told Sonam from Seva’s Tibet office, “I never had a husband, but I have two children. Dorjee is the younger one and he brought me here. The older one, my daughter, is at home herding the animals. I became an orphan when I was just 5. My only surviving family member was my older brother and he died 3 years ago.”

She groaned, but continued with a trembling voice. “I lost my sight two years ago and since then I have been depending on Dorjee and my 12-year-old daughter for living. I hope that my sight will be restored from this operation. There is a huge amount of debt mounted from my brother’s illness and death that I need to paid off and I need to free Dorjee for schooling and to raise my brother’s four children. Their mother died five years ago and left all the kids for my brother to raise. His death left no choice for the kids than to depend on me.”

Dekyi's son Dorjee at the Seva eye camp in Tibet

She continued. “I am Dekyi. You know my that name means ‘happiness’ in Tibetan, but I’ve never been happy once in my life. My life has been all about death, loneliness, debts and now blindness. Often, I think I must have been a bad person in my previous life and that my bad karma is causing all this pain.”

Dekyi before her cataract surgery in Tibet

When called to the examination room, Dekyi quickly pulled herself together, stood up with the support of her stick and called for Dorjee who was outside playing with other children. All of the sudden, Dekyi looked pale and restless. She fumbled with her hair and pressed it down at the back and said, “This is it. The only chance I have got. What if my blindness is diagnosed as untreatable?”

Dorjee led her by the hand to the examination room. With Dorjee’s help, she placed herself on a chair in front of the slit lamp. A few minutes later, she was diagnosed with bilateral cataracts and scheduled for a surgery in the afternoon on the same day. Dorjee rushed to her and held her from her behind and buried his head into her coat and cried for a long time. He shed tears for the joy of a new hope and for all the pain borne all the years by her mother and himself. Dekyi thanked and prayed for the Buddha, drawing her palms together at her chest, and then spoke with a tearful face, “I am now feeling happy and happy for the first time in my life.” She wiped her tears with her right-hand sleeve and then followed Dorjee for lunch. Dekyi was operated in that afternoon.

Dekyi getting her eyes tested after cataract surgery

The next day, Dekyi had her vision tested and it was 6/9. She and Dorjee came to thank the Seva staff and to say goodbye. She looked much more tidy on that day than she did when she arrived at the camp. Her black hair was neat, she was smiling and she walked without the aid of her stick.

Dekyi feeling happy after cataract surgery by Seva

Carefully taking off her new sunglasses, she expressed her deep appreciation to Seva and asked that a particular message be conveyed to Seva’s donors. “Please tell all the people in your organization. They are the ones who have helped me end my bad karma and bring a glimpse of light to my life!” Tears of happiness were rolling down her cheeks as she said it.

Please consider supporting Seva Canada’s sight programs by becoming a monthly donor or giving the gift of sight. Call 604-713-6622 or visit our website at www.seva.ca.

Group photo of eye patients at Seva surgical camp Chamdo, Tibet. You can just see Dekyi in her red jacket at the top right-hand corner of the photo.

On Saturday, the Globe and Mail published a two-page feature “A Clear Vision for Better Health” about cataract surgery on Vancouver Island.

Line of blind women patients going for cataract surgery in India

The article was about streamlining the surgical process by following the Toyota Production System to make cataract surgery faster and cheaper and to save our health care dollars. Using this model, Royal Jubilee Hospital has increased its cataract surgical rate from 2,800 in 2003 to 3,900 surgeries in 2008.

Here at Seva we know all about CSR — cataract surgical rates. Our mission is to create high-volume, high-quality, low-cost, sustainable eye care programs in the developing world. The gold standard for efficient cataract surgery is our partner in India — Aravind Eye Care System.

A line of women cataract patients in India

With Seva’s help and with funding from CIDA, the Canadian International Development Agency, Aravind has become the most productive eye care centre in the world in terms of surgical volume and number of patients treated. In 2008, Aravind’s network of 5 hospitals saw over 2.7 million patients and performed over 300,000 surgeries (over 200,000 of them cataract surgeries). A cataract surgery can be performed in about 5 minutes.

It’s a good enough model for Professor Yunus, the economist and Nobel Prize winner, who is using some of his funds to build a network of eye hospitals in Bangladesh. Teams of eye specialists from Bangladesh are now being trained at Aravind.

So move over Toyota! You’re fine for cars, but if Canadians are looking for a health care revolution in eye care, they should look at Seva’s partner in India.

Imagine if you were blind from cataracts and lived in a village deep in the Himalayan region of Tibet. The world has gone dark. You can no longer see faces of loved ones. You have no way to cook or feed yourself. There are no seeing eye dogs, beeping crosswalks, or eye surgeons to help you.

Tibetan landscape. Photo courtesy of Gary Hahn

In Tibet’s under-served mountainous region, seeing an eye doctor would have likely meant a multi-day trek to Lhasa. It would cost you many months salary pay to have cataracts removed. For too many, this means a mother, father, grandparent, or even child could not have cataracts removed and would remain blind.

Since the beginning, Seva has already tried to help the most vulnerable and has reached out to remote areas where there is no care. Now, in Tibet, people needing eye care but who have no way to travel to get it, can take Seva’s new bus on the Roof of the World!

Seva's new bus in Tibet which transports blind people to and from hospital

This bus will travel to remote mountain villages, picking up blind patients and transporting them, free of charge, to a hospital in the city of Lhasa staffed by local Seva trained eye surgeons. There they will have cataracts removed and their vision restored! And after they have had their sight checked and all their post-operative care, they will be transported back to their villages. A magic bus!

Thanks to Seva’s generous donors like you, this bus will help us better reach the underserved and restore sight.

The following is a special post by Laura Spencer, a Seva volunteer:

I have been privileged to work with Seva projects in Guatemala that have been developed by amazing Seva staff. The highlight so far has been Seva’s three-day eye care outreach excursion to isolated villages, reaching indigenous Guatemalans who had never received eye care services before!

Seva eye camps - a joyful thing to witness

The three-day eye camp was funded and organized by Seva, with community development links made between the eye hospital – Vincent Pescadore in the northern region of Guatemala – and the community health promoters in various villages.

A crew of six Guatemalan eye clinic workers from Vincent Pescadore and I made the journey into the hot jungles of Guatemala’s mountainous central region. We ventured off with supplies of glasses, instruments and charts. After a four-hour drive, we arrived in Coban, the nearest town.

Outside of Coban, we transported ourselves and the supplies into a pick-up truck along with some local villagers. We made the slow, bumpy ride along the uneven, rocky road through mountains of corn and coffee fields to the community of Chilten.

The road was long, with a broken down van on the way holding us up. The difficulty in reaching the community was a testament to the difficulty the people have in reaching services on their own. Many of them had trekked even further from Chilten, from surrounding villages even deeper in the mountains.

Hundreds of people lining up to be seen at the 3-day Seva eye camp in the remote village of Chilten, Guatemala. Photo by Laura Spencer

An hour and a half later, we arrived! Over 500 people were waiting in line to receive eye care. Excitement was in the air! The eye camp was set up in a school and the children were given the day off. As a result, they were either getting their eyes checked or running around adding to the excitement!

The organizing staff quickly set up six stations for smooth service delivery. They included an area for registration, for a visual acuity exam, a consultation with the optometrist, a meeting room for cataract patients, and another location for dispensing eye glasses.

A Guatemalan ophthalmologist examines patients at the Seva eye camp in the mountainous central region of Guatemala. Photo by Laura Spencer

For patients in need of cataract surgeries, transportation to Vincent Pescadore, food, and accommodation were free of charge. Those in need of glasses were provided with them at low cost or free of charge. It is such an amazing opportunity for these people and it was priceless for me to see the people’s faces as they went through the emotions of being offered free surgery and eye care.

Seva was one of the supporters, having developed the community link between the health promoters and the hospital Vincent Pescadore. The local volunteers were an integral part of the process, acting as translators for the hundreds of indigenous people who could not speak Spanish, but the Mayan language Quechi.

The first day was a great success! Thirty cataract patients were driven the 5 hours and back with free food, board and surgeries fully paid for by Seva and partners.

Cataract patients at the Seva eye camp in Guatemala being given free transportation to the hospital for surgery. Photo by Laura Spencer

My personal contribution has been conducting research for my MA on why so few rural women are taking advantage of free surgeries, as is also the case in most developing countries. With the help from volunteers with translating, I surveyed or interviewed over 80 women over the course of the weekend, collecting information regarding the barriers to service for themselves and with regard to the women in need of eye care who were not present. I also enjoyed the company of the local children who were running around the school and waiting for me to finish interviewing their mothers and grandmothers!

Interviewing Guatemalan women at the eye camp with support from a young friend!

The second and third day we drove a few hours more to another village, meeting the needs of the other surrounding communities. More free surgeries and eye care services were delivered and received.

Just before leaving the last eye camp, a truckload of the first patients from two days before arrived. They were returning from the northern clinic where their surgeries were conducted by Guatemalan surgeons. Their post-operative eyes were healing behind their large, protective sunglasses. Accompanied by the community volunteers, they made their way home, with new hope for survival, with the ability to contribute to their family again and with an increased quality of life.

The first cataract patients returning from hospital after their sight-restoring surgeries. Photo by Laura Spencer

The six of us made the four-hour trip back to the northern eye clinic which is located in the largest, poorest and most secluded province of Guatemala, El Peten. Once we arrived, the patients from the same day and the others from the day before were either waiting for their surgery or waiting a day to have a post-operative examination. Whether through translation or directly in Spanish, the patients shared their fears and excited anticipation of their restored vision.

I will remember well many of the patients. In particular, I will remember one man who said to me, “Vision is the most important thing. Without it, all is painful.” Another patient, an older woman in traditional dress, will remain in my memory because of her smile. She smiled throughout the whole experience, which is unusual for the culture (but she would not smile for the camera, more common for the culture!). I was honoured to see her through the whole process: from the line-up for services, the waiting room for cataract care, on the bus up to the northern clinic, before, during and after surgery, at meals in the hospital and finally to see her off as she got on the minivan back to her village.

One of 500 Guatemala patients who received eye care at the 3-day eye camp. Photo by Laura Spencer

Thank you to all the donors, sponsors and Seva staff for making this eye camp a success!

Blog by Justine Spencer

Earlier this year, I had the privilege of accompanying my father, Dr. Martin Spencer, on his trip to Nepal and Cambodia. In Nepal we visited many cities where Seva supports eye care hospitals and centers: Kathmandu, Tansen, Baratpur, Butwal, Parosi, and Lumbini Eye Institute in Bhairahawa, to name a few.

As a 20-year-old university student, I don’t have any expertise to offer the program and I didn’t come in with much knowledge of how an NGO is run. After attending many meetings and seeing with my own eyes how the programs work, I began to understand. Along with the understanding, came a deep respect and admiration for Seva and its mission. I always knew Seva was doing good work, but its one thing to know and quite another to feel.

At every hospital we visited, my father was greeted not simply as an ophthalmologist who had worked with them 12 years previous, but as a friend. Although it was more than that — they revered him! He was offered not only hugs and handshakes, but gifts and garlands of fragrant magnolias that were placed around his neck with a beaming smile. The training he had offered the local hospital staff so many years ago have had profound effects on the program, and they were understandably appreciative.

Sometimes it’s hard to look past the big picture of Seva’s amazing projects and undertakings. But I think it’s important to remember that it all comes down to the patients. Every patient has a story. The stories are unique, but there are trends I observed among patients that are hard to miss: many arrive blind and, as a result, expressionless. Their interactions are cold. The next day they can see and it’s the closest thing I’ve witnessed to a miracle. They are suddenly glowing with warmth and overflowing with emotion: joy, gratitude, relief, and all areas in between. I can’t imagine what that would feel like, but I feel very fortunate to have been able to see this happen, to feel it.

I also feel fortunate to have been able to interview some patients and hear their stories. It is the best way I can communicate to the rest of the world how it feels to witness this miracle.

Justine Spencer with Mr. RP Kandel of Seva Nepal, interviewing a cataract patient prior to her surgery

A huge thank you to Shelagh Smith, Rob McClure and all the people in Whitehorse who made last night’s fundraiser for Seva Canada (www.seva.ca) a big success. About 80 people attended and raised $1,000 for the Kham Eye Centre in Dartsedo.

Tibet has the highest rate of blindness in the world. Cataract is the leading cause of blindness in the Kham region, as it is in other Tibetan regions. Cataracts can be removed, and sight restored, with a relatively simple and highly cost-effective operation costing about $50, yet the cataract surgical coverage in the area is just 40%; 60% of patients remain untreated. Seva is trying to change this.

A 50-bed eye hospital, the Kham Eye Center, is currently being built in Dartsedo and will open in 2009. The Kham Eye Center will be a non-profit eye care institution specializing in clinical services, research, teaching and prevention and treatment of eye disease. Seva is funding human resource development, technical and managerial mentorship, and provision of ophthalmic equipment, instruments and supplies. The Kham Eye Care Center will have a multitiered pricing system to make the eye care more affordable and accessible to all patients in the community. The ultimate goal of the Kham Eye Center is to build a high-quality, sustainable, accessible, affordable eye care system.

It’s pretty amazing to think that for the price of a condo in Vancouver (even after the slump), you can equip an entire hospital, train the staff, help set up 10 vision centers and provide medical materials and surgical supplies for 4 years. Cost: $825,000. Gifts of sight for thousands of Tibetans for generations to come: priceless!

The goals are:
- to conduct a minimum of 14,000 cataract sight restoring surgeries over the next 5 years;
- to establish 10 vision centers by 2010;
- to train 10 eye doctors and 10 county level nurses;
- to establish the Center as a standard national eye hospital, using state-of-the-art technology;
- to become the model eye care program in the Kham region;
- to become an eye care training center;
- and to develop as a community ophthalmology center.

Thanks again to all the folks in Whitehorse for your generosity and compassion.

Grateful Tibetan patients at a Seva eye camp in 2008

Yesterday we received this very moving story from Guatemala:

Fidelia Silverste Fajardo, age 84, began to lose her vision 20 years ago, making it nearly impossible for her to do her daily activities at home like cooking for her five family members and cleaning the house. Fidelia lives with her family in the town of San Jose which is a few miles from the Mercado Municipal. One of the consequences of her vision loss was a bad fall that caused her to fracture both hips. With little sight and the inability to walk, she was limited to a wheelchair. Fidelia thought that her life was over being bound to a wheelchair and unable to see. She felt useless because she could no longer contribute to her family. In Guatemala, the working poor work and contribute to their families till the day they die. Without a purpose Fidelia was starting to lose hope. Also, Fidelia’s family was beginning to struggle to care for her. Someone had to stay home from work to take care of her. This meant a loss in one person’s wages. This was a loss that the family, which was already struggling, could not afford. Then a member of her family found out about Seva’s partner, Visualiza, where Fidelia was diagnosed with cataracts resulting in light perception visual acuity in both eyes.

She had surgery on her right eye first on February 12, 2009 and she received an operation to her left eye on February 26, 2009. After the second surgery she told the doctors, “I am so happy that I can see again and little by little I am able to walk. I am able to cook and serve my family. I thank you so much and do not know how to pay you. May God bless you for helping me!”

Fidelia Silverste Fajardo, age 84, after both cataract surgeries