Seva Canada: A Solution in Sight

It’s now been just over two months since the devastating earthquake hit Yushu (Jyekundo). The official final death toll from the 7.1-magnitude earthquake on April 14 was 2,698, with 270 people missing, according to the authorities. We are told it was far higher.

We wanted to share with you the picture album below and to update you on the outcome of Seva Canada’s fundraising efforts and the use of your gifts. If you can’t access the pictures, let us know by emailing admin@seva.ca. These photos were taken by Kunga, Seva Tibet’s Program Director.

As a recap – 100 per cent of the Seva Canada board and staff donated specifically to the immediate relief efforts, together with some close Seva family, raising a total of $7,100. In addition, generous Seva donors contributed $5,072 towards the rebuilding of the eye care programs in the Yushu region. The pictures below show our relief efforts. The rebuilding of the eye care programs is a longer-term effort.

The Seva team and convoy of three trucks led by Kunga distributed 70 tons of food, water, clothing and tents for those severely affected. Our convoy was the first to arrive with tsampa (roasted barley flour), yak butter and black tea – the traditional food of the area. Shortly thereafter, the princess Rinzin Wangmu (the late Panchen Lama’s daughter) led a relief convoy of nine trucks and our team stayed on site to assist with that distribution. The princess summoned around 300 monks at the mass funeral to pray for those who lost their lives during the earthquake. There are pictures of all of this in the album below including the procession and the cremation site.

The hospital where our eye unit was located is being torn down due to structural damage. They are using a field hospital now and have short-term plans for a series of prefab buildings and eventually a new hospital. There is a picture of Dr. Norwu, the eye doctor we trained, sitting with Kunga in front of his tent… he too lost everything. The eye department is housed in a tent now but most of the equipment was removed in the immediate aftermath of the quake and warehoused. We have not been able to locate it (as of last month). The Zeiss microscope we had provided fell and the head was damaged. It will go to Beijing for repairs as soon as we can recover it from the same warehouse.

Next steps – we continue to work on re-establishing eye services to the community. We are planning to buy some new equipment and to fully re-supply the clinic with the funds raised. We’ll be doing our usual eye camps that include screening and surgery for Yushu and the surrounding communities. Hopefully there will be a prefab structure soon where the eye department can be housed before the onset of winter.

If you would like to contribute to the rebuilding of the eye care programs in this area, please visit https://app.etapestry.com/hosted/SevaCanada/OnlineDonation.html

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Italian researchers have demonstrated the long term effectiveness of using stem cells to cure corneal blindness. From 1998 to 2006 the team, headed by Graziella Pellegrini at the University of Modena, performed 125 stem cell procedures on 112 patients, all who had lost partial or complete vision due to chemical or thermal burns. Stem cells were taken from the limbus in the patient’s own eye, cultured, and then grafted back on the eye. As recently published in the New England Journal of Medicine, the grafts had a success rate of 76.6% – leading to restored or improved vision. Better still, the positive results have lasted – one patient has been followed for more than 10 years and still has healthy vision. That’s remarkable. This work represents a real group of people who have already had their lives radically changed through stem cell treatments. More patients all around the world may see benefits from this technique soon.

Using grafts of stem cells to treat corneal blindness isn’t a new idea. Pellegrini and collaborators like Michele De Luca, were pioneering different versions of the technique back in 1997. We’ve seen related approaches to restoring damaged corneas, most notably in New South Whales. This report in NEJM, however, has something that few (if any) have presented before: a relatively large sample set that shows positive results verified over the long-term. Ten years for a successful stem cell transplant? Outside of bone marrow grafts, almost no one has that kind of follow-up history for stem cells. It’s a great sign that what Pellegrini and colleagues are doing is a viable long term cure for corneal blindness.

These before and after pictures are astounding. The top example required no further surgery to correct vision, but the others need keratoplasty.Notice the small notations in the right picture that indicate how long after treatment the images were taken. The arrows in the last row highlight that blood vessels no longer intrude onto the cornea.

The NEJM article also describes an important development in being able to predict the success of a stem cell treatment. Many of the patients in the study had mild to severe limbal damage, limiting the amount of healthy stem cells that could be harvested and cultured. Pellegrini’s team monitored levels of p63 transcription factor in the stem cells they harvested from patients. When the number of ‘p63-bright’ cells was greater than 3%, the success rate of the eventual transplant ended up around 78%. When it was less than 3%, the outcome was successful only 11% of the time. This work demonstrates that very little of the limbus need remain healthy for the stem cell transplant to still work. Using p63 levels as a metric could allow doctors to present patients with a better idea if a corneal stem cell transplant would be successful. It also hints that p63 transcription factor could be augmented or controlled in some way to improve stem cell therapies of this kind.

Amidst all the success in this recent report, we must also face some serious limitations of the work. First, these stem cell treatments were only used for corneal blindness. Not only that, but a very specific cause of corneal blindness – burns. Chemical and thermal burns can cause a wide variety of injuries to the eye, but often leave all parts of the inner eye and optic nerve functioning. Some patients retain some form of (very limited) vision. Also, because of the nature of the causes of these injuries, more than 78% of the 112 patients were men. While thousands lose their vision to chemical accidents every year, there’s a huge number of people with vision problems related to other corneal damage, retinal damage, and nerve damage that are unlikely to benefit from this technique in stem cell transplantation.

It’s also important to note that while the study followed one patient for more than 10 years, the average follow-up was closer to three years (with large variation). That’s still pretty good, but it’s not the same as saying that all 112 patients were tracked for a decade. As always, smaller data sets mean data has to be taken with a grain of salt.

Finally, I should point out that the term ‘positive results’ covers a wide range of changes in vision. A few went from seeing nothing to having restored vision. Some patients went from only being able to see the vague outline of fingers to actually being able to read and determine fine shapes. Others saw more modest improvements, and 24% failed to benefit. These changes didn’t happen overnight; they often took many weeks or more than a year to develop. About half of patients needed keratoplasty (reshaping of the cornea) to correct their vision, though that is a relatively simple procedure these days. Bottom line, it wasn’t like these patients got an injection of their own stem cells and could miraculously see the next day. Stem cells taken directly from their eyes had to be cultured and then grafted onto the cornea, and there was a sustained period of follow-up and further medical care before doctors or patients knew how successful (if at all) the procedure would be.

Still, these results are real world examples of how stem cells are already treating a loss of vision. Pellegrini and her colleagues may be able to adapt their technique to treat other (more common) forms of corneal blindness with the same impressive outcomes. Their confirmation of the importance of p63 transcription factor could also prove helpful in the wider field of regenerative medicine. This work is another victory for stem cells and another step towards being able to regenerate or regrow every part of the human body. I’m deeply impressed.

[image credits: Rama et al NEJM 2010]
[source: Rama et al NEJM 2010]

On Friday June 4th, over one hundred women golfers teed off to raise funds to restore sight to women and girls in Africa.

The Marine Drive Ladies Golf Tournament, organized by Diane Hardouin, was a resounding success and raised $15,700 to provide eye care through Seva’s programs in Tanzania.

Our thanks to Diane Hardouin for her months of hard work and to her fellow committee members, Esther Adamson, Dianne Cook, Sue Biddle, Naz Remtulla, Louise Forsythe, Lynn Neilsen, Carolyn Butt, Margaret Gillis and Michele Holwill. Kudos to David Hardouin and his hardworking  group of guys; Tim Tait and his great team of professionals; Wade Hawksworth and his links crew; Haymond Ng and the clubhouse staff; and Ron Pauls and the office personnel. Special thanks to Kara Koszman, and a huge thank-you to Michele Greatrex for her undying support and optimism.

Our thanks also to all the golfers and to these generous donors:

Esther Adamson
Marj Allen-Balance Group, Macdonald Realty
Mayzelle Allen
Susan Biddle
Joanne Brydon
Lynn Buntain, Buntain Insurance
Carolyn Butt
Canaccord Wealth Management
Tosh Chu
Judy Clarke
Dianne Cook
Rose Chung
David Hunter Garden Centres
Teri Dwane
Dynamic Funds
Deb Faurot, Unique Gift Baskets
Rosemarie Gallagher
Haida Forest Products
Scott Hall, Hall Wealth Management
Michele Holwill and Ken Labron, Assante
Dave Mills, Hub International TOS Limited
Picton Mahoney Asset Management
Al and Naz Remtulla
Riverside Golf Centre
Sentry Select Capital
Linda Sung
Lorraine Sung
Tim Taint, T2 Development Inc.
Tradewinds Consulting & EDRT Environmental Response
Bryan Uyesugi, Freshpoint
Peeyush Varshney
Nosh and Nina Vellani
Vertexone
Barb Whidden
Alan Wong

Tournament organizer, Diane Hardouin (left) with Seva's Executive Director, Penny Lyons

Huge thanks to Zaf and all the folks at Delta Optical‘s four locations.

For the month of June they are donating $30 to Seva Canada for every pair of glasses sold.

For 40 years, Delta Optical has been providing exemplary customer service and has built lasting relationships with their customers. The small optical chain provides service in Square One, Fairview Mall, Hillcrest Mall and Oakville, Ontario.

Here’s their wonderful poster: