Seva supporter, Michael Buckley was in Cambodia recently and kindly offered to journey to Battambang, in the far west of the country, to see and photograph Seva’s eye care programs there.

During the genocide, Cambodia’s health care system was devastated and the country was left with just one ophthalmologist. Now Cambodia has 9 ophthalmologists serving a population of 14 million and Seva has helped train over half of them.

There are about 168,000 Cambodians who are blind — and, as is true in nearly all poor, developing countries, 80% of this blindness is due to preventable or treatable conditions such as cataract. The backlog of cataract blind is estimated to be 90,000 people and there are a further 20,000 who go blind from cataract each and every year.

View Michael’s Flickr slideshow which gives a glimpse of the incredible work being done by the team in Cambodia.

Source: New York- Presbyterian

A physician at New York-Presbyterian/Columbia University Medical Center, using an experimental electronic retinal implant has been able to partially restore the sight of a woman previously blinded by retinitis pigmentosa. The woman is able to see light and make out figures for the first time in 20 years, explained lead researcher Lucian V. Del Priore, MD, PhD, an Attending Surgeon at New York-Presbyterian Hospital and a Professor in the Department of Ophthalmology at Columbia University College of Physicians and Surgeons.

The retinal implant is currently being investigated for the treatment of retinitis pigmentosa, a progressive disease that causes degeneration of photoreceptor cells in the outer layer of the retina. The inner layers of photoreceptor cells still function in patients with retinitis pigmentosa so the implant is used to bypass these damaged cells to reach the healthy ones.

How the Device Works

The device works as a three-part system. The first part is an external video camera that is mounted on a pair of eyeglasses worn by the patient. That image is processed and then a signal is transmitted wirelessly to the second part of the system – a microprocessor implanted on the outside of the eye under the lid that translates the information into a series of electrical pulses.

Those electrical pulses are then sent to the third part: a tiny patch containing 60 electrodes that is attached to the retina. The electrical stimulation from the electrodes causes retinal nerves to transmit a message through the optic nerve to the brain. The brain then interprets the electrical stimulation into light and dark spots that form an image. The images seen are rudimentary. However, for a patient who has had no vision initially, the level of vision afforded by this device can represent a remarkable improvement, Dr. Del Priore said.

The device works best with high contrast images (eg, a white object on a black background or vice versa) and at night, when there is high contrast between lighted objects and the dark background. The patient who received the device five months ago at NewYork-Presbyterian Hospital/Columbia University Medical Center is now able to see large letters on a computer monitor and she also describes being able to see street and traffic lights as well as light coming in through the window of her front door. Her vision continues to improve, Dr. Del Priore said.

Learning to use the implant properly requires a major commitment on the part of the patient, as it takes several years of rehabilitation to learn how to use the device and interpret the patterns that the patient sees. This part of the visual training involves using direct electrical stimulation of the retina; successful interpretation of the image by the patient requires that she participate in one day per week of visual training in a laboratory and then practice the techniques learned at home. The visual training includes, for example, asking the patient to find shapes on a computer screen and point to them, allowing the patient to relearn eye-hand coordination.

The surgery required to implant the device took approximately 5 or 6 hours with the patient under general anesthesia. While the patient treated by Dr. Del Priore and colleagues did not experience any serious side effects, he said that there are surgical complications that can result from surgery of that length, such as infection, low eye pressure, and movement of the device after surgery.

Currently, the device is only being investigated for use in the treatment of retinitis pigmentosa. Dr. Del Priore said that patients with conditions like macular degeneration would not benefit markedly from the current generation of the implant device, as the additional vision gained from the device is not worth the risk of surgery and length of rehabilitation the patients would have to undergo. Dr. Del Priore believes that the technology will continue to improve and offer a higher image resolution in the future. “At that point, we will have more experience and it is likely that use of multi-electrode arrays will likely expand to other eye diseases,” he said.

Faculty Contributing to this Article:

Lucian V. Del Priore, MD, PhD, is an Attending Surgeon at NewYork-Presbyterian Hospital and a Professor in the Department of Ophthalmology at Columbia University College of Physicians and Surgeons.

For a what is supposed to be a rare eye condition, I’ve heard way too much about retinoblastoma cases lately.

Just the other day an ophthalmologist friend in Vancouver mentioned seeing a case and today we got a story of a little boy in Nepal who suffered from retinoblastoma.

Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light detecting tissue of the eye. Retinoblastoma is rare and affects approximately 1 in 20,000 live births. Untreated retinoblastoma is almost always fatal; therefore, early diagnosis and treatment is critical to saving lives. In the developed world, retinoblastoma has one of the best cure rates of all childhood cancers (95-98%), with more than nine out of every ten sufferers surviving into adulthood.

There are two forms of the disease; a genetic, heritable form and a non-genetic, non-heritable form. Approximately 55% of children with Rb have the non-genetic form. If there is no history of the disease within the family, the disease is labelled “sporadic”, but this does not necessarily indicate that it is the non-genetic form.

In about two thirds of cases, only one eye is affected (unilateral retinoblastoma); in the other third, tumours develop in both eyes (bilateral retinoblastoma). The number and size of tumours on each eye may vary. In certain cases, the pineal gland is also affected (trilateral retinoblastoma). The position, size and quantity of tumours are considered when choosing the type of treatment for the disease.

Himal, age 5, from was brought to Seva’s partner hospital, the Lumbini Eye Institute by his grandmother on February 1st with a history of no vision in his left eye.

The family hadn’t noticed that the boy was blind in one eye until a week earlier when they were watching TV and the little boy’s right eye was itchy so he covered it temporarily.

Himal, age 5, is examined and diagnosed with retinoblastoma in his left eye. Photo courtesy of Seva Canada

The family immediately took Himal to the local health post in a nearby village and the staff there referred him to the Lumbini Eye Institute. After a detailed examination, Himal was diagnosed with retinoblastoma in his left eye.  The pediatric ophthalmologist was unable to restore the sight in the boy’s damaged eye, but was able to save the child’s life by removing the left eye.

It is vital that children receive eye exams. The most common and obvious sign of retinoblastoma is an abnormal appearance of the pupil. Many parents refer to this reflection as “cat’s eye” or “white eye”.  Medically, it is known as leukocoria. Other less common and less specific signs and symptoms are: deterioration of vision, a red and irritated eye, faltering growth or delayed development. Some children with retinoblastoma can develop a squint, commonly referred to as “cross-eyed” or “wall-eyed” (strabismus). However, retinoblastoma presence with advanced disease in developing countries and eye enlargement is a common finding.

Screening for retinoblastoma should be part of a “well baby” screening for newborns during the first three months of life, to include:

• The Red reflex: checking for a normal reddish-orange reflection from the eye’s retina with an ophthalmoscope or retinoscope from approximately 30 cm / 1 foot, usually done in a dimly lit or dark room.
• The Corneal light reflex: checking for symmetrical reflection of beam of light in the same spot on each eye when a light is shined into each cornea, to help determine whether the eyes are crossed.
• Eye examination: checking for any structural abnormalities.

Treatment of retinoblastoma varies from country to country. The first priority is to preserve the life of the child, then to preserve the vision and thirdly to minimize any complications or side effects of the treatment. The exact course of treatment depends on the individual case and will be decided by the ophthalmologist in discussion with the pediatric oncologist.

The process of removing an eye while leaving muscle tissue intact is known as enucleation.  For many cases of retinoblastoma, and particularly unilateral cases, enucleation is considered the primary treatment.  Removal of the eye in unilateral, non-heritable cases is curative.  While the child will suffer some peripheral vision loss as a result of the removal of an eye, the risks associated with attempted treatment, including spread of the tumor beyond the eye, are generally viewed as too great.  Removal of the eye also spares the child invasive chemotherapy and its inherent risks.  Bilateral cases of retinoblastoma, because of the threat of complete vision loss, are often treated more aggressively.  An eye is generally removed only if there is a significant threat of the tumor spreading beyond the eye.

Eye care for children, including school screening, are essential parts of all of Seva’s sight programs. You can support Seva’s work providing eye care for children by making a donation. Himal has lost an eye, but his life has been spared.

By Penny Lyons
Executive Director, Seva Canada

November 20^th

Thirty six elderly Tanzanians sit under the shade of a Poinciana tree in Ndatu village.  All are from the same village in the district of Arumeru, about an hour from Moshi.  They know each other well so the air is a filled with the sounds of laughter and conversation.

I have come to this village with a team from KCCO.  There are 4 of us:  Herieth Mganga, KCCO’s new gender and blindness coordinator, Fred the driver who doubles as the visual acuity tester in the field,  Dr. Amadou Bio from Benin,  who is training to be an ophthalmologist, and myself.

Fred at the Kilimanjaro Centre for Community Ophthalmology in Tanzania

All 36 of these people have agreed to participate in a study (there will be 150 participants in total from 4 different villages) to determine the effect that correcting presbyopia (or age related far-sightedness) has in their daily life.  Do reading glasses make an elderly Tanzanian’s life easier?  Most are illiterate but if they can now pick the stones from the rice, thread a needle and take thorns from their fingers will this significantly improve their quality of life?

A patient has her eyes examined in Tanzania

There is very little refractive error in Africa and most of these people have distance vision that someone 40 years their junior would envy.  The flip side of that great distance vision is that many of the 36 have difficulty seeing things that are close so “reading” glasses (even though most do not read) are provided to them free of charge.  While doing the vision testing, four cases of cataract were diagnosed and referred on to hospital for treatment and a few infections were treated.

Each person who received reading glasses will be visited in their homes in three months to determine what difference, if any, the reading glasses had on their daily life.

Heriath Mganga, KCCO’s new gender and blindness coordinator, working with women in rural Tanzania

At this point you might be asking yourself if this study is important, or even relevant, to the elimination of preventable and treatable blindness.  It is because it illustrates the cornerstone of all of Seva and our partner’s work; together we create programs that are based on evidence.  Evidence tells us a problem exists, it tells us the extent of the problem and it tells us what should be done to correct that problem.

With evidence, we can spend our donor’s dollars effectively and get the maximum benefit – whether we are studying presbyopia, childhood blindness, the incidence of cataract in a population or the barriers people face when trying to access treatment.

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!

By Penny Lyons, Executive Director, Seva Canada
November 16, 2009

Madagascar, where do I even start? Stunningly beautiful, heartbreakingly poor, rich in culture, language and traditions and complex in its politics.

I travelled here from Tanzania with Dr. Paul Courtright, co-director of the Kilimanjaro Centre for Community Ophthalmology (KCCO) based in Moshi, Tanzania. KCCO has been working with Madagascar eye care programs since 2007 – at first helping create national eye care programs and now also funding training, outreach programs and a pediatric program.

Our task here is to follow up and expand on the work that KCCO has done, as well as evaluate the programs that have been funded by Seva donors. The Canadian International Development Agency (CIDA) has funded outreach in the Vakinankaratra region, as has the May and Stanley Smith Charitable Trust.

Each of these two organizations have helped fund the creation and implementation of community outreach programs in this populous region in the highlands of Madagascar centered around the city of Antsirabe, just 3 hours drive south of the capital city of Antananarivo. In addition, Alcon Canada generously donated an enormous amount of ophthalmological supplies, including intraocular lenses.

Seva programs that I have visited previously have all been well established. National blindness plans were in place, outreach was active and well organized, a comprehensive training program was in place and all programs were working toward both financial sustainability and ensuring services were available to the most vulnerable – particularly children and women.

It has been both enlightening and rewarding to witness the birth of a new program here in Madagascar and to fully comprehend the partnerships at all levels of government, healthcare and community that have to be created in order for eye care programs to succeed. In fact, given the complexities, it is a wonder it happens at all. But here in Madagascar, as in our other programs, there are individuals, hospitals and local governments that have dedicated themselves to making it happen and are committed not only to creating eye care programs but are also committed to creating excellent ones.

Today I visited an outreach program in Mendoto, a small centre about 150km west of Antsirabe. When the team from Fitsaboana Hospital in Antsirabe arrived at about 8am, there were over 300 people in the courtyard of the local hospital. We assumed they were patients waiting to be seen at ALL the hospital departments, but as we started to set up we realized they were all there to have their eyes screened and treated.

The team quickly organized the room we were given. A visual acuity chart and registration desk was set up; there were 2 examination areas for the ophthalmologists; the counselors, who provide information to those requiring more care like cataract surgery or low-vision services, had a small table; and a makeshift pharmacy was created. Patients were divided into two lines, one for children and one for adults, and each ophthalmologist took one line. Periodically someone was sent to scout the lines to make sure those who required the most complex care or who were very elderly were brought to the front of the line.

It was hot, both outside and inside the makeshift clinic. No one complained and no one took a break. Bottles of water were brought to the team, but they barely stopped to take a drink. Everyone knew how many patients were waiting and how far they might have travelled to get there. They could drink later.

In the first two hours, 4 children were diagnosed with congenital or developmental cataract in both eyes and appointments for surgery were made.  Many more children were seen but who could not be helped – children blind because of damage to their corneas – many of whose sight could have been restored if they lived in a developed country. Children with birth defects or severe low vision were referred to the counselors so their families could learn where to find help. Twenty-four adults were scheduled for cataract surgery and, once again, there were many more who simply could not be helped.

The ophthalmologists were unbelievably kind and gentle with all who came and, even after very long waits in the brutal sun, not one patient complained. The last patient was seen at 6:30 pm. All were grateful to be treated and I was grateful to be there.

Our gratitude to the Canadian International Development Agency, the May and Stanley Smith Charitable Trust and Alcon Canada for their generous support in bringing eye care to the people of Madagascar.

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

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!

Seva’s partner in eastern Africa is the Kilimanjaro Centre for Community Ophthalmology, popularly known as KCCO. Located in Moshi, Tanzania, within sight of Kilimanjaro, KCCO provides eye care services, ophthalmology training and resources to 9 eastern African countries – Tanzania, Madagascar, Rwanda, Uganda, Kenya, Malawi, Ethiopia and Zambia.

This short video gives an overview of KCCO’s work bringing sight and preventing blindness in eastern Africa.

[youtube=http://www.youtube.com/watch?v=SMYOYSXlpLw]

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

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

I was pleasantly surprised to be greeted at the Kathmandu airport by Parami Dhakhwa, Seva Nepal Program Coordinator, who whisked me away to the Seva office to meet Shravan Kumar Chaudhari, Finance Manager.  Due to some logistical constraints, Shravan had arranged for me to travel south by Lumbini Eye Institute (LEI) vehicle from Kathmandu in order to meet up with Ram Prasad Kandel, Seva’s Program Manager.

Kandel has proved to be a consummate host, and I am greeted warmly wherever we go.  En route to meeting Kandel, I briefly toured Bharatpur Eye Hospital the evening I arrived in Chitwan District.  The next day proved to be rather interesting.  Due to a bandh (strike) because of student elections, the LEI vehicle could not take me to Butwal.  Instead, I took a rather crowded public bus (I was lucky to have a seat!) to Butwal.

From there, Kandel and I went to Tansen, where the Palpa Lions Lacoul Eye Hospital was conducting a three-day surgical and screening camp.  With the exception of a minimal registration fee, all services were provided free of cost to the blind and visually impaired patients who filled the rooms and lined the hallways.

I met Dr. Salma KC, the eye hospital’s resident ophthalmologist, in the operating room, where she was performing one of many cataract surgeries that she would do that day.  Dr. Salma will be going to Vancouver soon for a pediatric ophthalmology fellowship.  Her specialized skills are much needed in a country of 29 million, where there are currently only three pediatric opthalmologists.

Dr Salma, one of 3 pediatric ophthalmologists in Nepal

The following day, we took a rather bumpy and hair-raising ride northwest to Gulmi District to observe a school screening.  All students with anything less than normal vision will be fitted and provided with eyeglasses.  Refractive error is especially prevalent in Asian countries such as Nepal, and by identifying children in schools, the Primary Eye Care Centre (PECC) in Gulmi is reaching children who may not otherwise come to the center for glasses.  They are also detecting eye conditions that can be prevented or treated before the affected children go blind. At the same time, this outreach will result in increased awareness among the community about the eye care services available. The children will go home and tell their families about the eye screening at school and the whole community will benefit.

The Primary Eye Care Centre itself is very well run under the capable and inspired leadership of Chairman Bharat Bahadur Chand, who proved to be an incredibly generous host: he invited us to his home for dinner and provided me with a very comfortable room to sleep for the night.  We also managed to squeeze in a quick trip to the Hindu temple of Yagyashala at the top of Resunga Peak.

On our return ride to Bhairawa, home of Lumbini Eye Institute (LEI), I got to hear one of Seva’s radio messages advertising free cataract surgery for children at LEI.  Although I do not understand Nepali, my ears perked up with I heard mention of Seva.  We also stopped by Butwal Lions Eye Care Hospital, which is quite an impressive facility with much space to expand.

I look forward to seeing the services at LEI today and tomorrow.  I have already met Sanjeeb Adhikari, Seva’s Child Blindness Coordinator, and hope to meet Dr. Karthikeyan, one of LEI’s two resident pediatric opthalmologists, soon.

I am both inspired and humbled by the dedicated staff and partners I have met.  Seva really is carrying out its mission of serving those most in need with high quality, affordable, and accessible eye care and truly embodies compassion in action.

Amanda Marr

Susan Erdmann writes from Nepal:

With all the thoughts and anticipation, nothing prepared us for the reception at the eye camp in Gulmi.

Behind the gates to the school where they has set up the eye camp, a crowd was waiting. Being one of the first through the gates, I was presented with one flower garland after another, most of them made out of local flowers or greens. One old woman placed a garland over my head that she had carefully made from little bits of evergreen. It was one of the most touching moments I have ever had, save the gratitude expressed by the Tibetans.

The entry into the eye camp for everyone was so moving that anything that happened after after paled in comparison.  The townspeople
were so happy, deeply grateful  and excited that we would even make the long journey (if they had any perception of what that meant) for what was happening for them;  the only way for them to express it was through their handmade garlands , ‘Namastes’ and smiles.  I was crying by the end of the line to the door as was Maureen and I am sure everyone else.  It was so moving and so worth the long arduous journey to get there.

Just the greeting, the welcoming had such a impact that the rest of what happened couldn’t come close to the impact of  the entry.  We were shown where the people were screened , eyes tested for glasses and those checked for cataract. They would continue the eye camp until everyone was looked after, and it was projected to last for 3 days.

Dr. Salma was doing all the surgery and a few of the group went in to the room designated for operating to  view her at work.  As we anticipated, going to Lumbini and we didn’t have a lot of time, not everyone who wanted to see surgery got to, but those that did were overwhelmed, not only by her deft skills but the speed at which she removed the cataracts.

Outside the building where the checking and operations took place was a area where people were being checked for general eye sight with a
chart at one end and a little stool at the other. One by one, people would sit down and a woman from the eye team would stand behind and hold one hand over the person’s one eye and then the other while her colleague pointed to the eye chart. Those who passed moved on, while those who did not went to have further tests and perhaps receive eye glasses.

One young woman we came upon as I was walking to the camp said she had an eye that weeped all the time and was instructed to return the next day to have it checked and hopefully fixed.  I am sure that everyone in the village and surrounding area was there. What a thrill.  I said to Kandel…this is really remote and he replied that despite the difficult journey in, this was not nearly remote as some eye camps.  I can’t imagine.

The following video of a Seva eye camp in Pyuthan, Nepal will give you a sense of what a Seva eye camp is like.

[youtube=http://www.youtube.com/watch?v=mz0yREq0N4M&hl=en&fs=1]

Seva Foundation’s Sight Program Director is Dr. Chundak Tenzing, a Tibetan ophthalmologist from Nepal, who lives and breathes Seva’s mission of restoring sight and preventing blindness. Anyone who has ever met Chundak cannot help but be impressed by his caring nature and his deep compassion.

Chundak is also a poet. He sent the following message and poem for Seva Canada’s blog:

I am sharing with you
Voices from the field
Where the blind
Receive sight restoration
And walk unassisted
To live a life
With  dignity

When a heart opens its petals
Like a blooming flower
And hands deliver
A gift of sight

The expression of gratitude
Rolls down a cheek
Like dewdrops
Glistening in the sunshine

To wonder and say
What a journey
It is to be giving
And receiving
Happiness
In its purest form
With no strings attached

grateful Seva patients young and old

Let’s face it — everyone loves Dr. Spencer.

Marty has been a Seva board member for over 20 years and is a respected and much-loved ophthalmologist on Vancouver Island. He has both performed surgery and trained eye care specialists in India, Nepal, Tibet, Malawi and Guatemala. 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.

In February 2009, Dr. Spencer travelled to Nepal and Cambodia to train eye doctors and to perform surgeries. His youngest daughter, Justine, accompanied him and said it was amazing to see the reception that her father received.  She said it was like her dad was going home again; everywhere Marty was welcomed with open arms.

We could go on and on about how wonderful Marty is (especially since we have the password to the blog and he doesn’t!), but instead we’ll share some of his excellent photos that he took in February in Nepal.

Click here to view a slideshow of Dr. Spencer’s photos of Seva’s sight programs in Nepal:

slideshow of Dr. Martin Spencer’s photos of Seva’s sight programs in Nepal