15/05/2008
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Charity Case Study - Writing & Photography Skills
Case Study for blindness charity ORBIS Burma, December 2004 Words and photography by Tine Frank “When I grow up I want to be an eye doctor. I want to have supernatural powers and cure people’s eyes – just like the ORBIS doctors.” What seemed like supernatural powers to nine-year old Pyit Sone Aung, was just a normal day at work for Consultant Ophthalmologist Dr Larry Benjamin. Normal, apart from the fact that the eye surgery took place on board an aeroplane at the Mandalay International Airport rather than in his more familiar surroundings at Stoke Mandeville Hospital in Buckinghamshire, UK.  Tine Frank with Pyit Sone Aung before his surgery
The reason for this rather unusual setting was the ORBIS Flying Eye Hospital’s second visit to Mandalay to facilitate a transfer of medical and surgical skills and knowledge between ORBIS volunteers and ophthalmic staff from throughout Myanmar. One of the training focuses during the two-week programme was paediatric cataract and strabismus, an area in which few ophthalmologists in Myanmar are specialised. There are an estimated 250,000 blind children and adults in Myanmar, and just 183 ophthalmologists to serve the entire population. Few of these are specialised in paediatric ophthalmology and most doctors are hesitant to take on complicated paediatric cases. Opportunities for further training is limited within Myanmar, and only a few doctors, with the support of international NGOs, go abroad for fellowship training. ORBIS has been working in Myanmar since 1991 and has over the years conducted ten Flying Eye Hospital and hospital-based training programmes in Yangon and Mandalay. The relationship is an excellent example of how ORBIS through continuous support builds capacity in the long term. Explains Dr Ye Lwin, an ophthalmologist at the Mandalay Eye, Ear, Nose and Throat (EENT) Hospital who has participated in every ORBIS programme; “ORBIS sparks ignition. Fifteen years ago we were fifty years behind in terms of medical knowledge and today, in some areas like cataract, we are more or less up to date. There are still other areas where we are ten to twenty years behind, but at least it’s no longer fifty! And with every programme we jump at least five years ahead.” It is not only a country’s medical specialists who benefit directly from an ORBIS programme, but also its patients. For each programme the local doctors will select a number of patients who through surgery and case discussions will serve as teaching cases. Pyit Sone Aung is one such patient. When Pyit was younger he had an allergic eye disease for which his local doctor prescribed him steroid drops. In February 2004 his vision had become increasingly blurred and his parents took him to the Mandalay EENT Hospital, where he was diagnosed with bilateral glaucoma, caused by over-use of the steroid drops. Pyit was put on glaucoma medication, which he will probably be on for the rest of his life, but was also starting to develop cataracts, so the doctors referred him to be seen by the ORBIS doctors in December the same year. By December, Pyit’s vision had decreased drastically, with only 40 percent vision left in one eye and 50 percent in the other. When presented to Dr Benjamin and his trainee Dr Saw Htoo Set, they immediately selected him for surgery. “His cataracts were probably associated with the allergy and most likely exacerbated by the steroids,” explains Dr Benjamin. “His vision seems to have deteriorated very quickly, and I reckon that he will be completely blind within a year if he is not operated on as soon as possible.” Pyit’s mother is delighted to hear that her son will receive treatment by the ORBIS doctors. “I have been so unhappy for the past year,” she says. “The doctors told us that his problems were caused by over-medication and I feel that it is partly my fault. I have been crying a lot lately, but now I am happy. Pyit is such a lovely and happy boy who is always willing to help other people. I just want him to get well.”  Pyit with his friend Toe Mimi Aung on their way to surgery
Pyit is indeed a lovely boy. Always sweet and smiley, sharing his candy with the other children on the ward, he quickly becomes fast friends with the ORBIS staff and his fellow patients. On the day he is scheduled for surgery on the Flying Eye Hospital he is perfectly comfortable, being treated to a special tour of the cockpit and colouring in pictures with ORBIS staff. The surgery is a great success and when Pyit returns the following day for his post-op examination, everyone is amazed and delighted by the improvement to his vision. His long distance vision is perfect, with Pyit being able to read the bottom line of the eye chart and his glasses can now be replaced with light reading ones. “It was just wonderful to watch,” says Dr Benjamin. “The way he worked his way down the chart, he was so excited. I really didn’t expect for him to get that much vision back and his reaction was just fantastic – it was definitely the highlight of my week.”  Pyit has his vision checked the day after surgery
Pyit and his family are equally thrilled. As soon as Pyit comes back to the hospital after the operation, his father checks his eye sight – something he has been doing on a daily basis for the past year – and he can’t believe the difference. Pyit himself still can’t believe it. “I can see a lot better now without glasses than I could yesterday with glasses. I love the ORBIS plane because it cured my eyes. I will miss you all when you go back.” For Dr Saw Htoo Set, who has been assisting Dr Benjamin all week, it has also been a valuable experience. “I am very happy with this programme, as I have learnt a lot. Dr Benjamin is a great teacher and an excellent surgeon, and he taught me things in a simple and efficient matter. I train two post-graduates at the hospital, mainly in paediatric cataract, so not only can I now do the surgery better myself, but I can pass it on to them as well.” For everyone involved, this tenth ORBIS programme in Myanmar has been a huge success. As Dr Tun, Medical Co-ordinator at the Mandalay EENT says: “ORBIS has changed our concepts, our technology and our equipment. It is essential that we update our knowledge and skills but it is very difficult for us to go abroad. This whole programme has been great – all of it. The surgical training, the nursing aspect and the equipment maintenance and we have had doctors participating from all over the country. The training subjects have been perfect. They have all addressed the big problems that we are facing right now, both at hospital and district level.” For Pyit, it is simple. He just wants to get back to school and tell his friends all about the doctors with supernatural powers and the plane that cured his eyes. Six weeks later, ORBIS Staff Ophthalmologist Pamela Tarongoy returns to Mandalay to follow up on the surgical cases. Pyit and his mother are back at the hospital and are all smiles – the recovery of his vision is beyond anything they expected. “I really did not think that the results would be this good,” his mother says happily. “No one did, really – all our friends, neighbours and family were so surprised when we came back home. We’re just all so happy.”  A happy Pyit six weeks after his surgery
For Pyit there has been more good news: Because he was struggling to keep up in school, his teacher had decided that he would have to repeat one year. But now, with his restored sight, she has agreed to let Pyit move up with his friends. Which to Pyit means being closer to his dream of becoming an eye doctor. In fact, the whole ORBIS experience has left such an impression on him that he one day hopes to work on the Flying Eye Hospital! ORBIS’s mission however, is that by then there will no longer be a need for a Flying Eye Hospital. That by then, avoidable blindness will have been eradicated and children and adults alike will no longer go needlessly blind. |
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