International volunteer work satisfies many of my passions: helping others, curing the blind, challenging my professional skill set and international travel and adventure.
If you have read stories about international volunteer work or seen photos of doctors or nurses glistening with sweat in unairconditioned clinics with indigent patients smiling with giant gauze eyepatches, you may have wondered whether this type of work was for you. Hopefully you considered how amazing it must feel to operate on people who have so fewer options than we do in the United States, and are grateful for everything you have to give. Or you may feel burned out at times and want a break from obsessing about your premium cataract surgery conversion rates and get back to feeling what it’s like to “cure blindness” for patients who desperately need your services. Sometimes getting back to the basics of being a “doctor” can be therapeutic for re-prioritizing.
Let’s give it some context. According to the World Health Organization, approximately 51% of world blindness is caused by cataract. This represents in the neighborhood of 20 million blind from cataract worldwide. Granted, the statistics are from 2010, but we know that as the world population grows, this number increases. Although the exact numbers of new cases of cataract blindness per year are unknown, estimates are that the number of cataract blind in India will reach 8.25 million in 2020, according to a 2018 study by Murthy et al published in the Indian Journal of Ophthalmology. In developing countries it is estimated that there are 1000 new blind from cataract per one million of population per year, according to the nonprofit eye care group SEVA.
In this article, I explain all the reasons that I find doing volunteer work exciting and provide specific instructions on how you can get involved — hopefully inspiring you and giving you the nudge you need to start.
A NEED FOR DOCTORS
Many times, the patients we see in our private practice visit us because we are the geographically closest to them, accept their insurance or their Medicare assignment or because of a referral from a happy patient we operated on or their family member, friend or even from an internet search. We are usually flattered that they “chose” our practice, since there are so many other practicing ophthalmologists to choose from — approximately 19,000 in the United States.
The people we help through international volunteer work don’t have the same options to consider. These patients are more desperate for our help and skills, because they have no access to care unless we come to help them. When I visited Papua New Guinea, the patients would appear out of “the bush,” four crammed onto a single moped — and then drive off back into the wilds of this beautiful country postop with their eye patches on. The jungle was so dense there were no roads, and I had to fly from one location to another by plane (without radar, and I was the only one onboard wearing shoes other than the pilot). But the patients always managed to find me when I was there. At the time of my mission, there was only one ophthalmologist in that country with a population of 4 million. He had been hired by the Ministry of Health to address the eye-care needs of this entire nation. Luckily, he was savvy enough to realize that the only way to get through his backlog of cases would be to try to bring in volunteers from abroad.
The cases we do on these mission trips not only make us better people but make us better surgeons, as well.
Most of us look at a white mature cataract and get a little palpitation. It isn’t our normal case, so when we see one in the middle of our surgical schedule we get a little list of nightmare complications dancing around in our heads as we scrub. On mission trips, white cataracts are the norm. You learn how to make them feel like a normal case by doing a ton of them — and performing them in less than optimal OR conditions actually makes you better. When you have a white or hypermature cataract in your home OR after a mission trip, it suddenly doesn’t feel like nearly as big a deal.
SEEING THE WORLD
I love adventure and traveling, but work doesn’t always give me time for that.
With volunteer work, though, you can combine your passion for cataract surgery with international travel in a meaningful way. You can visit cool places and be hosted by local people who are so happy to see you and want to help you see the beauty of their land and culture. You can add on a little time at the beginning or end of your trip to see the wonders of the country where you are volunteering.
I managed to scuba dive in Papua New Guinea every day after I finished in the OR, and, yes, the experience was amazing. I went to the Galapagos en route to a mission in Ecuador with my team. I swam with dolphins in a nature reserve with my daughter in Roatan. I have made amazing friendships that have lasted for years and decades with people I have met on these trips. Thanks to social media, I have been able to keep in touch with fellow physicians and locals I’ve met from just about any part of the world.
POTENTIAL TIME WITH LOVED ONES
Along with the other benefits of volunteer work, you can get your family involved. It is a great way to have them understand what you do for so many long hours a day and teach them the spirit of philanthropy and kindness.
On a recent trip to Roatan, an island off the coast of Honduras, as I mentioned, I took my high school-aged daughter with me as a “co-volunteer.” It was just as meaningful to her as it was for me. Exposing our children to how other people live is invaluable. She acted as an assistant in the preop area of our makeshift OR but was also able to visit local schools and meet local children. The experience changed her, and it was a bonding moment for a mother and teenager (those of you who have teenagers know that is no small feat). She keeps asking when we can go back to volunteer again.
SOME FACTORS TO CONSIDER
You are the volunteer, so you get to pick where and when you want to go and what appeals to you, whether that’s going with friends, with a larger group of other doctors and support personnel, or traveling alone. Whatever resonates with you, there are amazing organizations and resources to help you get there. They will give you contacts, support, supplies and equipment. I can’t name them all, but I can give you a good start.
I have travelled with SEE International programs, local programs such as Long Island-based A Promise to Peru and on mission trips that I organized through the AAO international volunteer registry. The AAO is a great resource, and I have found really interesting smaller scale mission opportunities through its international volunteer registry. The AAO also has great volunteer information available, including a “Before You Go” resource, a listing of programs such as international fellowships and a global ophthalmology guide at https://www.aao.org/eyenet/young-ophthalmologist/get-involved-in-mission-work .
In addition, the AAO also sponsors Eye Care America for those who want to volunteer but don’t want to leave home.
Prior to your trip, consider the equipment you will use. Some volunteer programs have access to more modern phaco equipment and OR set ups. It is amazing that we can transport such modern technology to the developing world. So if your preference is to do four-minute phaco in the bush setting, that’s an option.
Some locations, though, don’t have access to that level of equipment. Access to electricity is unreliable in some places, thereby requiring generators or techniques that are less technology dependent. You are the volunteer — you choose what you find interesting. There are resources to help you acquire the skill set to perform surgery in the developing world, if that makes you feel more comfortable. If you want to do manual small-incision cataract surgery but are nervous about this technique, courses are available to help surgeons learn it, including wet labs at major meetings. Another great education option is offered by SEE International, which hosts wet lab courses in multiple locations in the United States and abroad throughout the year.
For more information
If you want to get involved with volunteer work, here are some suggestions on where to start:
- SEE International: www.seeintl.org , 877-937-3133
- ORBIS: email@example.com, 1-800-ORBISUS
- SEVA: www.Seva.org , 1-877-764-7382 / 510-845-7382
- Himalayan Cataract Project: firstname.lastname@example.org, 1-888-287-8530
- Vision Health International: www.visionhealth.org , 970-462-7279
- Eye Care America: email@example.com
- Moran Eye Center Global Outreach Division: firstname.lastname@example.org, 801-213-3410
We all have a great gift to share — the magic of being able to restore vision. The resources are out there to help people all around the world, and helping them only makes your own practice stronger. Reach out and help somebody who needs you. You will change some lives, including your own. OM