EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/111385
20 EW NEWS & OPINION February 2013 Taking continued from page 19 model for rural China. The director was inspired by the vision and offered his hospital as a test case. In one year, the volume of surgeries more than quadrupled. Our hope is to double it in the next year and double it again the following year to reach the target CSR of 3,000. We are now in the process of partnering with a second hospital to help improve its volume and quality. Our plan is to assemble a team composed of an ophthalmologist, nurse, and manager who will initially go to Aravind for six months to be trained as trainers. They will then become a deployable team that can work at a hospital we are partnering with and help us raise the quality and volume of services. Once the hospital is meeting its targets, they can be deployed elsewhere. Since the challenge in China is both lack of well-trained cataract surgeons and affordable care, our long-term goal is to establish a training center in Shanghai. Dr. Chang: Regarding practicing ophthalmology and living in China, what ups and downs stand out the most? Dr. Khadem: There are, of course, many challenges. China, despite its impressive economic development, Ar Arita rita Me b mian Meibomian eibom has been designed by Dr. Reiko Arita to gently express dysfunctional meibomian special angles surgeon on the parallel broad, jaws are atraumatically relieving minimal pain instrument addressing an Watch Watch it! and working from either nasal approach. K5-5900 has the greatest burden of avoidable blindness, with cataract surgery rates among the lowest in the world. The biggest challenge is changing the culture of medical training and healthcare delivery. There is no systematic residency training anywhere in China. Doctors learn through apprenticeships that rarely provide opportunities for surgical training. Changing this approach, especially within the public system, is very difficult. The result is that of the more than 28,000 ophthalmologists, barely one tenth are experienced cataract surgeons. The other major challenge is that there is no systematic approach to patient care. The sheer volume of those needing care magnifies the challenge of a patientcentered approach. Doctors in busy public hospitals regularly see close to 100 patients a day without much nursing or technical support. Much of the care offered is more akin to triage than to comprehensive care. Despite these significant challenges, I can honestly say that there are more ups than downs. The Chinese people are very receptive to new knowledge and are extremely hard working. We have now been in China over two years and find that there are many like-minded people who genuinely want to see a higher standard of eyecare and desire to make services accessible to everyone, regardless of ability to pay. I have met true heroes who are hard working, self-sacrificing, and long to see avoidable blindness eliminated. On a personal level, I have been greatly enriched by living and working in China. I realize that the Chinese, like us in North America, have the same dreams, hopes, and desires for themselves, their families, and their communities. Having worked and traveled in many countries, I have become increasingly aware that what binds us together as a human family is much more powerful than what separates us. The warmth, kindness, and hospitality that our Chinese friends have extended to us underscores for me that those barriers that may seem insurmountable from a distance easily disappear when personal bonds of friendship are formed. They are barriers in our minds and hearts with no objective reality. We have chosen to view our friends and co-workers in China as our Chinese family with whom we have embarked on a profoundly fulfilling journey of learning. EW Contact information Khadem: mkhadem@visioninpractice.org �� 973-989-1600 U 800 0-225-1195 U www.katena.com