Cataract Team Performs 35 Surgeries
The floods can't stop "Team Loloma"
by P. Lance Hendricks, MD
Our cataract surgery team landed in Nadi on Monday, January 19th. They were brought to Suva (a 130 mile trip to the eastern end of the main island) from the airport in Nadi on the western end. The trip was slowed by several hours due to residual flooding from the heavy rains the previous week.
Upon arrival that afternoon the team proceeded to Colonial War Memorial Hospital, a 450 bed hospital and the main referral hospital for the country. We had a very pleasant planning meeting with Dr. Jai Narayan, the head of Ophthalmology and then began unloading our cataract surgery supplies and equipment that had been shipped in our Loloma container from Los Angeles. Dr. Narayan went to work calling in patients from his list who needed surgery.
On Tuesday morning we immediately went to work organizing and setting up  instruments, medications and intraocular lenses for the week of surgery while Dr. Victor Zablit, our ophthalmologist screened patients. We started surgeries that afternoon. During the week as we finished one patient, Dr. Zablit would go back to further screening and doing follow up exams on previous surgery patients while we prepared instruments, lenses and medications for the next surgery. Work was nonstop each day. The Fijian staff at the eye center were extremely competent and a delight to work with. We had a chuckle at how they would try to get us to stop briefly for morning tea as was their custom but who in the US could imagine that! Besides, we wanted to help as many people as possible in the limited time we had. We had to admit it was nice after several days to finally sit for a bit for midmorning tea.
Cataract surgery in the US takes 15 minutes or so with newer equipment. However, in the Fiji Islands, patients have had cataracts for a long time. They are very mature and firm requiring manual extraction rather than the ultrasound device used to break up the cataract as done in the US. In fact, they are simply too firm for the ultrasound equipment. Each patient required 45 minutes of work to safely remove the cataract and replace it with a synthetic intraocular lens as here in the US. We were also aided for two days by Dr. Mundi Qalo, a Solomon Island doctor in his third year of training as an ophthalmologist. We were able to complete 35 cataract surgeries and provide a great help to Dr. Narayan with the backlog of his patients waiting for surgery. Needless to say there were very happy patients, some of whom were nearly blind and had been so for some time. For two days I was monitoring the vital signs of two patients at once in order to complete as much work as we hoped to. We were also treated to seeing families we had met on our reconstructive surgery team visits to the outer islands over the past two years. They families had travelled to Suva for their cataract care.
We were for tunate to have been able to alter our plans and provide help where it was greatly needed. The patients in the Yasawa Islands where we had originally planned to go were of course disappointed however they were much more concerned with replanting crops, obtaining clean drinking water and basic medical care after the floods. Fortunately our medical team was able to get to the Yasawas and provide much needed help there.
Alcon Medical very generously donated all the intraocular lenses and eye medications for our work and Baxter Medical provided the solutions necessary for surgery. Cardinal Health, our Scripps Health pharmaceutical provider, donated all the medicatio ns required for our medical team and Professional Hospital Supply, our Scripps Health hospital supplier donated all the surgical supplies we needed for our work. Scripps Clinic Carmel Valley Surgery Center provided the surgical instruments and eye medications. We are deeply appreciative of their generosity for our volunteer team work. It is such a contrast to live in the US where everything we need is immediately available in abundance and then work in a country where even the most basic supplies are often unavailable. We each sense a degree of counterculture shock as we return to our land of abundance.
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