It was a harsh lesson to watch a young girl learn: tardiness can leave you blind. Ten-year-old Hatsaline had endured a ten-hour bus ride from her village to arrive at the Laotian capital, Vientiane, little more than half an hour late for her doctor’s appointment. She sat alone on a waiting room chair clinging to a stuffed tiger and the slim hope that Dr. Hakin would still examine her. If he didn’t she’d be sent home and eventually go blind.
Dr. Hakin is a plastic surgeon from the UK and his expertise with eyes has landed him a role with ORBIS, a nonprofit devoted to curing blindness in the developing world. He and a team of talented medicos from around the globe visit impoverished nations like Laos and Myanmar to train local eye doctors, nurses and medical engineers. And I’m here to see how their style of voluntourism works. In the sparse examination room next door, I find Dr. Hakan cursing quietly at the tiled floor, his head in his hands, jetlag and food poisoning having long ago robbed him of his patience and his ordinarily dry wit.
Of the thousand hopefuls like Hatsaline, only a dozen are chosen as sample patients on screening day. “We call it screaming day,” confided Dr. Hakin, explaining that, in some countries, the chaos borders on a riot. Laos had been especially calm. Guided by loved ones, each patient had shed their shoes on the steps of the local eye hospital, leaving a brown carpet of worn footwear like fallen magnolia leaves.
The patients, many with eyes the color of poached eggs, diligently shuffle from one waiting area to the next — waiting to be identified, waiting to be examined, waiting to be told yes or no. A monk, resplendent in orange robes collects his sandals and shuffles slowly back into the beating sun. He will not be operated on. The crowd parts for a wheelchair-bound man swaddled in dirty sportswear. His story is tragic: he was struck by lightning, leaving him paralyzed, burnt and without eyelids. His condition seems tailor-made for a remarkable transformation. Dr. Hakin shakes his head regretfully. With only a few operations in which to demonstrate techniques, Dr. Hakin and the other ORBIS doctors must choose common conditions the local doctors can learn from rather than unusual, more challenging cases. It is ordinary conditions like glaucoma and cataracts that afflict 45 million blind people worldwide (90 percent or whom live in the developing world and 80 percent of whose cases can be cured or prevented).
Fortunately Hatsaline’s case is common enough: she was born with no tendon to hold open her right eyelid, causing it to droop uncontrollably. In time her brain will ignore the signal from her eye and she will lose her vision. In her polka-dot outfit she is too adorable to ignore and, upon seeing her Dr. Hakin adds her to his roster. Her operation will take place in two days time at the airport in the ORBIS flying eye hospital.
Before joining Dr. Hakin and his team for dinner, I take a sunset stroll through Vientiane’s dusty streets and along the Mekong River. Makeshift restaurants fashioned from a bird’s nest of split bamboo line the banks, their stalls filled with enticements like freshly skinned frogs and live catfish. At dinner, the spirited conversation is made livelier by a trio of murderous cats fighting at our bare ankles. I take a seat next to Dr. Shoba, a cataract specialist from India who I learn can perform up to ninety procedures in a single day. Across the table, glaucoma specialist, Dr. Myers is talking shop. He looks vaguely familiar. “Glaucoma takes your sight quietly,” he says. “By the time you notice you can’t see, it’s already gone. You can’t get it back. You can only stop it getting worse.” The sun is down but the heat is still stifling. The program director, Hunter Cherwek, passes me a jug of water – an antidote to the chilies I just mistook for green beans. While I’m dousing my tongue he tells me there is more to curing blindness than teaching local doctors how to wield a scalpel. “In Cambodia we were putting glasses on a child and his grandmother started crying. The Khmer Rouge killed anyone who wore glasses because they were seen as intellectual.”
The following morning, at the airport, we pass beyond a sign reading “SHOW ALL WEAPONS” and onto the tarmac. Nothing quite prepares me for the ORBIS flying eye hospital. First class has been replaced by a lecture theatre; business class is now an examination room; and the whole of economy has become an operating theatre and recovery. The O.R. is linked to the lecture theatre by way of a studio full of cameras and microphones, enabling Dr. Hakin to talk through every step of the operation. Not only does the plane generate its own clean air and reliable power necessary for sensitive medical equipment, it can filter hospital grade H2O from ditch water in five minutes flat. The plane is so laden with gear, it can’t cross the Pacific Ocean — instead having to chart an overland course through Russia.
The patients seemed equally impressed. They huddle in the examination room, trying to take in their new surroundings with whatever vision they have left. Through a Red Cross interpreter, I ask a particularly bewildered looking farmer, Toum, how much her cataract operation would cost in Laos. “Six pigs,” she replies brightly. It would be her family’s entire life savings. I am distracted by a hubbub at one of the examination stations. A patient is desperately trying to explain something to Dr. Myers. Finally the interpreter giggles and tells him, “He thinks you look like Keanu Reeves.” In another corner two nurses are attempting to soothe Kamla, an inconsolable woman who — if it were not for early detection — would be completely blind from glaucoma within a year. She points at a small mark on her cornea she thinks unsightly and it becomes clear she knows nothing of how close she came to permanent blindness.
Like all the patients, Hatsaline wore her best clothes to the operation: a Barbie outfit with matching patent leather shoes. She slips into her hospital gown leaving her shoes to shine brightly in the drawn out oval of sunshine spilling from the window. Propped in a chair alongside is Dr. Hakin, his eyes closed. “This is no Zen preparation technique,” he says, stretching into action. “I’m just shagged.” In the operating room he deftly cuts three holes in Hatsaline’s delicate brow and threads an artificial tendon to join the muscle to the lid. The procedure is quick – fifteen minutes at most. In first class, a room full of ophthalmologists nod appreciatively and eagerly take notes.
When I see Hatsaline the next day her eye is already fully open. She clasps her hands together and bows in thank you and, for the first time, she smiles. My vision grows blurry.
Words by Adam McCulloch. Originally published in The Australian. The format has been altered to suit Tumblr. To view the original story click here.
