International Vision Organization (IVO) is a Canadian not-for-profit organization providing community aid and eye health care to developing areas. In 2017, we completed our first mission in Zimba, Zambia, which included 3 focuses: ophthalmic medical and surgical management, climate change advocacy and tree planting, and technological advancement seminars.
IVO joined International Vision Volunteers (IVV), an American charity that built the local Zimba Eye Clinic, for a 2-week long clinic. For the second and third focuses, we collaborated with local Kocebuka Community Foundation. First, we addressed local climate change by donating fruit trees to schools and hosting day-long workshops for women’s groups. For computer education, we donated tablets to schools and hosted a week-long computer workshop for local teachers.
The following tells our story, a glimpse into our work in healthcare, from Dr. Peter Huang’s experience (edited for clarity).
The night before we started work, patients started to arrive. Some came as far as 400km. It's quite amazing and humbling as many are elderly and had poor vision or are outright blind. They came by bus, car and many walked a long, long ways. Some patients and their loved ones will often camp out in the open by the clinic until they receive their care and sometimes for days after their care for follow-up. Since we came during the rainy season a lot of the roads were washed out and made travel impossible. Sadly many people couldn't make it.
Eye Diseases and HIV:
The clinic was very busy and the eye diseases were mostly quite severe. The remarkable thing was that very poorly sighted people were not just the elderly - we saw large numbers of blind young people. There were many patients with terrible cornea scars from infections and solar exposure. We saw 6 young patients with squamous cell carcinoma of the conjunctiva, which is very rare in Canada but rampant in Zambia because of HIV.
The virus attacks the immune system and young people develop unusual cancers and infections. We remove as much of the cancer as we can and put them on mitomycin-c drops, an anti-neoplastic drug. Brighton, the resident at the clinic, told me the official HIV incidence is 10% but given so many of our patients are HIV positive I would think it's much higher than that. Anti-HIV drugs are provided free by the government but many people don't get tested and many stop treatment for various reasons.
Glaucoma:
Glaucoma is the other devastating disease and difficult to treat in rural Africa. People have very little eye care, so when they are seen their disease is very advanced and they have either lost most vision or on the verge of losing all vision. Glaucoma drops are the best treatment but access to care and medication is very difficult. Surgery is an option but the lack of consistent follow-up means lots of potential complications. I showed Brighton how to do a trabeculectomy in hopes he will stay in Zimba. We both hope this straightforward inexpensive procedure could save vision for a lot of people.
Cataracts:
Cataracts are the major cause of blindness in Zimba (and I presume in Africa). Patients come in with stone hard advanced cataracts and are usually blind. Surgery is much more difficult than in North America because the cataracts are too hardened to remove with our conventional techniques. Mark, a surgeon from IVV, is an expert with small incision cataract surgery and showed Brighton, Ivan and myself this technique. I was able to show Brighton our phacoemulisifcation technique and we did a number of surgeries with this.
Overall Impressions:
There were no shortage of surgical cases of all types. Given the circumstances , the surgeries are decisive and of tremendous benefit to the patients. Patients with severe painful blind eyes are grateful to have their eye removed. Cataract patients are extremely pleased to see after, for many, years of blindness.
I was surprised on the number of young people with bad cataracts. One especially gratifying case was an old man brought in by his son. He'd been blind for many years. After his cataract surgery he was ecstatic that he could see his son's face and he walked around the waiting room peering into people's faces and looking at and naming the objects.
Thanks to years of donations and different surgeons volunteering in Zimba, the eye clinic and OR is well equipped and supplied. I was pleasantly surprised with the quality of the clinic, and even more impressed with the local staff.
The Zambian staff are well educated and trained, pleasant to work with, and eager to learn. I'm sure that over the years they have helped and saved sight for many, many Zambians. I felt very fortunate to meet and work with wonderful colleagues who donate huge amount of their time, expertise and heart really to people who have very little.
IVO is a family-based not-for-profit, led by Dr. Peter Huang, an ophthalmologist with over 30 years of experience and two of his children, Katie and Stephen Huang. Katie (author) is completing her MSc Geology. Stephen has a BSc Computer Science and BSc Physics and works as a video game developer. Follow them on Facebook @InternationalVIsionOrganization.