Austin Meeker MD – 2020 (Haiti)

I was very fortunate to spend the first week of March in Cap Haitien, Haiti with Dr. Reed Kindermann and Mr. Jeremy Joseph on a SEE International trip through WIRE.  We worked out of the Vision Plus Clinique led by Dr. Pierre Dupuy, seeing both patients from Cap Haitien, and those referred in from community and rural vision screenings performed by optometrists and their staff volunteering through VOSH – Volunteer Optometric Services to Humanity.  Many of these patients traveled hours from rural villages for their first every eye exams.  The trip to Cap Haitien for eyecare was held in high regard and many patients wore their nicest clothes for the occasion.
 
The clinic mornings were busy seeing patients of all ages, and all types of pathology from children with congenital cataracts and Duaneā€™s syndrome to adults with trachoma and posterior uveitis among other diagnoses.  There is a tremendous amount of severe open angle glaucoma for which we were able to perform selective laser trabeculoplasty (SLT) and start many patients on IOP lowering therapy.  Many of those referred in also had very advanced cataracts – often bilateral – with only the ability to count fingers held right in front of their face or see movement with no other details.  
 
Each morning, the waiting rooms adjacent to the clinic area were packed wall to wall with patients waiting to be seen.  We thankfully had wonderful help from the clinic staff in screening patients, refracting, and translating.  During this time, I was grateful to work closely with Luis – a resident from Port Au Prince who was rotating with Dr. Dupuy for the month.  He taught me how to conduct my exam in Haitian Creole (though roughly, I must confess) and I was happy for the opportunity to teach him how to perform SLT treatment for glaucoma patients using the laser that Dr. Kindermann had donated to the clinic several years prior.
 
In the afternoons, we operated, performing mainly manual small incisional cataract surgery (MSICS) and other anterior segment surgeries including several pterygium excisions.  I learned a great deal from Dr. Kindermann and Mr. Joseph about the intricacies and subtleties of this procedure and felt significantly more confident by the end of the week, having performed 9 of the 60 MSICS cases our group tallied for the week as primary surgeon.  The operating room, though densely packed with 3 operating stretchers side by side, was neatly organized with a plethora of supplies from donated materials from visiting ophthalmic groups – even including multiple types of minimally invasive glaucoma surgery (MIGS) devices which Dr. Dupuy had mastered and used for his vast glaucoma population.  The scrub nurses (who were the same staff as those in the clinic checking vision, and refracting) were well-organized and knew the procedure as well if not better than I did.  The OR afternoons often ran into the evening assuring each patient identified for surgery was taken care of.  Seeing the post-operative patients the next day was extremely rewarding, watching each patient experience the restoration of their sight after removing their shield.  I am grateful to have had the opportunity to deliver care in Cap Haitien, to have learned from phenomenal teachers, and to have gotten to work with so many different groups of dedicated individuals devoted to the protection of sight.