By Peter J. Kelly, M.D.
In 1993 I had just returned from a mission trip to Africa and received a phone call from the Catholic Medical Mission Board asking if I would be interested in volunteering in Haiti. Haiti had a special place in my heart since my volunteer experience in college. At that time, I returned from 6 weeks in Haiti feeling that I had received much more than I gave and resolved to return when I had something to give. As an ophthalmologist with a skill that was definitely needed in Haiti I felt that now was the time.
After giving a positive response to the CMMB I received a call from Ted Dubuque, M.D., the founder of The CRUDEM Foundation, who introduced me to CRUDEM and Hôpital Sacré Coeur and welcomed me on my first trip. In Africa I worked in a fully equipped clinic and OR and did 70 cataract surgeries in a week. In Haiti I encountered a clinic that only had an ophthalmoscope (basically a sophisticated flashlight to look into the eye) and an operating room that had an OR microscope that only had manual controls and no microsurgical instruments.
To say it was a challenging environment is an understatement! Yet, Ted Dubuque was the calmest and most encouraging person I think I had ever encountered. Despite my concerns, he reassured me that we could make a difference and in my first visits he actually was in the OR monitoring the patients while I did surgery. Despite the limited equipment we were able to help some people regain vision.
The most dramatic patient and the one that I think is responsible for me returning over the past 20 years was a 15 year old diabetic boy. He was led into the clinic since he could only see light. He had dense cataracts from his diabetes.
Clinical education and training of HSC staff is a priority for the volunteer ophthalmology teams.
I have tried to convey that attitude to all the volunteers that come to CRUDEM. So often we are all caught up in numbers and feel our success is dependent on the number of people we have treated.
During one of my trips I met a Haitian ophthalmologist and realized that the focus of our trips should be training local ophthalmologists and staff rather than trying to do it all ourselves. Since that time we have had Haitian ophthalmologists from the local area and other parts of Haiti come to work with us at Hôpital Sacré Coeur. They learn new techniques from us and we learn how to successfully do procedures without sophisticated equipment from them.
Some of the MDs trained by Dr. Kelly and his team are now experienced enough to train other Haitian medical professionals.
The two most common causes of blindness in Haiti are cataracts and glaucoma. Cataracts cause a cloudiness in the eye that gradually decreases vision and results in blindness. It is common in tropical environments and in people of African descent.
Glaucoma is a more insidious disease since it starts by decreasing peripheral vision and ultimately destroys all vision. It does not cause symptoms and since central vision is the last to go, it gives no warning.
It also is more common in people of African descent and can result in blindness at a young age.
Cataracts are cured by surgery but glaucoma can only be prevented. Once you lose vision from glaucoma you cannot regain it. That is why screening is so important in prevention of blindness from glaucoma.
If we detect glaucoma we can treat patients with eye drops and laser. As you might imagine laser is more effective in Haiti since people are too poor to buy eye drops and usually don’t use them.
In 2004, we brought the first laser for glaucoma to CRUDEM. It was the only laser in Haiti for glaucoma until last year. We perform over 100 lasers a year and the laser is now permanently at Hôpital Sacré Coeur for the Haitian ophthalmologists to use when the volunteers are not present.
Dr. Peter Kelly often performs over 100 procedures a week during his volunteer missions to Milot.
Our goal has been to have a volunteer team of ophthalmologists at Hôpital Sacré Coeur every 4 months so we can provide continuity of care and teaching. We have had ophthalmologists from around the country volunteer and each team that comes brings donations from the two major ophthalmic supply companies, Alcon and Abbott. They donate all the medications needed to treat patients and all the supplies needed in the OR.
One of our volunteers, Mildred Olivier, M.D., is a glaucoma specialist from Chicago and is also a board member of the Academy of Ophthalmology and the Haitian American coordinator of eye care for Haiti. She has been a member of our teams for over 5 years and has been conducting genetic testing of patients for glaucoma, as well as teaching glaucoma surgery to the Haitian ophthalmologists. This will be a major factor in our efforts to prevent blindness from glaucoma.
All of our volunteer ophthalmologists pay their way to Haiti and pay the way of the nurses and technicians, as well as pay for their room and board. Since CRUDEM charges a nominal fee for care these ophthalmologists also pay for the surgical fees for the patients that cannot afford them but need surgery. They are all in active practice and in addition to paying these expenses; they give up income for the week that they are in Haiti. We are truly blessed to have so many dedicated volunteers.
We have come a long way over the past 20 years but have a long way to go. We can say with confidence that we are winning the fight against blindness but the fight is not over. With the support of our many volunteers and our donors we will ultimately win.
Peter J. Kelly, M.D. has volunteered at Hôpital Sacré Coeur for over 20 years. He served as President of The CRUDEM Foundation from 2006-2011. He and his wife Linda live in Western Massachusetts where Dr. Kelly maintains a full time medical practice.
