Report of Haiti Eye Mission in Partnership with Sové Lavi

VOSH PA (Volunteer Optometric Services to Humanity, Pennsylvania) Report of Haiti Eye Mission in Partnership with Sové Lavi
By Dr. Paul D. Halpern

We opened a new VOSH PA mission site in Pont Sonde’, Haiti about sixty miles northwest of Port au Prince and just inland from the sea. We were sponsored by Sove’ Lavi, liberally interpreted to mean “save lives”. Founded by one time Haitian presidential candidate and American food industry capitalist Dumas Simeus, Sove’ Lavi is a community based group that concentrates on uplifting health care in Haiti.

Included on the trip were first timers Michelle Cadet-Honore, O.D, Nawana Ceraso, optometric assistant, Angeline Rapone, pre-optometric student from Penn State University, and Jonathon Halpern, nephew of the trip leader, Paul D. Halpern, O.D. Veterans included Sheth Amir, Susan Bentley, R.N., Linda Boss, optician and without whom I make no trips, Andrea Clyman, Joanna Doan, Anita Halpern, Ruth Osborn, and Ray Osborn, O.D. Vanessa Brown was our go-to person from Sove’ Lavi.

This mission was unique for me in that we stayed in a small hotel located adjacent to the Sove’ Lavi sponsored community health clinic. This very clean small two story building is a hodge-podge of small examination rooms connected by narrow hallways and located on the main street of the town. Because there was no large staging area available the patients were forced to line up along the heavily traveled street prior to registration causing some episodic breakdown of behavior. As is usually the case, once registered and in line for care, the most outspoken of them became sweet and tame!

We saw about 1125 patients and referred 35 for cataract surgery to the ophthalmology residency program at the University of Haiti Medical School in Port au Prince. Unfortunately they are not equipped to provide tertiary care for glaucoma patients so we could only load them up with a year’s supply of glaucoma meds and our good wishes. We successfully treated several trachoma cases, most notably a seven year old who returned for follow up the next day and was essentially clear. As is our policy, we instructed the family on the necessity of good personal hygiene as the best way to combat this condition. We did do one remote village clinic on our last day in Noe’, a very poor community with few resources. The living conditions were about the worst that I had personally encountered in ten trips to Haiti. But our team made the best of it and did great work.

We were fortunate to have with us a Surgical Eye Expedition (S.E.E.) physician from Harvard University, Paul Cotran. Dr. Cotran is a fellowship trained glaucoma specialist and educator. He stayed with us for two clinic days and then moved on to the University Hospital to tend to our cataract patients. It is important to note that we saw some of the worst glaucoma sufferers that I have ever encountered. At least six were totally cupped out and stone cold blind. As Dr. Cotran and I began to see more of these people and certainly others with emerging glaucoma we became increasingly frustrated with our inability to provide proper care for them. We had pretty much come to the conclusion that Haitian eye surgeons and ophthalmology residents needed to be trained to do more complex and lasting procedures to treat glaucoma. And we need to make this care geographically available to the people, perhaps at yet to be created Centers of Excellence, located in the north, central, and southern Haiti. Spaced about 100 miles apart these centers would bring glaucoma care close to the people. As the discussion broadened by taking it to the internet and various national and international glaucoma experts for input and suggestions, a plan began to evolve centering on ways to best treat for long term well being and just as importantly plans to train local ophthalmologists to provide this care. Ab externa cilliarycyclodialysis ( AEC) and/or selective laser trabeculectomy (SLT) have been the consensus treatments from our unofficial panel of experts and it seems that the most cost effective is the AEC. This procedure involves creating enhanced aqueous drainage by surgically cutting through the trabecular meshwork. It is fast and seemingly free of complication. In a recent small sample of 22 patients the median IOP was reduced from 32 mmHg to 12 mmHg. It is my hope that VOSH PA will become actively involved in the funding of these centers and / or the training of the surgeons, most likely through financial assistance. It is most important that we stay at the forefront of this exciting new effort.

Two volunteers raised an additional $2930 by simply sending an email to friends and family outlining their upcoming trip to Haiti and explaining the extent of the care we provide. I would certainly recommend this form of easy and effective fundraising for future missions. As it was our mission produced a healthy positive cash return of $3651.70.

For future missions I recommend the following:

  1. Pre-registration, mandatory in Pont Sonde’ but equally effective at other sites eliminating a historical bottleneck.
  2. Sunglasses for children
  3. Purchase an extra set of hand instruments
  4. Extra bulbs and batteries for ALL equipment
  5. 100′ electrical extension cord
  6. Always send report and photos to our partners Restore Vision and Optometry Giving Sight
  7. Leader has discretionary use of the VOSH PA credit card

Finally, we are indebted to the wonderful group of volunteers that made this trip. They were spectacular under often difficult conditions. They never faltered; they only asked what else they could do. I don’t understand how we are so fortunate to be blessed by this quality volunteer but we as an organization must recognize them, treasure them, and when possible, reward them. I love them all.

This was taken in the village of Noé.