Things to ponder:
If you spin an Oriental person around and around, does he become
disorientated?
If you try to fail, and succeed, which have you done?
Fact of the Day:
Measurements have nothing to do with a Ten-Gallon hat. The name comes from
sombrero galon, which means 'braided hat' in Spanish.
Help Me See: The Organization Dedicated to Eliminating Cataract Blindness
Globally
By Bill Holton
American Foundation for the Blind
"Access World Technology"
http://www.afb.org/afbpress/pub.asp?DocID=aw160606
It is projected that by the year 2020 there will be 452 million people
worldwide with visual impairments that are not correctable by lenses. This
is a global crisis, especially since, according to the World Health
Organization, nearly 80 percent of blindness is avoidable.
Ninety percent of individuals with visual impairments live in the developing
world, where the infectious disease called trachoma and vitamin A deficiency
used to be the leading causes of blindness. Improved sanitation and
nutritional changes and aid have all but wiped out these conditions, leaving
cataracts as the current number one cause of preventable blindness.
<http://helpmesee.org/> HelpMeSee is a nonprofit organization whose mission
is to wipe out cataract blindness in the developing world. To date it has
facilitated nearly 200,000 successful cataract surgeries, at a cost of just
$50 per surgery.
Cataract Treatment in Developing Countries: Why Blindness is Prevalent
The onset of cataracts usually begins in people age forty and older. By the
time we reach 80 nearly half of us have developed cataracts. However
cataracts are not just confined to the elderly. According to Mohan
Thazhathu, cofounder and President/CEO of HelpMeSee, "Between five and seven
children in every one hundred thousand are born with congenital cataracts."
Here in the Unites States, the criterion for cataract surgery is usually
when vision fades to less than 20/60. "In India and other developing
countries, public policies set this number as high as 20/500," says
Thazhathu. In the developing world, 51 percent of blindness is due to
treatable cataracts, which means there are hundreds of thousands of children
and adults who are currently blind but do not need to be."
Thazhathu notes that one of the major obstacles to reducing this backlog of
patients is the severe shortage of professionals who are qualified to
diagnose cataracts and perform surgery. According to a 2012 RAND report,
throughout much of Africa there is currently just a single ophthalmologist
for every million people. "Even where there are significantly more doctors,
only about half of them are trained in surgical techniques, and their skill
levels vary widely. Many are still using archaic surgical techniques,
opening the entire eye and then trying to stitch it shut. Their success rate
hovers near zero. In fact, today in China, the leading cause of blindness is
botched cataract surgeries."
A Solution
HelpMeSee takes a comprehensive approach to eliminating cataract blindness.
To date the organization has evaluated and trained 192 partner surgeons
spread across India, Nepal, Vietnam, China, Togo, Sierra Leone, and Peru to
perform a quick, effective surgery called Manual Small Incision Cataract
Surgery (MSICS).
For this technique, adults receive local anesthesia and, children are given
general anesthesia. The surgeon begins by making a small, five to six
millimeter incision in the sclera (the white of the eye.) The incision is
cut at an extremely shallow angle, and after the opening is made, the
surgeon removes the clouded-over lens and replaces it with an artificial
lens. The eye's natural fluid pressure closes the incision and the
overlapping edges of the angled slit do not require a single suture. The eye
heals by itself within a day or two, when the bandage is removed. From start
to finish, the surgery can take as little as five minutes for an adult,
fifteen minutes for a child, which means HelpMeSee-trained surgeons can
perform up to 100 operations in a single day with a success rate that rivals
outcomes here in the US.
When it comes to children, Thazhathu reports, "In the past, the theory was
that if you do not take care of congenital cataracts in the first three
years of life, that child will never develop functional vision. Research
done at Harvard medical school has proven this is not true, and we have
definitely reaffirmed this research. We have been able to restore vision to
children as old as 12 and 13."
HelpMeSee is currently completing the planning stage for a training center
in Beijing, China, where it will train upwards of 100 new surgical partners
every year. This training will be facilitated by a new, high tech tool: a
virtual reality, haptic simulator. "Our simulator is all but
indistinguishable from a patient's head while you are practicing the
surgery. It includes data from all of the surgeries we have done to date,
along with a haptic engine so you don't just see an image of what is
happening during a simulated operation, you can actually feel everything
from the pressure when the scalpel touches the eye to the resistance of the
intraocular fluid as the surgeon uses the microscope's x/y control handles
to remove the defective lens and replace it with the new plastic lens. The
processing power and data mining capabilities we needed to create this soft
tissue modeling [were] not possible just five years ago," describes
Thazhathu.
HelpMeSee will also assist these new partners to obtain the standardized
operating room equipment they will need in order to perform the
surgeries--everything from autoclaves for sterilization and surgical
microscopes to beds and, where needed, actual brick and mortar construction.
To do this the organization has established a revolving capital fund that
provides start-up capital of up to $20,000 per practice to assist newly
trained MSICS specialists. "This is a micro-loan program, not a grant,"
notes Thazhathu. "Loan recipients are expected to repay their start-up funds
over a period of five years through small deductions from the $50 proceeds
of each surgery. This will enable the revolving fund to support
establishment of even more practices."
Thirty-five dollars from each operation pays for a standardized surgical
kit. These pre-sterilized, single-use kits include everything from
anesthesia to an artificial lens. The remaining $15 pays for the surgeon's
fee and those of his support staff, and repayment of the micro-finance loan.
And if the patient can't afford $50? "We cover the fee," says Thazhathu.
"Our priority is to first help those who would not otherwise be able to
access or afford care."
Monitoring Results Through Data Mining
HelpMeSee practitioners input data from each surgery from start to finish
into a cloud-based data monitoring system. All surgical outcomes are scored
for quality, and feedback is provided directly to the surgeon as necessary.
"Data mining can help us uncover things like which procedures need to be
refined, or if there is a particular surgeon who is slightly off in his or
her incisions and would benefit from additional training," says Thazhathu.
"We also use this data to improve our simulators and make them even more
realistic."
Another source of data is a new GIS (Geographic Information System)-GPS
Android app which is enabling local community health workers to more
efficiently locate patients, map the incidence of cataract blindness, and
connect patients to partner specialists who can provide care. The app uses a
voice recorder to input data, since in small, remote communities the
outreach workers cannot always read. The collected data can also help define
the geographic market for new clinic locations, as well as collecting
demographic and epidemiologic information on the prevalence of cataract
blindness in that region. "The app is also integrating with our surgical
reporting system to help monitor patients and validate successful outcomes,"
says Thazhathu. "Thanks to these measures and the single-use surgery kits,
infections and other postoperative complications are practically
nonexistent."
HelpMeSee estimates that if all the patients treated in 2014 go back to work
and make their country's minimum wage, they would make more than $140
million over their lifetimes. "Almost all of that would not have been earned
if they remained blind," says Thazhathu.
To date, the organization's greatest success is the district of Chitrakoot,
India, a city of one million where, after 10,044 surgeries, HelpMeSee was
able to eradicate cataract blindness. "Now that we cleared the backlog, we
are now transitioning to a market sustaining model," says Thazhathu.
"Statistics say that for every one million people, we can expect to do
approximately ten thousand new surgeries every year."
"Over the next several years we hope to eliminate cataracts as a cause of
blindness in a large majority of the world," says Thazhathu. "We believe
this is a goal we can achieve."
Contact Information
HelpMeSee, Inc. is a 501(c)(3) nonprofit tax exempt organization recognized
by the IRS, and all donations to Help Me See, Inc. are tax-deductible in
accordance with US tax regulations.
HelpMeSee, Inc.
20 West 36th Street, Floor 4
New York, NY 10018-8005
E-mail:
<mailto:info@xxxxxxxxxxxxx?subject=Help%20Me%20See:%20The%20Organization%20D
edicated%20to%20Eliminating%20Cataract%20Blindness%20Globally>
info@xxxxxxxxxxxxx
Telephone (toll free): 1-844-HelpMeSee (1-844-435-7637)
US fax number: 212-221-7604
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"I rejoice in following your statutes as one rejoices in grate
riches.
I meditate on your precepts and consider your ways.
I delight in your decrees;
I will not neglect your word."
Psalm 119:16:
Robert Acosta, President
Helping Hands for the Blind
(818) 998-0044
www.helpinghands4theblind.org
