Thursday, March 17, 2016

My Most Memorable Experiences........

My most memorable experiences

Following the earthquake in Nepal in April 2015, there was mass destruction.  I saw many, many piles of bricks, evidence of devastating structural damage.
These bricks in Nepal were handmade by men, women and children.  The masonary yards dot the countryside surrounding Kathmandu.  These bricks are handstamped with pride.
I like to think the bricks represent the people of Nepal.  They have suffered, but remain strong and resilient, the founding stones of rebuilding.
I hope that I was part of that rebuilding.  I hope that the work we did as the TWECS team made it a bit easier for the people of Nepal to rebuild their cities, buildings, houses and their lives.

My experiences on this trip were overwhelming and complex.  I could cry because I was happy or sad and it flip flopped greatly.

Here are a few of my favourite memories:

Buying oranges at a roadside stand and them being weighed with old scales and weights

An early morning run in the foothills with my new friend, Dr Rita.

Getting a sour face from an elderly woman when she didn't like the glasses I dispensed (+13D) and trying -6D and she was happy.  One eye was +13 due to aphakia and the other eye was -6 but had a dense cataract.  I thought she would appreciate the correction in the eye with clear media but I was wrong).
Pollution:  Noise (vehicle horns, dogs barking), air (smog, exhaust, need to wear masks), garbage and litter

Seeing the beautiful women in the red dresses on Saturdays for weddings.

Being upset that I had to tell many people I could not help them.

Learning to use a squat toilet and remembering to bring your own toilet paper.

Hearing thousands of "Namaste"s everyday.

Crazy driving!!!  Potholes, dueling buses on narrow mountain roads. But our driver was calm and I felt safe.

Our very talented translators, who by the end of the day had learned so much about eyes, they were telling me what to do.

"Rock 'n Roll"  Dr Nixon White coined the phrase very early into our trip.  Any patient who had good vision, didn't need glasses and had healthy eyes, were told such but it was just easier to say a code word/phrase for the translator to tell the patient.  So our code was Rock n Roll.

Challenging conditions in clinic.  Dirt floors, dust, direct sunlight, never enough blackening out of the windows, no electricity or running water.

Food and beer (Gorkha, Tubourg), bento box lunches

A four year old patient grabbing my water bottle and taking a swig and returning it back to my bag.
Being included in a team in which I didn't know many.  Fabulous group of volunteers.  I learned a great deal from each one and laughed heartily with all.

Witnessing Dr Annu's donation of clothes, backpacks and shoes to a local orphanage. 

The best leaders organizers:  Marina, Derrick (and their twin 13 year olds, Evan and Emma) and David Sakaki.  Without your vision, hard work and generosity, this trip would not be possible.  I am humbled to be part of it.

A tree shaped as a heart

 I feel extremely fortunate to have participated in this project.  I think it is human nature to compare the lives we have to the people of Nepal and to feel thankful for all the comforts we have.  But that's not even the start of it for me.  I am fortunate to have met and served these kind and beautiful people.  I feel great love and gratitude. 
By Dr. Dana Blakolmer

Wednesday, March 16, 2016

I Was Immediately Drawn to the Baby.....

I was immediately drawn to the baby. Chubby-cheeked, swaddled in a cozy blanket and a flannel, this infant wore a snug knitted red hat and almost looked ready for a Canadian spring day. The baby fell asleep in my arms a few minutes after one of the "mothers," the older women who work at the orphanage we visited, put him in my arms. I couldn't help but recall the infant faces of my own son (now 10) and my daughter (now 8), and how different their lives in Nanaimo, BC, are from this child's. 

The unfairness in this world, where people don't have equal access to health care and eye care, is what drew me to Nepal. This is my third TWECS project in the developing world and I believe we truly make a difference: perhaps a person with correctly prescribed glasses can see well enough to work, and to better their lives. 

I saw thousands of people flow through our "triage" station, the stage at which patients in a TWECS clinic are first assessed. Many, especially the children, had surprisingly good eyesight. But the dominant complaints were sore, itchy, watery, burning eyes and headaches - some of the untold "aftershocks" of the earthquake that devastated this region a year ago. The Kathmandu area is covered in rubble, and the dust, heat and rough conditions take their toll on people's vision. I saw an 18-year-old who lost vision in one eye from a piece of glass. Stories like this are too common here.

I met someone I'll never forget on my first TWECS project in the Philippines. She was a 40-year-old woman, almost entirely toothless, with vision so poor she could hardly count my fingers in front of her face. At the time, she was close to my age. Yet she couldn't work, care for herself or enjoy what we'd consider a "normal" life. Anything I can do to help correct this kind of injustice makes the time away from my home, family and regular practice all worthwhile.
Dr. Allison Chang

Connect with People in Unexpected Ways.....

As a Hindu-speaking Canadian, I never anticipated that one of my childhood languages would be a huge advantage in this predominantly Nepalese-speaking country. But to my surprise Hindi can be widely understood here, and I've often been able to facilitate complex interactions and connect with people in unexpected ways.

For instance, yesterday an octogenarian retired teacher came to our clinic at Shree Sangla Balkumari Secondary School, where she used to work. She had cataracts and very low vision, and though we couldn't entirely resolve her problem we were able to provide reading glasses to magnify her near vision, to help her with sewing and everyday tasks. She was able to understand my Hindi and communicate with me directly, instead of through our teenage interpreters. She was so thrilled that she wanted to do a song and dance for us! She proceeded to sing a traditional Nepalese song and do a choreographed routine. The rest of the clinic's patients joined in with the singing, and my colleagues Drs. Rita Messing and Allison Chang


and I, got pulled into the dancing. These random moments of joy in the clinical days lighten the mood, and remind us all that we've come around the world to discover that some experiences - joy, love, pain, empathy and a sense of place and community - are truly universal.

A teenager came in, never having had glasses in her life, and required +8.00, a very high prescription. We gave her the strongest and most appropriate glasses available in our dispensary, and she left with much-improved vision and a huge smile on her face.

At Lalitpur, I examined 4-month-old baby whose mother said the baby had barely opened her eyes since birth. Her eyes were like slits and she had no vision we could discern. Heartbreakingly, the baby had been born with a hole in her heart and been given only 3 months to live. Without the money for private hospital care, this twenty-something mother had brought the baby to us in a desperate attempt for her child to perhaps see her mother's face at least once. This extraordinary tiny child and her hopeful mother had already defied the odds, but unfortunately I could do nothing to help them. At home in Canada, the baby would have received immediate post-party's care but the average Nepalese family has no recourse.   I did give this woman some donated clothes from my own mother, just one moment in which I was reminded how lucky I am to have a supportive and generous family. 
My own father and sister set aside CDN$600 for me to use for earthquake-relief donations on this trip, and with this support from my family and the TWECS team we were able to supply so much to help. We gave away probably 50 pairs of sturdy plastic slip-on shoes to shoeless kids and adults; more than 20 children's school backpacks; dozens of bars of soap; and 100 kg of rice and 15 kg of daal to an orphanage housing more than 50 children. I had packed two large suitcases full of clothing donations, including more than 50 brand-new t-shirts. I gave thise away at the orphanage and at our most remote clinic site, in the mountains at Kunchuk, where the school principal gratefully received them.  
Dr. Michael Kellam helps give the shoes to the children in the orphanage
Children in the orphanage take delight in seeing their photos.
That 7-hour driving day in Kunchuk was, for me, the epitome of why I am here, on my third TWECS mission. It was apparent from the remoteness of that community and our warm reception there that few had ventured this far to provide post-earthquake relief. I am grateful to TWECS and its local host organization for making the extraordinary effort to get us there to do our work. It has been unforgettable. 
Namaste by Dr. Annu Kaul

Sent from my iPhone

Friday, March 11, 2016

No One Has An Ego......

Every team member has been asked to write a BLOG for our TWECS web page. This is my 7th TWECS mission and each one is very different. Unlike Canada, Nepal has from what I can see, has no middle class! Poverty every where we go, every home has a shop on the first level, a garden even if it is only 4' square, no one in the lower class has a car, everyone including the elderly have a rickety old bike. But here in Nepal, no one has an ego! Very gracious and courteous people, driving is a nightmare and taxis are dirt cheap. 
Man carrying a fridge
Dispensing in Lalitpur
Line up 
Walking to the clinic in Tarkeshwor

Walking with our dragon lady


I've delayed writing this post to the blog because I'm struggling to come to terms with the sensory overload. Words are really quite inadequate to describe the visual, emotional, olfactory, tactial and auditory experience.

I'm a rookie TWECS volunteer and the entire adventure has been a roller coaster ride from day one. The kindness and gratitude of the people, the geography of the remote areas, the poverty, the devastation from the earthquake, the guilty pleasure of volunteer work all combine to create a swing in emotions from grief to euphoria in a ridiculously short period of time.

I'm at a loss to try and describe the breadth and depth of this experience but what I can do is share some vignettes.  Some are clinical and may appeal to those drawn to the necessary and commendable work of TWECS but others are simply insights into my exposure to volunteering. Most of these comments will relate to events and impressions of the last couple of days because the start of this project seems like an eternity ago.

-Our 7 hour return bus ride from Dhulikel to Sindhupalchuk along roads that more closely resembled goat paths. The skill and precision of our driver will stay with me forever.
-Coping with some clinical settings that were less than "optimum", where if a cow appeared I would not have been surprised!!! To call it stable-like would have been an exaggeration of the conditions.

-Examing a 3 month old girl blind in both eyes due to corneal scarring with a heart defect giving her no chance of surviving to her first birthday.

-Prescribing glasses for an 8 yr old girl with crossed eyes providing eye alignment and relief from her double vision. Her name was Angel and the significance was not lost on me.
-The caliber of the Nepali volunteers has been impressive in terms of their ability to work long, busy days yet maintain a level of engagement and genuine interest in their duties.
-Interacting with my 18 yr old translator, Sahanna, and developing our "Rock and Roll" counselling terminology. Basically code for her to tell the patient that their eyes are healthy and they don't require any glasses. As well, Sahanna and I developed a few dance moves together but we'll debut those on Dancing With The Stars so I won't give any more details.
-Today in dispensing two separate elderly gentlemen, one aged 91 and the other 87, gave me very unique and heartfelt gestures as we parted after they received their glasses. The first straightened to attention and provided a full military salute. The second gentleman, ironically wearing a T-shirt emblazoned with a Canadian flag, grasped my hand then kissed it. 

My heart swells and aches even writing these comments.

For some background, my wife Dr. Cindy Anderson, has participated in previous TWECS projects but this is dawn of a new day having us contribute together. She inspires me to be a more caring and giving person, fully realizing I'll likely never match her generosity. Just as Dr. Marina Roma-March has inspired Cindy and others to give time, money and effort, so that the needs of the impovershed will be addressed. Our TWECS Nepal Team is comprised of capable, kind and caring people providing a desperately required service.

I'm both grateful and humbled to be part of such a group.

By Dr. Nixon White

Clinic in the Condemned School Building

Today we arrived after an hour’s bus ride to a part of Nepal greatly affected by the earthquake of April 2015.  Almost one year later you can still see families rebuilding their houses out of brick, mortar, concrete and rebar. It is done by hand in the outskirts of Kathmandu, where we have been visiting and it looks like it is a painstakingly long process.

At the end of a small, windy dirt road we arrive at our destination.  It is a school which collapsed during the earthquake and has remained condemned as it is only partially rebuilt, but serves our purpose quite nicely.  It is cool as there is cover over head and a breeze for ventilation.  Also the lighting is good whereby we just have to position some black-out tarp and boxes for seeing into people’s eyes with our ophthalmoscopes and other equipment.  

Believe it or not we actually have running water and soap to wash our hands!  (this is a big bonus and first time this trip) And one of those squat toilets serves it purpose in the ‘doctor’s only’ washroom.  Hmmmmm.  Some of us find other places to pee.

Dr. Dana Blakolmer with the patient who had coloboma
The patient which sticks out in my mind from today is this lovely lady photographed with Dana who had a condition called coloboma.  It is a condition which represents an incomplete formation of the eye during development much like cleft palate.  Often it minimally affects vision, but this woman was almost legally blind in both eyes all of her life.  With a pair of TWECS donated glasses, we were able to get her vision to 20/40 (within the legal driving limit in Canada for perspective).  She was very happy!

By Dr. Shea Colpitts