This mission was organized in Senegal by the Peace Corps with close cooperation with Dr Abdulaziz Diallo, ophthalmologist and dr Sall, the ophthalmic technician from the Department of Ophthalmology, Regional Hospital, Ourossogie, Senegal.
From the US, five members of the nonprofit organization “Right to Sight and Health” participated: Pamela Spranger, RN, Bethelena Weston-Knotts, RN, Patrick McCarthy, Silka Spranger and Judith Simon MD.
Ourossogie is a small town in an underdeveloped Eastern area of Senegal with 20 000 inhabitants, and a regional center for health care. It is the only hospital providing eye-care in several hours drive in each direction. The hospital director, Dr Diouf warmly welcomed our group and assured an excellent working environment.
The Peace Corps volunteers, with the leadership of Meredith Hickson and Ivy Renfro took care of all the logistics: calling patients for their surgical appointment, relationship with hospital administration and workers, assuring patient flow, translation, preoperative and immediate postoperative care, vision check, biometry, eyeglasses and eye drops distribution, and working as circulating nurses. They also provided for all the needs of our group from the US, including transportation, lodging, food, and obtaining supplies. Ivy and 3 other Peace Corps volunteers worked with us last year in Bakel, which made things much easier, as they were already familiar with the work and did not need to be trained.
The pre-screening of the cataract patients was done by Dr Diallo, Dr Sall and Dr Baa, with the help of the Peace Corps Volunteers. They started to go out to the surrounding villages, mainly at the Ranerou region, 2 months prior to our arrival and they scheduled 200 patients for us. As one of our doctors cancelled and we had only one surgical microscope (the local one was not suited for eye-surgery), only 15 patients per day were called in for surgery. Most of these patients showed up and most of them were good surgical candidates. We also operated on a few patients who showed up and were not on the schedule, but only if they were bilaterally blind. We also operated on a 10 year old child in general anesthesia. We offered bilateral cataract surgery but the father did not consent. His other eye will be operated on by Dr Diallo after our departure, for free.
During our 10 surgical days performed the following surgeries:
115 cataract surgeries, 110 with PC IOL, 4 with AC IOL – 1 was subluxated cataract – and one with no IOL.
The primary goal of the mission was not to perform cataract surgeries but to train dr Diallo in the technique of small incision cataract surgery (SICS). He has been performing ECCE with sclero-corneal incision and sutures for 5 years. He is a very talented surgeon and he made great progress, at the end of our mission he could safely perform uncomplicated SICS in 15 minutes, with good results. He was also trained in performing complicated cataract surgeries. We donated an operating microscope “Endure” with excellent optics to the hospital which is portable, so he would be able to use it also on outreaches. We also donated 3 surgical instrument sets to him, and also a direct ophthalmoscope, a slit-lamp, other surgical supplies and eye drops. We also trained Dr Sall, an ophthalmic technician with excellent knowledge of ophthalmology in surgical assisting. We trained both Dr Diallo and Sall giving peribulbar anesthesia, in the use of intracameral Cefuroxime to prevent endophthalmitis, and in the use of intravitreal Vancomycin to treat endophthalmitis. We trained them and the hospital personnel in the use of a new autoclave which was donated to them a while back but have not been in use because of lack of in-service. The use of the new autoclave is a big advance as the one in use previously took over 2 hours to sterilize and this one took about 40 minutes.
We distributed about 300 pairs of glasses, mainly reading glasses. We donated 500 pairs of glasses, mainly reading glasses and some myopic glasses to the hospital for further distribution. All postoperative patients received sunglasses for light protection.
Overall, this was one of our most successful missions ever, not so much regarding the number of surgeries we performed but because of the teaching aspect. Dr Diallo made a huge progress and after our departure he will be able to perform cataract surgeries much faster, cheaper and with significantly better results. With the new microscope he will be able to tackle complicated cataracts and monocular patients. He was already on a relatively high level professionally which will make it possible to develop further on his own. He asked us to return next year, but we answered that then probably he will be the one who can teach us!
We want to say a huge « THANK YOU » to the Department of Ophthalmology of the Ourossogie Regional Hospital, especially to dr Diallo, Sall and Diouf, and to the Peace Corps of Senegal for making our mission possible.