Friday, December 8, 2017

Dooley Intermed & Operation Restore Vision Gift of Sight 2017 Blog

By Jeff Blumenfeld -

Gift of Sight December 14, 2017

Chinja Ghale, 65, is a proud Nepali who became blind three years ago. For five hours yesterday her son-in-law guided her along precipitous trails to the Dooley Intermed - Operation Restore Vision eye camp here in Machhakhola. Cataracts in both eyes turned her world into darkness. She walks barefoot to better feel the ground.
Chinja Ghale, 65 (far right)

Yesterday, the mature cataracts were removed from both eyes, replaced by intraocular lenses.

This morning was the "reveal." As expedition leader Scott Hamilton, a certified ophthalmic technician, removed both bandages from her eyes, a smile came over her deeply lined face.

She passed the finger test; was asked the color of the jacket on a volunteer.

"Hariyo" (green)," she says in Nepali, now able to see colors again.

Then suddenly she jumps up and begins walking in the dirt and hay-covered courtyard of our makeshift eye hospital, walking for the first time unassisted in three years.

Through a translator she tells videographer Daniel Byers she is looking forward to returning to the fields. Her son-in-law, for his part, no longer has to serve as caretaker.

She was carried in piggyback style, and walked out like a spring chicken.

Ophthalmologist Chris Teng was astounded. "I started residency in 2005 and this is the first time I've seen someone with bilateral (both eyes) mature cataracts make such a complete recovery. In the States you typically don't see cataracts this advanced." 

Another 24 patients, some who had single cataracts removed, others with infections and other eye ailments, were also sent home this morning.

Down the hillside below the eye camp, a woman squats next to her home pounding rocks into gravel which she'll later sell to support her family. We see numerous other women throughout our eight hour trek, also pounding rocks, making gravel.

We can't help everyone in this impoverished village, but over these past four days, for over 800 eye patients (71 surgeries), the quality of their lives forever changed for the better.

Friday is our planned extraction by helicopter. The sooner our doctors return to their U.S. practices, the better.

GOS - December 13, 2017

Often during our stay in Machhakhola schoolchildren we meet will clasp their hands together, say "Namaste," and in the next breath ask for chocolates, money or pens. Our Nepali hosts say this engenders a beggar mentality, and that donations should be made through schools. Besides which, we're told, the kids don't need chocolates due to concerns about their dental health.

Numerous patients, some blinded by bilateral mature cataracts, speak a local dialect called Tamang instead of Nepali. This necessitates one Tamang-to-Nepali translator working with a Nepali-English translator so our doctors can communicate with them. This complicates matters for our videographer, Daniel Byers, who is documenting the project.

This morning was the reveal for 42 surgery patients; bandages were removed, doctors performed a final check, and sunglasses were handed out.

These are not particularly emotive people. Their reactions to regaining sight were quite subdued, just a few smiles here and there, especially among family members who now no longer have to lead their loved ones by the cane.

Tomorrow: another reveal, patient follow-up and the docs will handle any walk-ins from the surrounding communities.

- Jeff Blumenfeld

GOS - December 12, 2017

These people have so little, their lives made harder still by the spring
2015 earthquake whose epicenter occurred here, directly below the hillside village of Machhakhola.

We awaken this morning at 5 a.m. to the beating drums of a funeral ceremony in the distance. Our unheated tea house rooms are luxurious by Nepal standards. There is electric power for three hours at night, padlocked doors to secure our possessions, two single beds with one-layer foam mattresses, and a single squat hole toilet down the hall, which admittedly, requires a certain skill to successfully employ.

During a morning walk I cross a swaying steel footbridge and look back at a scene of particular desperation. Smoke from poorly ventilated tin roof shacks billow out; mules, chickens, a pig and goats roam freely; and a few single room stores sell a few dusty items of household necessities.

A single water tap in the central square provides water for drinking, washing, cooking. Those of us with delicate western stomachs give it a wide berth as we frequently apply Purel sanitizer to our hands.

We are, some might say, blissfully isolated from the world. Our Kat-bought Sim cards are temperamental, there's no internet, and no newspapers. One consolation is an inReach emergency satellite device that allows us to send 160-character texts, and summon emergency aid if necessary. Otherwise, this blog has to wait until I return Friday to the city.

Into all of this arrives the Dooley Intermed-Operation Restore Vision team.
In short order, our ophthalmologists find patients with facial skin cancer, blocked tear ducts, droopy lids, chronic eye infections, and over 76 operations are scheduled, mostly mature cataracts rendering the patients blind.

So far its been a grueling, but intensively satisfying trip.

GOS - Dec 11, 2017

For decades, Dooley Intermed has been providing health services to those in need in the remotest regions of the world.  That never became more apparent to me than here in one of the world's poorest countries.

The only way to reach our final destination, the hillside village of Machhakhola, was another four hour trek along this undulating, rocky terrain, making this impoverished settlement a total eight-hour hike from the nearest road.

Four hours today doesn't sound like much, and the elevation is only about
2,800 feet, but the trail at times narrows to a footpath on precipitous cliffs above the rushing Budi Gandaki river. We see the carcasses of two pack mules that failed to successfully navigate particularly hazardous sections.

Piles of mule crap line the trail, making passage particularly tricky.

Speaking of mules, we share the trail with numerous mule trains, some carrying large containers of explosive propane cooking gas. Best tip when faced with an oncoming mule: stand on the uphill side; I was already whacked once by a bag of rice hanging on the side of one particularly large beast - the sideswipe got my attention.

Gingerly crossing a tremendous landslide caused by the earthquake, we arrive at Machhakkola to applause from a crowd of 100 Nepalis eagerly awaiting our arrival. Marigold garlands are ceremoniously placed over our heads.

Dozens of villagers crowd the central square - old men hunched over with walking sticks, women in brightly covered clothing, young mothers carrying babies on their backs, some nursing. There's  a young man leading an obviously blind parent by the hand.

We're told some walked a day to get here, an impressive feat considering most locals wear a pair of open-toed sandals, certainly not the modern hiking boots or trekking poles that we couldn't imagine going without.

Dozens of Nepalis crowd our makeshift examination room. We hit the ground running.

GOS - December 9-10

Bone-jarring. There I've said it. How else to describe an 8-hour 4WD kidney-rattling drive from Kat to Soti Khola about 80 miles away.

Dust kicked up by the bus ahead inhibits our vision. Leaves are coated a mocha brown. The roads are more like trails. You can't read, you can't sleep. As you're Maytagged on washboard roads, you hold on and try to absorb the shocks as if riding a bucking bronco.

What appears to be hay bales with legs are women along the side of the road carrying enormous bundles supported by straps to their foreheads. Frequently we see elderly Nepalis pounding rocks by hand to create piles of gravel to sell.

We arrive at our tea house along the Budi Gandaki River, our rooms enveloped in the incessant white noise sound of rapidly flowing water.

Sunday morning the plan blessedly allows us to leave the claustrophobic 4WD's behind and trek on foot two hours and 1,000 feet higher to Lapu Besi, our stop for the night. The porters and cooks follow behind, aided by pack mules to carry our personal and medical gear.

I marvel at the speed of one porter who passes me at a good clip. I'm kitted out in Sherpa fleece, LEKI collapsible poles and Hi-Tec boots with Michelin soles that mimic car tires. Yet I'm smoked by an elderly gentleman loaded down with a camera case and medical equipment while wearing open-toed rubber sandals, both of his heels listing to either side.

These are strong, resilient people for sure.

The Dooley Intermed/Operation Restore Vision eye screenings began this afternoon  at the Shree Prabhat Kiran Secondary School in Lapu Besi with eye tests using a tumbling E eye chart, and a retinoscopy test to determine the need for correction.

The school had been completely rebuilt after the spring 2015 earthquake, in part through the help of Prince Harry.

After just two days in this underserved region of Nepal, it's easy to see the need for quality eye care here on the other side of the world.

Jeff Blumenfeld

203 326 1200

GOS 2017 - Friday, December 8

Imagine you live in a remote Nepali village one day's trek from the nearest road. Now imagine a group of strangers arrive with sharp instruments and want to operate on your eyes. It requires an abundance of faith.

For their part, the communities know we're due to arrive. Thus it was important for the Dooley Intermed - ORV team to understand a bit more about the rich, if somewhat enigmatic culture of Nepal and its people.

Such was our goal today.

First stop was Pashupatinah Temple, a UNESCO Cultural Heritage site, and sacred Hindu temple on the banks of the Bagmati River. From across the hill we watched as a half- dozen families cremated their dead loved ones. Red-bottomed monkeys, stray dogs running through the river, and vendors selling all matters of trinkets added a festive air.

We pay to pose with a sadhu, a colorfully decorated Hindu holy person said to renounce all worldly possessions. However our guide tells us this particular fellow's insistence on being paid for photos makes his piety somewhat suspect.

We see evidence of the spring 2015 earthquake that killed 9,000 Nepalis - numerous construction sites and still cracked walls - as we head to Bouddhanath Stupa, the holiest Tibetan Buddhist temple outside Tibet. Dating to the 14th century, from above it looks like a giant mandala, or diagram of the Buddhist cosmos.

Nearby we tour the Ribcheling Thanka Gallery and Art School, an artist co-op. It specializes in thangkas, Tibetan Buddhist paintings, some with 24 karat gold and natural stone colors, used as an aid to meditation and prayer.

We next tour the Healing Bowl and Therapy House where, bizarrely, heavy hand-hammered bowls made of seven different metals are placed on our heads, and over our bodies, then are struck repeatedly, thus summoning the healing qualities of both sound and vibration. The procedure dates back to the Bronze Age, about 3000 BCE.

"It's not magic, it's physics," we're told by the singing bowl therapist staffing the store.
Perhaps. As I request treatment for my one kidney, I'm reminded what my mother used to say about the medicinal value of chicken soup: "It couldn't hurt."

With some free time I snake my way through the popular Thamel neighborhood, the labyrinthian center of Kat's tourist industry for four decades. Shops offer $200 sightseeing flights to view Mt. Everest, restaurants prey on timid Western stomachs, and outdoor stores offer $35 down jackets, most counterfeit, most filled with anything but natural feathers.

There are cobwebs of wires everywhere, rubber-coated spaghetti on every pole. One for telephone, one for power, one for internet, one for TV, going into every apartment.
Like much of everything else in this country of 29 million, no one knows how, but it all seems to work.

Tomorrow we travel by Jeep eight hours into the hills, then trek from there on foot for 10 hours with mules. It's in these remote areas at the end of the road - and beyond - that Dooley does its best work.

Jeff Blumenfeld
203 326 1200
Sent from iPhone

GOS 2017 - Thursday, Dec. 7

Kathmandu at Last
The Dooley Intermed-Operation Restore Vision Team Arrives

What do you do for 12 hours in the air? Frankly, whatever you can to pass the time: watch two movies, begin reading "Annapurna" by Maurice Herzog, eat three meals, read the airline inflight magazine, clean out your wallet, make space by deleting iPhone photos, sleep in an upright position (good luck with that), play iPhone blackjack, and rip articles out of magazines to read again maybe never.

We have a four-hour layover. While Dan Byers, our videographer, and Yale ophthalmologist Christoper Tang walked off their jet lag at the ultramodern Hamad International Airport in Doha, Qatar, I was on a singular mission to determine whether this rich country on the northeast coast of the Arabian Peninsula  is called "cutter," or "cuh-tar."

A stately gentleman in a long flowing white tunic called a thawb, sandals and keffiyeh headpiece, settled it for me: it's "cuh-tar," which vaguely rhythms with "gui-tar."

The Qatar Airport, with its high end Rolex, Coach, Harrods, and Swarovski shops, was a sharp contrast to what we experienced in Kathmandu this evening.

Kat is the loud, raucous, polluted  capital of Nepal. A city of 1.2 million that assaults every sense from the moment you arrive at Tribhuvan International Airport.

Our driver presents us with marigold garlands we wear like Hawaiian leis. Nice touch.

We pass hundreds of tiny store fronts, mopeds seemingly coming at us from all directions, dogs everywhere in the streets and pedestrians wearing dark clothes on dark, poorly-lit washboard streets.

It's election day and private vehicles are banned from the city. Dooley Intermed guides proudly show us ink-stained thumbs that indicate they voted today in the national election. They have secured special permits and we breeze into the Marriott free of traffic. The hotel will be our home base for two days, as we decompress from our nonstop journey to the other side of the world.

Jeff Blumenfeld
203 326 1200

Sent from iPhone

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