An Eye Hospital in a DC-8, Project Orbis Makes House Calls Around the World
In medicine, the only frustration greater than an incurable disease may be finding a cure and not being able to get it to the people who need it. That has been a particular problem in places like Laayoune, a dusty territorial capital in the disputed Western Sahara, now under Moroccan administration. Hundreds of victims of curable eye diseases are going or have gone blind in Laayoune, yet local doctors lack the expertise necessary to help.
But last month in Laayoune—as in 25 other cities on four continents during the past year—assistance arrived in the form of a 133-ton angel of mercy called Project Orbis, a flying eye hospital, complete with surgical and teaching facilities, built into a DC-8. Orbis (Latin for "of the eye") was the idea of Texas ophthalmologist David Paton, 53, who a decade ago saw the need for a practical way to exchange skills among surgeons and bring advances in eye surgery to the developing countries that often needed them most. The eventual result was the New York-based Project Orbis, which supports its 600-mph clinic and staff of 18 with donations from more than 1,000 corporations, foundations and individuals, plus a grant from the Agency for International Development and gifts from the countries it visits. "Orbis relies on donations to keep the project flying," says Orbis External Affairs Director Oliver Foot. "With a budget of almost $3 million a year, the project is always in need." Since its first flight a year ago, Orbis has traveled 31,500 miles, dispensing surgery and know-how in 20 countries from Sri Lanka to China to Peru. It landed in Laayoune for two weeks as part of a Moroccan sojourn sponsored by that country's Alaouite organization for the blind. "We are so few doctors and too many patients," said Dr. Abdelhadi Sekkat, a leading Moroccan ophthalmologist. "And many people come to us too late because of fears and superstitions."
From the moment the plane touched down on a strip of paved desert, word spread among the province's 70,000 inhabitants. The scene at the local hospital, where doctors selected cases for treatment, was one of tragedy and hope. Nomads in turbans and caftans, workers in Western dress, mothers with blind children crowded a doorway, waiting for an interview with the American and Moroccan doctors, conducted in a dizzying mix of English, French and Arabic. For some no help would have been possible. For others the doctors came too late. For a lucky 50 the three doctors on the Orbis staff, plus three surgeons visiting on this trip, agreed to see what modern science could do. Orbis' Dr. Robert Munsch likened the emotional onslaught to "a life experience coming at you through a fire hose." For one mother's blind baby there was no hope. An elderly patient who was not selected couldn't believe that this monument to technology was unable to help him. "What do you mean? You've been to the moon, you can make me see!" he insisted.
One by one, those selected were prepped in a pre-operating room in the back of the aircraft, then moved into surgery. One boy, a 15-year-old orphan named Mohammed, was blinded by congenital cataracts. Aboard Orbis, Dr. Sekkat performed an hour of surgery under the guidance of Dr. William Collis of Lexington, Ky., who flew over for a week to teach his method of cataract removal and artificial lens implantation. When the patch was lifted from Mohammed's eye 24 hours later, for the first time in many years he could see fingers held up before him. In a rush of emotion he embraced his surgeon. That sort of thing, says Orbis' Dr. Simon Holland, whose home is in Zimbabwe, "makes me high 10 times a day." A 57-year-old nomad received a cornea transplanted from an eye flown in from Texas. A 60-year-old woman, did not know how to acknowledge in words her first moment of sight after a lens implant. But when the doctor finally waved to her from three feet away, she happily waved back.
In all, the surgeons performed some 12 lens implants, seven vitrectomies (removal of the eye's clouded vitreous gel) and several complex retinal detachment operations, procedures rarely performed in Morocco before Orbis landed. More important, 20 of Dr. Sekkat's students watched every incision and microsuture, thanks to four video cameras in the operating room that feed TV monitors in a small classroom in the plane's front section.
After the operations drew to a close, the Orbis crew packed up and headed to town to join local officials for a toast and an exchange of gifts (Orbis membership certificates for the Moroccans, blue caftans for the Orbis staff). Munsch points out that the project often gets as much as it gives. "Seventy to 80 percent of the techniques used on Orbis originated outside the U.S.," says Munsch, remembering in particular an acupuncture procedure used by the Chinese during an operation to correct crossed eyes and a speedy cataract-removal technique used by Pakistani doctors.
Other, more personal exchanges also took place. Although a Moroccan mayor's offer of 5,000 camels for nurse Carol Cozzolino of Yonkers, N.Y. was politely turned down, nurse Toysa True, 30, who had been courted by a Malaysian prince and proposed to by two foreign ophthalmologists, finally accepted an offer from Fabio Carli, an Italian pop singer she met in Dubai. They plan to marry in her hometown of Dowagiac, Mich. this week. "My life has changed drastically with Orbis," says True of her work. "I understand the world better and feel more optimistic now. Orbis cured my blindness." With luck and funding, many more people around the world may be able to say the same.
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