Volunteer Surgeon in Third World Countries

I did my residency in ophthalmology from 1968 through 1971 at the Washington Hospital Center in Washington DC. I had previously graduated from UCLA Medical School and completed a one-year internship. I turned down a residency at UCLA’s Jules Stein Eye Institute, Baylor and a few other institutions to go to a program in Washington DC that provided wonderful clinical experience and tons of surgery. At that time many programs provided great teaching, but little surgical practice. I had heard that the Mayo clinic residents were lucky to do 20 cataracts. I did close to 10 times that. Our program had ONE paid faculty member, all the others were volunteers. I decided that if they were willing to teach me voluntarily, it would only be fair to pass on the gift. To that end, I have been teaching at the Long Beach Veterans Hospital since 1974, part of the training program of UCLA initially, and for the past 30+ years at UCI. My first experience was in 1976 when I accompanied a UCLA resident to Honduras and assisted in his training, along with the local (USA trained) ophthalmologist. The experience was fulfilling and made a difference in the lives of local patients as well as in the training of the UCLA resident. The next trip was to Mexico in the late 1980’s. I went with a group
from S.E.E. (Surgical Eye Expeditions). We paid our own expenses and brought donated supplies, intraocular lenses, medications, etc. These were long weekend trips. They included Zacatecas three times, a wonderful city north of Mexico City that once was the capital of Mexico and the center of silver mining. The local Lions Club provided some assistance and the locals were very grateful. Often, they showed their gratitude by trying to get us drunk, a tradition we found all over the third world. They were not successful, as it might have had problems for us to drink and then operate the next day. The Mexicans were quite vocal about their happiness with greatly improved vision.

In contrast, in some countries, patients were stoic and reserved afterwards, even though they could now see and enjoy their families. I believe some felt that if they were too happy, the gift of sight could be taken away. We also did a trip to Parral, in the northern state of Chihuahua. This is where Pacho Villa was assassinated. These trips were all fulfilling, fascinating and memorable. I can easily remember these trips better than other things I did in those years, including trips to Europe, Mexico or Hawaii.

Growing up, I was a stamp collector, not just pasting stamps in spaces in an album, but trying to learn about the individual countries. Doing volunteer surgery has allowed me to complete some of this knowledge and see countries in a way the usual tourist never does, as the hosts invariably go out of their way to show us unusual sites and provide insight into their culture. I was at an American Academy of Ophthalmology annual meeting in Anaheim several years ago and a well dressed foreign physician kept looking at me, then introduced himself as someone I had helped teach when I was in Katmandu Nepal teaching at the medical school. I then remembered him. He thanked me profusely as the “father of modern cataract surgery in Nepal” as I had taught the faculty how to do surgery with ultrasound (phacoemulsification), like we have been doing it in the USA for the past 30+ years.

Over the past seven years I have spent about two weeks per year in Zambia, a poor sub-Saharan African country with 13 million people and only 10 ophthalmologists.
In the future I will discuss my experiences there, contrast them to trips to
Borneo, Mongolia, Nepal, Tibet, Vietnam, Philippines, etc. I will share with you the difficulties getting supplies into different countries and the types of eye problems we handle.

-Michael R. Kaplan, M.D.