2010 ANNUAL REPORT, ABBA PHILIPPOS MEMORIAL EYE CLINIC (AMPEC)

Transcription

1 2010 ANNUAL REPORT, ABBA PHILIPPOS MEMORIAL EYE CLINIC (AMPEC) Summary 2010 was a great year. For the first time, modern cataract surgery was done in Dembi Dolo. Cataract surgery was done by surgical eye teams in January, September and October of 2010 and 166 eyes were given their sight back (due to the large numbers of cataract blind patients who presented for care, nearly all patients had only one eye operated). Thanks to donations, the eye clinic also gained possession of a first-class operating microscope, a slit lamp, A-scan, keratometer and three sets of cataract micro-surgical instruments. History of the eye clinic Eye care activities in Dembi Dolo date back to 1972 to the Vincentian Catholic missionary priest, Gerhard Hendrik Johan Maria Essing. Gerhard was the eldest of eight children. After completing high school, he entered the major seminary of the Vincentian Congregation (Lazarist) where he did his Philosophy and Theology studies. Upon being ordained, Fr. Essing volunteered to work in Ethiopia. Arriving to Ethiopia, and finding that the people had difficulty pronouncing his name, he took the name Abba Philippos. One day, a young man visited the new priest with a complaint of blurred vision. After studying the matter, Abba Philippos determined that the young man had astigmatism. With much additional study and effort, he measured the refractive error and sent the young man to the capital city, Addis Abeba, to have a pair of eyeglasses made. These greatly helped the young man which caused the reputation of Abba Philippos as eye specialist to grow. Seeing the great need for eye care, Abba Philippos determined to learn even more. Missionary Vehicle Association Holland (MIVA) granted him a scholarship at the University Of Amsterdam Department Of Ophthalmology with special permission to study for half a year. At completion, Abba Philippos received a certificate stating that he was only allowed to practice as an ophthalmologist in Ethiopia. MIVA provided him all instruments necessary to do refractions and to treat simple medical conditions of the eye. People from all walks of life, poor and rich, powerful and beggars, came to receive treatment from the hands of Abba Philippos. Big trucks from the north, south, east and west came bringing truck-loads of people as early at 4:00 in the morning. Abba Philippos became a legend to the people of Dembidollo. He was not able to do cataract surgery but he treated many medical eye conditions. 1

2 In the late 1990s, Abba Philippos retired and eye care services ceased in the Sayo district. There was only very limited eye care throughout the entire West Wollega region at this point. After returning to his native Holland, Abba Philippos returned to his Creator on September 1, Anxious for the work of Abba Philippos to continue, the local Catholic Church asked for help from the local government. In 2004, land was donated by the Ethiopian government for the purpose of putting up an eye clinic. Construction of the eye clinic took place in 2006 and Sr. Evelyn Puestra of the Daughters of St. Vincent de Paul was given administrative charge of the eye clinic. The eye clinic is centrally located close to the bus stand in Dembi Dolo. While construction was ongoing, Nurse Mitiku Asefs was sent to Quiha Ophthalmic Training Center, Tigray (Mekelle). He was sponsored by the Spanish organization, Proyecto Vision. After finishing his training as an Ophthalmic Medical Assistant (OMA), Mitiku opened the Abba Philippos eye clinic in He was soon joined in this work by nurse Tsehai Wolteji. Nurse Tsehai then enrolled in the Ophthalmic Medical Assistant training program in Mekelle and she returned as a trained OMA in Many blind people with cataracts presented themselves for treatment in 2007, 2008 and Efforts were made to find an ophthalmologist who would bring a team and all necessary equipment to do cataract and intraocular lens surgery (cataract and IOL surgery) to the eye clinic at Dembi Dolo. Dr. Larry Thomas, an American Emergency Room physician and a long-time friend of the Daughters of St. Vincent de Paul made many contacts with American ophthalmologists. The first ophthalmologist who visited the Eye Clinic was Dr. Tomas Huguet Marti from Barcelona, Spain in He screened patients and treated medical eye conditions. The first ophthalmologist to do cataract and intra-ocular lens implant surgery at Dembi Dolo was Dr. James Guzek from Richland, Washington, USA. Project area and reporting The Town of Dembi Dolo is located in the extreme western part of Oromia region which is in the extreme western part of Ethiopia. This town is located in the Kelem Wellega Zone which has a population of 803,701. It lies within Seyo district which has a population of 117, 511. The population of Dembi Dolo town is estimated at about 30,000. Dembi Dolo is the capital town of the zone. The director of the eye clinic (APMEC) is Mitiku Asefa. He reports to Sr. Evelyn Puestra. Sr. Evelyn reports to her superiors at the Sisters of St. Vincent de Paul. The Eye Clinic functions loosely both under the Sisters of St. Vincent de Paul and the Apostolic Vicariate of Nekemte. 2

3 The altitude of the Dembi Dolo township varies between 1600 and 2000 m (about 5800 feet). The rainful is, in general abundant and estimated at 1400 mm per year (50-60 inches per year). Sayo district forms part of Ethiopia s Highlands and has a beautiful hilly landscape. Dembi Dolo is built on a ridge. As a result, one of the main problems the people face is with getting water during the dry season. Waterborne diseases are wide spread. The predominant occupation in Dembi Dolo is farming with mixed crop-livestock production. There is a low literacy rate. Also, the health status of the community (especially of the mothers and children) is often poor. The government health service is inadequate for the needs of the people. The major eye diseases are refractive error, cataract, trauma, glaucoma, trachoma and vitamin A deficiency Medical activities at the eye clinic The average daily intake at the eye clinic at Dembi Dolo is about 25 patients. The total number of patients seen at the eye clinic in 2010 was The following medical conditions were the most prevalent: DIAGNOSIS # CASES SEEN IN 2010 Conjunctivitis 1158 Cataract 500 Refractive error 260 Trachoma (acute = 134; TT = 44) 178 Glaucoma 50 Keratitis, uveitis 150 Vitamin A deficiency 100 Outreach medical eye camps were done to 11 areas in 2010: Aleku, Lalo Kile, Alem Teferi, Dale Sadi, Hawa Galan, Tedjo, Mugi or Anfilo, Gidami, Jima Horo, Gawo Kebe and Chanka patients were screened at these camps of which, 361 patients were found to have cataracts. In 2010, 260 refractions were done and 164 spectacles were dispensed. 3

4 2010 Surgical activities In January 2010, Dr. James Guzek (American ophthalmologist), Dr. Gerald Wodtli (optometrist), and a team of nine other Americans spent 6 days doing cataract and intraocular lens implant surgery at Dembi Dolo. Dr. Guzek borrowed an operating microscope and microsurgical instruments from Surgical Eye Expeditions International (SEE International) for this trip. He also received donations of supplies from Allergan Medical Optics (AMO) and Alcon Ophthalmic. Dr. Guzek and his team rapidly screened large numbers of patients in order to identify those bilaterally blind from cataract. They successfully operated 62 blind patients without any eye infections (one eye per patient only). There remained many who the team did not have time or supplies to operate. In early September 2010, Dr. Marti from Spain returned with another ophthalmologist. They performed 45 cataract and intraocular lens implant surgeries. In October 2010, Dr. Guzek, Dr. Cindy Murrill (Optometrist), Dr. Joseph Pfeifer (Optometrist), Dr. Asfaw Natu (Ethiopian-American Optometrist) and a team of eight others returned to perform cataract and IOL surgery on 72 patients. Equipment donations Ophthalmic equipment which was donated by the Tri-Cities Sunrise Rotary, Dr. Guzek, Dr. Thomas (Tropical Health Alliance Foundation) and others in 2010 include: 1. Zeiss OPMI-6 operating microscope with assistant microsope and foot control 2. Haag-Streit slit lamp with applanation tonometer 3. A-scan 4. Hand-held keratometer 5. Three sets of cataract microsurgical instruments 6. Bipolar cautery 7. Large Pressure cooker (autoclave) 8. Two surgical stools 9. Two Mayo tables 10. Two diamond knives for doing manual small incision cataract surgery Thanks to the generosity of the Columbia Center Rotary in Kennewick, Washington, USA, funds for an air conditioner were donated in March 2010 At the end of 2010, the staff of the eye clinic numbered seven. This includes two eye nurses, one clinical assistant, one registration clerk and three watchers/guards. 4

5 In Ethiopian Birr 1 USD = 16.4 B 2010 BUDGET Cash on Hand on January 1, , Cash in bank account(s) on January 1, , INCOME (in Birr): Pharmacy 61,790 Sale of spectacles 12,128 ` Surgical revenues 9,080 Clinic consultation revenues 83,052 Overseas donations: ` 1. Light of the World 190, Tropical Health Alliance Foundation 61,906* ` 3. Private donors 78, Mill Hill, England 22,348 THAF donation was given in 2009 to prepare the Operating Room with furniture and other OR needs. This donation is taken out under the EXPENSES 2010 TOTAL CASH INCOME FOR 2010 = 620, EQUIPMENT DONATED BY FOREIGN SOURCES IN 2010: 1. Zeiss OPMI-6 operating microscope $13, A scan $ Keratometer (electronic hand-held) $ Haag-streit slit lamp and appl. Tonometer $ Bipolar cautery $ Two stools $ Two Mayo tables $200 5

6 8. Pressure cooker $80 9. Two diamond knives $ Three cataract surgery trays $5500 TOTAL COST OF EQUIPMENT PROVIDED AS FREE DONATION = $39, Expenses (in Ethiopian Birr): Staff salaries and other staff expenses 84,111 Purchase of eyeglasses 500 Purchase of pharmaceuticals 137,590 Electricity / internet 5,865 Building Maintenance 17,368 Staff training and education 9,035 Office and household supplies 22,722 Transportation 72,066 Hospitality 99,340 Outreach program 10,177 Surgical eye expenses 39,548 Upgrade electrical infrastructure 21,354 THAF for OR furniture, etc. 61,906 TOTAL EXPENSES FOR 2010 = Birr 581,582 TOTAL CASH INCOME FOR 2010 = Birr 620, TOTAL COST OF EQUIPMENT PROVIDED AS FREE DONATION = $39,230. TOTAL EXPENSES FOR 2010 = Birr 581, CASH ON HAND ON DECEMBER 31, 2010 = Birr 2, CASH IN BANK ON DECEMBER 31, 2010 = Birr 36,

7 Remaining problems: The main problem is that there remains a massive number of blind people who could be made to see with cataract surgery. Many thousands are waiting to have their sight restored. The biggest limitation is the lack of trained ophthalmologists who are willing work in this remote area in difficult circumstances. There is also a problem with lack of running water at the eye clinic and in the guest quarters (the convent). A rain-water collection system is needed at both sites. A stable source of funding for the smooth running of the eye clinic is also needed. Funding from the Netherlands has been exhausted. Unfortunately, the people of Dembi Dolo are so poor that reimbursement for services is low. Currently, the charge for cataract surgery is only Birr 170 (USD 10). A clinic visit costs B 10. Despite this low cost, there are many who cannot afford it who are treated for lesser amounts or even for free. Thanksgiving We would like to thank all our donors, especially the Tri-Cities Sunrise Rotary, Dr. James Guzek, Dr. Tomas Marti, Dr. Larry Thomas, The Tropical Health Alliance Foundation, Mr. and Mrs Van Walkley and Evelyn Walkley, Surgical Eye Expeditions International, Allergan Medical Optics and Alcon International. 7