Linda Jackson
Executive Director, Helping Hand for Nepal, Inc., Anchorage, Alaska
Field: Communications
Host Institution: BP Koirala Center for Ophthalmic Studies
Grant Dates: October 1, 2002 - November 11, 2002

Medicine with Compassion 

It is hard for a Westerner to comprehend Nepal can be this flat. As far as you can see…miles and miles of miles and miles. Neat farmland squares and livestock-goats, pigs, water buffalo, ducks and chickens abound. Simple huts. Women kneading and patting slabs of manured straw as if it were bread dough, forming triangular loaves to be dried and sliced for fuel. Ponds dot the countryside. Fishermen pole flatbottom boats skimming over tranquil water. Nets light on the water somehow man-age to catch fish for the evening supper or market. The magnificent Kosi River now cradled in its em-bankments to prevent annual flooding, and canals to bring water to crops. Bananas. Oranges. Coco-nuts. Carrots. Cauliflower. Turnips. Eggplant. Birds of all kinds-huge cranes delicately balanced on long-stick legs, the small kingfisher darting between branches, and ravens black as after sunset. Then the sun and a multitude of birdsongs rising together in the soft morning air. Can this be the home of Mt. Everest?

Rajbiraj. Roads shared by bicycle rickshaws, goats and pigs rooting for the same scraps, amazingly relaxed cows, bicycles, hay on trucks piled so high it appears to be an impossible feat, and pedestrians unbothered by all this cacophony of activity. Also the site of the December 2002 Surgical Eye and Ear Camp sponsored by the BP Koirala Center for Ophthalmic Studies, and the Lions Clubs of Rajbiraj and Tilathi. A virtual hive of activity.

Like bees this well-honed team of professionals swarms down on the city, turning the rooms in their assigned building into specific screening areas for eyes and ears, pre- and post-op rooms, and of course the operation theater (OT). The Lions skillfully manage the crowds for registration. Although almost no advertising is done, crowds there are…the masses speaking volumes about the need for ac-cess to medical care. A BPK Center administrator and two student optometrists efficiently screen the patients. In our five-day camp 1344 patients are registered and screened for eye and ear problems. Some 153 patients have cataract surgery, and 1050 patients receive ear treatment. Others take away medicines, prescriptions for glasses, referrals for further treatments/surgeries.

From a tape deck Anan Sumi's soulful voice soars over the operation theater upstairs while two oph-thalmologists, two ophthalmology residents, three nurses, and a technician work swiftly, deftly, and skill-fully long hours. It is amazing how quickly each one works and yet still shows such care and tender concern for each and every patient. The day in the OT dawns warm, progressing to sauna status by noon. Even with the fan humming, heat exhaustion seems inevitable. Still they labor on seemingly un-aware of discomfort, the occasional patient's foot tapping now to a Beatles song, a doctor or nurse join-ing in on the chorus.

Downstairs two ENT doctors sit in a small room barely big enough for their meager table, the chairs on which they sit, a stool for each for their patients. Two bare light bulbs illuminate the room. The audi-ologist works in a similar adjacent room. The temperature rises proportionately with the number of bod-ies squished into the tight space. Can they really be drinking hot Nepali milk tea this afternoon? Hear-ing loss and deafness, I learn, are as big a problem in Nepal as vision impairment and blindness. 

Nepal was the first to join the World Health Organization's movement Vision 2020: The Right to Sight. This global initiative challenges developing nations to target and eliminate their main source of avoid-able blindness by the year 2020. Already behind 137,000 cases and adding 35-40,000 new cases yearly, the BPK Center is taking a leading role in the reduction of cataracts in Nepal.

Recognizing the immediate and growing need for access to eye care throughout Nepal, the BPK Center recently started Nepal's first School of Optometry to help deal with mid-level eye care problems. The BPK Center is the ophthalmic manpower-training center for the nation, training both ophthalmologists (medical doctor/surgeon specializing in treatment of the eye) and now also optometrists (medical pro-fessional that gives eye examinations, diagnoses eye problems and diseases, prescribes and fits glasses and contact lenses, prescribes limited medicines, refers appropriate patients to an ophthal-mologist).

In addition, faculty, ophthalmology residents, and optometry students see 300+ patients a day at the BPK Center, plus conduct six specialty clinics. Community service and outreach are done weekly, and a new eye-screening program for elementary school children is currently underway. In their spare time these amazing medical professionals organize and conduct surgical eye camps in remote and rural ar-eas. For the most part these camps are free to the patients.

I am used to multi-tasking and working long hours at home in Alaska, but still I wonder. We all have the same 24 hours in a day. How do they accomplish all this? I marvel at their professionalism, their quiet patience, their confident skill under less than pristine conditions, and their never-ending compassion for their patients. Surely there are lessons to be learned here. Hopefully I have not only learned a few, but have documented them photographically to share with others when I give presentations back in the U.S.

When I close my eyes, I still see vividly the young eye surgeon, himself a graduate of the BPK Center, gently scooping up his next patient in his arms. Frail and literally frozen with fear, she is paralyzed-too terrorized to even get up off the cot in the pre-op room and walk the short distance to the operating room herself. He smiles down at her, crooning soft reassurance. Calling her Ama, he cradles her in his arms, carrying her confidently towards her new sighted world.

Note: Linda "Jay" Jackson is a Fulbright Specialist in Communications and Journalism, re-cently assisting at the BPK Center. An award-winning photographer and educator, she is the Founder and Executive Director of Helping Hand for Nepal, Inc.
helpinghandnepal@acsalaska.net

-©2003 Linda "Jay" Jackson

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