From for the Record, Wednesday, August 6, 1997: Spelling error: Dr. Seth Fiadorova’s name was spelled incorrectly in a photo caption on the front page of the Aug. 5 In Life section.
When the electricity went off while Dr. Eric Sorensen operated on a patient’s eye, he was caught by surprise and had to finish the procedure by flashlight.
Dr. Michael Cunningham, however, wasn’t fazed by the event. He’d seen it all before during previous trips to eye clinics in Africa.
The ophthalmologists recently spent two weeks in Ghana, Africa, treating some of the thousands of people who are effectively blind from advanced cataracts.
It was Sorensen’s first visit, and Cunningham’s sixth. During his first visit to Africa, Cunningham spent a month alone at a Sierra Leone clinic without any power the entire time. A generator was turned on only long enough to power the operation microscope during procedures, then immediately turned off.
“I have my American doctor’s mindset and my African doctor’s mindset,” said Cunningham, 49. “In America, I expect everything to go right. In Africa, you just have to expect things to go wrong.
“It’s stressful for a doctor to have an eye open and be working in there and not be able to see what you’re doing,” said Cunningham of Sorensen’s experience. “It makes you realize how dependent we are on help and how spoiled we are because we always expect the electricity to be here and the water to be clean.”
The surgeons went to Ghana as part of a program run by Christian Eye Ministry based in California. The ministry recruits doctors willing to travel to different locations in Africa. They pay $2,500 to cover airfare, meals, housing and visa, and provide their own supplies.
“I had not seen a Third World country,” said Sorensen, 53. “I had no concept of how these people actually lived.”
Sorensen calls it “medicine in the raw,” treating people who need help without the hospital setting and all the fancy computers, lasers, and microscopes. “It’s just you and the patient in broken down old house,” says Sorensen. “It doesn’t have all the trappings.”
Once word spread the American doctors were in town, Ghanaians flooded the clinics. Moving at a fast pace, the doctors squeezed 90 or more patients into each 12-hour day. They managed the fast pace by having two patients at a time in the operating room. That way, when the surgeon finished with one patient, he could simply pivot and start work on the next. Patients shared beds - two per bed - in the pre-op room to maintain a steady supply.
A country with a population of nearly 20 million, there are about four qualified eye surgeons to treat the estimated 70,000 people who are blind from cataracts.
What’s more, eye surgeons educated in Ghana are trained in techniques 15 years out of date. Using the older method of cataract surgery, the cloudy lens of the eye is removed in one piece, requiring a large incision. Patients must wear thick glasses to see, and then their vision is distorted and only good enough to discern the shape of objects, like a door.
Patients are often so poor, they can’t afford the glasses even when they’re available.
With new techniques, only a small incision is required and a special lens is inserted in the eye, allowing patients to see without glasses.
“With the implant you can see well and it’s a miraculous thing,” said Cunningham. “That’s eons better as far as the rehabilitation of the person and their quality of life afterwards.”
Some Ghanaians travel to other countries for training in modern techniques, but that leads to the problem that plagues many Third World countries: brain drain. Once they leave, the don’t want to come back.
“They want to educate their children and they want to feed and clothe their family, and they can do it so much more effectively in the First World,” said Cunningham. “It’s hard to get them to go back once they’ve left.”
Spokane’s doctors worked with a Ghanaian doctor who was the exception to the rule. Dr. Seth Fiadorova was trained in Russia and learned the new techniques from the steady stream of American eye surgeons who visit the eye clinic in Cape Coast where he works.
Fiadorova is a board-certified ophthalmologist and works a second job at the government hospital in addition to his duties at the clinic. He makes less than $300 a month.
“This guy is very unusual, because he’s sharp and well trained, and yet he stays,” said Cunningham.
The poverty that grips the country is evident in the eye clinics, especially with equipment which is often broken. Repair parts are hard to find and costs money the clinics don’t have.
Add to that the weather.
“The very high humidity causes things to rust,” said Cunningham. “It causes fungus to grow inside the lens systems of the microscopes we use. That’s an unavoidable cause of a lot of problems.”
Cunningham began these trips to give something back.
“The need is so great and I am so blessed, that I feel a debt to human kind, almost an obligation; a need to repay somehow a portion of the wonderful blessings I’ve received,” said Cunningham.
But, “It’s selfish, too.” he added. “It’s exciting to go help somebody see.”
Cunningham sought an organization that would send him to Africa in 1988, but he still had a tough time making the decision to actually go.
“I went through all the excuses,” said Cunningham. “My kids were still in school and I wasn’t that excited about going away for a month anywhere, let alone to some place I was afraid of. By the time the month was over, I was anxious to come home, but I knew I was going to go back again.
“The first time was the hardest,” he said. “I didn’t know if I was man enough to survive it.”
After his second trip, Cunningham’s wife Linda realized he wasn’t going to quit going, so she took a class on assisting cataract surgery and now travels with him. Cunningham describes her as an important part of his crew. “She has been my scrub technician the last four trips, and will continue to do so. It was real neat that she bit the bullet and decided to do this. She does a great job.”
Already Cunningham is planning a trip to Camaroon this fall and doesn’t see an end to his trips.
“This subject is near and dear to my heart.”
“It was basically a wonderful experience,” says Sorensen. “I would highly recommend it to any of my colleagues.”