Mission to Uganda
In December 2017, Dr. Matthew Bujak, Alex Kaplan (PGY5), Stephan Ong Tone (PGY5) and Celina Wu (Physician Assistant) travelled to Uganda for an international ophthalmology mission. The trip was a huge success and in just two weeks the team was able to screen and treat hundreds of patients, which included five corneal transplants and 98 cataract operations. The first week was spent in Kampala, where the focus was on corneal transplants, as well as teaching local residents in wet labs and didactic lectures. The second week took place in Kabale, a small town in southwestern Uganda. The focus there was to screen patients and perform cataract surgery. The highlight was watching these patients dance and sing once their eye patches were removed. They were led into Kabale regional hospital completely dependent on their family members – quiet, subdued, and afraid. They left as whole people – dancing, smiling, and singing. It was a privilege to help them through this transformation!
A documentary filmmaker, Darcy Muenchrath, joined the team to capture these and other highlights of the trip. His film will spread awareness of the Uganda mission and the huge need for international assistance in helping to tackle blindness in the developing world.
This mission would not have been possible without the generous support of the Nanji family and corneal tissue donated by Sightlife Labs and the Eye Bank of Canada. With the Nanjis’ help we were also able to purchase and donate a new surgical microscope that can accommodate two surgeons at one time. This will be instrumental in helping facilitate resident surgical training.
A remarkable story, the Nanji family gives back to help fight blindness in Uganda.
University of Toronto dual mission to Uganda tackles both cataract and corneal blindness.
Video production provided by filmmaker Darcy Muenchrath. To learn more about his work, please visit: https://hinge-visual.com/
Mission to Ehiopia
One of the Department of Ophthalmology and Vision Sciences’ most poignant goal is our global health mandates to develop collaborative programs in impoverished communities across the globe. On January 27th, Assistant Professor, Dr. Matthew Bujak, flew to Addis Ababa to aid in an ophthalmologic surgery mission in conjuncture with the Himalayan Cataract Project.
Ethiopia, with a population of over 97 million, has one of the highest rates of blindness in the world with 1.6 million blind people and 3.6 million people living with low vision. Cataract related blindness is the leading cause of Ethiopia’s vision issues, and with only approximately 130 ophthalmologists in the country the condition is out pacing the aid. NPO’s and global health missions are crucial to providing relief and updated tools and training techniques.
On the first day, Dr. Bujak arrived in Mekele and travelled to Adigrat for the Outreach Cataract Camp. The abundance of prospective patients filled the waiting areas the evening before the screenings began. One patient that stood out for Dr. Bujak was seven-year-old Abel. He was completely blind, unable to attend school or have the freedom to interact with the rest of his peers. When one of the doctors asked him what the first thing he wanted to do after surgery he responded, “I want to go to school for the first time.”
Over the next four days, the team at the Outreach Cataract Camp operated for 12 hours performing surgery on 452 blind patients and 486 cataract surgeries. The surgeries were successful, including young Abel’s. After surgery, Abel regained his vision and is now able attend school with his classmates.
Dr. Bujak and the team returned to Mekele, where they performed five corneal transplants. This included the second DSAEK corneal transplant ever done in that region of the country. Along with the surgeries, Dr. Bujak was able to relay advanced techniques to the local surgeons, helping to create opportunities for more surgical advancement and training.
Dr. Bujak was able to take part in these missions through the support of the Nanji family, whose donation ensures our ability to help those afflicted in underdeveloped areas to maintain and improve their vision and their ability to live fully in their communities. And also through the support and organization of the Himalayan Cataract Project, who organize outreach missions across the globe. Please visit www.cureblindness.org for more information.
Pediatric Ophthalmology in Ethiopia
In February 2018, Drs. Asim Ali, Helen Dimaras and Stephanie Kletke (PGY4 resident) travelled to Ethiopia to work with Dr. Sadik Sherief (previous UofT and SickKids Paediatric Ophthalmology and Strabismus fellow) at the Menelik II Hospital, Addis Ababa University (AAU). This is the main Ophthalmology department for the capital, and AAU has the largest and oldest ophthalmology residency program in Ethiopia. The group conducted a situational analysis in preparation for the development of a pediatric ophthalmology academic partnership between the University of Toronto and AAU. This work was funded by a CIHR Planning & Dissemination grant awarded to Drs. Ali, Dimaras and Sherief.
During the week, the team observed in the clinics and operating rooms, visited the local Eye Bank and wet lab, and met with faculty and residents. Availability and quality of resources and staff, paediatric patient case load, residency program structure, and current resident paediatrics exposure were comprehensively reviewed and compared to the International Council of Ophthalmology fellowship requirements, which will be the basis for the potential fellowship program.
Drs. Ali and Dimaras gave lectures and teaching sessions for the AAU Ophthalmology Department, residents, and Ophthalmological Society of Ethiopia on retinoblastoma genetics, the Kenyan national retinoblastoma strategy, corneal neurotization, pediatric cataract, glaucoma, corneal transplantation, and management of Stevens-Johnson Syndrome.
The visit culminated in a strategic working meeting to discuss curriculum development for a Pediatric Ophthalmology and Strabismus Fellowship Program at AAU, the first of its kind in East Africa. This will be tailored to the local population needs with support from UofT faculty through didactic teaching and supervision of clinical/surgical skills for priority training modules. The group aims to partner with the Toronto Addis Ababa Academic Collaboration (TAAAC), an educational partnership established in 2008 that supports Ethiopian graduate training.
They concluded their trip with a visit to the National Museum of Ethiopia to see Lucy the Australopithecus and traditional Ethiopian music, dance and food!
Mission to Costa Rica
Dr. Allan Slomovic and Dr. Amandeep Rai completed an international ophthalmology outreach mission to Costa Rica to work with DOVS alumni Dr. Randall Ulate. The team presented grand rounds to the University of Costa Rica's ophthalmology department, resident teaching and completed an outreach mission to the small town of Nicoya. There, the team performed pterygium surgeries, phacoemulsification cataract extraction, and extracapsular cataract extraction, and also provided resident surgical training. Of course, they also had the opportunity to enjoy the remarkable natural beauty of Costa Rica!
Retinoblastoma in China
In November 2017, Dr. Brenda Gallie and Stephanie Kletke (PGY4 resident) travelled to Guangzhou, China to participate in retinoblastoma care and education. They worked closely with Dr. Junyang Zhao (Retinoblastoma specialist) and Dr. Liwen Jin (Pediatric Ophthalmologist) and observed vitrectomies performed by Dr. Qiyan Li (Vitreoretinal surgeon) at the Guangzhou Aier Eye Hospital. This group recently described planned PPV and endoresection of active retinoblastoma refractory to standard treatments as an alternative to enucleation in children with only one remaining eye, with no cases of extraocular dissemination.1
They also attended the 2017 Lifeline Express Paediatric Ophthalmology and Strabismus International Summit Forum in Guangzhou. Dr. Gallie gave a lecture on steps to eliminate retinoblastoma-related deaths within the next 10 years. Dr. Gallie and Stephanie also observed intra-arterial chemotherapy at the Guangzhou Women and Children’s Hospital. Stephanie then travelled to Shenzhen to participate in examinations under anesthesia with Dr. Zhao. Dr. Gallie continued for a second week as a Visiting Consultant of the Chinese Foundation for Lifeline Express Eye-Train, giving lectures on retinoblastoma to Chinese physicians at the Zhanjiang Second People’s Hospital in Guangdong province, LiuZhou Women and Children’s Hospital, Guangxi, and Shanghai 9th People’s Hospital. This was a fantastic educational experience that will facilitate future collaborations with retinoblastoma providers in China.
ORBIS mission to Vietnam
The mission trip to Hue in Vietnam in Feb 4-9, 2017 was organized in conjunction with Orbis. Our team comprised of Dr. Jamie Oestreicher, Dr. Imran Jivraj (fellow), Harleen Bedi (PGY4) and Mindy Shinoff (Nurse). We were joined by Anesthesia staff from the UK and other anesthesia doctors from various cities in Vietnam.
We started our hospital-based training program with a screening day when we provided consultations for several patients and selected candidates for surgery. Dr Oestreicher spent time in the OR training three hands-on trainees in various oculoplastic procedures.
Imran and Harleen delivered a daily lecture series, which was received very well by residents and staff. Mindy delivered lectures to nurses and OR assistants to review sterile technique and proper OR equipment management. The overarching vision of the Orbis initiative is to develop this institution into a training centre well-equipped in delivering oculoplastic care to patients.
Overall, the mission trip was a great success. Each day the team explored the beautiful city of Hue, which is known as the Imperial city of Vietnam. Our food adventures, shared conversations and laughter made each day fun and memorable. We returned home grateful for the new friendships and lifelong colleagues.