Observing Realities and Seeing Hope: My Experiences Volunteering Abroad Twice in Bihar

By Kristin Ow Chapman
Cornell Ophthalmology Resident
Global Impact Fellow

I never knew so much could happen in three weeks.  After four years at Pepperdine University, preparing for medical school in every possible way, I could not have imagined how much I would learn in such a short time from the people and country of India. 

I was searching for a summer internship when I stumbled across Unite For Sight, a 501(c)(3) non-profit organization that aims to help communities worldwide improve eye health and eliminate preventable blindness.  I searched the webpage and found that 80% of blindness is preventable, and the posted list of statistics was heartbreaking.   I learned that India is home to 25% of the world’s blind.  680,000 of the blind in India are children, and 40,000 of the blind children are blind due to cataracts.  The list continued with desperate statistics, but strangely, it seemed as if the problems had a common theme of hope:  many of the visual problems were problems that could be fixed.  As a read posted stories of past volunteers and the organization’s history, I realized that this was an organization that was making a difference, and I wanted to become involved.

The Incredible Sinha Family

Through Unite For Sight’s summer volunteer program, I was paired with the Sinha family in Panta, Bihar in the northern portion of India.  Dr. Ajit Sinha, along with his son, Dr. Satyajit Sinha, and Dr. Ajit's daughter-in-law, Dr. Pooja Sinha, work as a team in the A.B. Eye Institute and surrounding clinics.  I was inspired by their dedication, generosity and aptitude which was demonstrated daily in their home and work.  In many ways, their work is almost their home.  The doctors can, and often do, serve hundreds daily.  After seeing patients in the morning and afternoon, Tram Nguyen, my partner volunteer, and I would travel with the doctors to charity clinics five days a week to see patients who could not afford to come to a private clinic. 

The trip out to the clinics would sometimes include packing seven adults into a five passenger car and driving up to an hour through undeveloped roads in heat rising over one hundred degrees.  The streets were packed with people, carts, cows, rickshaws, and many other modes of transportation, all moving at their own pace and by their own rules.  Dr. Satyajit would deftly navigate through the crowds and down the narrow paths to the different clinics each day.  When the rains came, the streets flooded, the people disappeared, and some of the roads became impassable.  There were never any complaints from the doctors about the driving, the heat or the rain, and when we would arrive to the clinics, the patients were always so thankful and gracious about our visit that any traveling difficulties were easily forgotten. 

Many of the patients would travel far on foot and wait all day until we were able to arrive.  We would set up our flashlights (torches), visual acuity charts, paperwork, and eye glasses that we had brought.  We would then begin to receive patients, many of whom huddled around the door, waiting their turn.  The doctors would examine patients with great care and skill, but also at an amazing speed.  Tram and I would help to take visual acuity, distribute glasses with the appropriate fit and prescription, and maintain records.  Some took their glasses and left quietly with shy smiles, while others were so eager and excited that they would try to wear their reading glasses out the door!  The excitement and efficiency of the work at these clinics was inspiring.  Many of the patients screened and examined were given passes to come to the A.B. Eye Institute free of charge, and the next day, Tram and I would meet them again at the hospital.  For many, it is their only opportunity to receive much needed care and attention. 

Visiting the charity clinics in the rural villages helped me to develop a clearer understanding about many of the health issues and how some of the shocking statistics concerning rural health can be true.  The poverty and illiteracy does more than leave the people without proper nutrition or education, it shapes their way of thinking and way of life so that proper health care does not seem to be a hope or reality.

After meeting with the charity clinic patients, the doctors return to the A.B. Eye Institute and continue to see patients into the late evening and night.  The Sinhas' dedication goes far beyond anything I had expected.  We once made a midnight visit to the hospital to alleviate a patient’s pain after suffering an infection from another hospital, and I have seen the doctors work relentlessly through the week and weekends without rest.  Every day was a new lesson, and the opthalmologists of the A.B. Eye Institute in Patna were eager and compassionate teachers. 

Surgeries and Sibbi

The first surgery I witnessed was of a twelve year old boy.  Dr. Satyajit performed the surgery in twenty minutes.  Before coming, I was so impressed with the fact that the surgeries could be done so quickly with so little expense, but standing there, I was impressed that it could happen at all.  The boy and his family could not have afforded the surgery, let alone the consultation that first diagnosed the condition, and yet he lay there with two ophthalmologists, an optometrist and anesthesiologist caring for him with the same attention and skill that they would provide to a top paying patient.  It is that commitment and passion for the cause against preventable blindness that is making such a great difference in Bihar.

As the summer continued, and the heat began to climb and rest at 120 degrees, our experience in India only became more intense and interesting.  We visited a charitable clinic where we met Sibbi, a fifteen year old girl.  She suffered from triachiasis and nystagmus, and her mother had brought her into the hospital to be examined.  I watched as the doctor tried to explain to the mother that her daughter was blind, and though her eyes were open and moving, she could not see.  The doctors believed that if Sibbi had been examined and treated earlier, in infancy, she might still have her vision.  It was heartbreaking to see how lack of awareness and poverty could rob a child of her sight.

The Sinhas work to eradicate cases such as Sibbi’s, and in cases where it is too late to prevent blindness, they work to create a greater quality of life for the sight impaired.  Dr. Ajit Sinha founded a Girl’s School for the Blind after realizing that there were no facilities in the area for sight impaired girls. We visited the school where sixty girls are housed and educated without any cost to their families.  Some of the girls were at the school during the summer holiday, and they sang a welcome song and a song of prayer with enthusiastic and joyful voices.  The girls were so friendly and confident that I was initially intimidated, but the girls soon made me feel at home as we talked about some of their favorite activities, including the long jump and cricket.  The school is a special place that helps them to develop useful and special skills that will not only help them to survive, but to shine in the world.

Summary

In three weeks, we saw nearly 720 patients at the A.B. Eye Institute and charity clinics.  We observed six cataract surgeries and saw examinations of over 46 cataract patients.  The Sinhas have worked hard to provide the best patient care available, but in terms of supplies, there is a lack of provisions and updated equipment for the charitable clinics.  Donated reading glasses or even clean frames are a greatly needed resource for the clinics. 

I came home from India with a new and developed perspective on health care.  My experience in India exposed me to the devastating realities of public health, but also to the overwhelming progress that can be made through the generous use of skills and services by those who are willing and able.  Although at times, the need seemed insatiable, it is clear that people like the Sinhas and organizations like Unite For Sight are effectively meeting that need with great hope, determination, and compassion.

Update

Months after returning from Bihar, I submitted my medical school applications, spent an anxious year waiting, and finally started at NYU School of Medicine. I continued to be involved with UFS in the city and found that there was a need for education and a need to provide access for care.

The barriers to health care were different than in India, but they were just as formidable. Unite for Sight helped me to develop my view of the role, limits and responsibilities of a non-profit clinic through online readings and modules, and more significantly through the annual Global Health & Innovation Conference. The annual conference brings together people in various stages of professionalism and with diverse perspectives and experiences. The conference provides the space for an active and inspiring dialogue, and as a young medical student, it was a challenging arena that impacted my thought process regarding health care.

I decided to return to Bihar after my first year of medical school and brought a research component to my time in the clinic. It was a seemingly simple project, but proved to be difficult to execute and had frustrating results. With the struggle came such a great education, that by the completion and presentation of the poster, I felt so thankful and satisfied with the experience that I had already begun designing a new project at NYU with enthusiasm.

Five years after my first trip to meet and work with the Sinha family, I will be beginning my residency in ophthalmology. Although my time abroad sparked my interest in the field, the organization as a whole and its excellent model have maintained and supported my pursuit. Unite For Sight continues to influence the way I develop my view of health care and my role in the field, and I hope to remain involved throughout my career.