Daily Diary: Unite For Sight Volunteer in Patna, Bihar, India

By Patrick Leneghan, Fourth Year Medical Student, Georgetown School of Medicine

Day 1

I arrived in Patna after staying in Delhi for two days with Dr. Sinha's relatives. Driving through downtown Patna was an experience itself, with the road being shared by cars, buses, rickshaws, bicycles, pedestrians of all ages, cows, and dogs. I arrived with my host family (Sinhas) and enjoyed a traditional Indian meal with them. I was struck by their genuine hospitality and their desire to make sure I was as comfortable as possible.

Day 2

We awoke early to drive to a charity boarding school for blind girls founded and run by Dr. Ajit Sinha. It was Sunday morning, and there was an official from the Indian royal bank visiting the school to donate two musical instruments. The school was an amazing place, with 92 girls from grades 1-10 going to class, eating, sleeping, and studying together. They were instructed by specially trained teachers in all the basic subjects including math, English, Braille reading, computer typing with assistance from a voice activated computer typewriter, and music. All of the services are paid for through donations organized by Dr. Sinha. After visiting the school for the blind, we toured the AB Eye Hospital and saw all the modern technology present there, including a Yag laser, A-scan, B-scan, retinal flourescein angiography, and a modern OR suite.

Day 3

Today was the first day of seeing patients at the AB Eye Hospital. It was a busy day there, where we saw about 50 patients during the morning hours, all of whom pay two dollars per month for the eye services they receive.

Our primary job was to screen patient's vision, take histories of any eye problems, and screen for any eye diseases.

After the morning clinic, we rushed over to the Red Cross clinic in central Patna where we performed visual screenings on over 100 patients and donated some of our glasses to very happy patients. We then returned to the clinic following a short rest for more clinic hours with Dr. Sinha.

Day 4

The day began once again at the AB Eye Hospital in Patna. We busied ourselves with vision screenings and eye health assessments of patients prior to being seen by Dr. Sinha. One interesting and sad case was of a 6 year old boy who has had declining vision over the past two years, now down to just counting fingers at 2 meters. His anterior segment was normal, so Dr. Pooja did a flourescein angiography test on him which revealed a hereditary macular degeneration, an irreversible and untreatable cause of blindness. It was unfortunate for this child, but his parents were happy to finally know the cause of their child's devastating vision loss.

The afternoon was spent traveling 20 miles outside of the city to an extremely poor roadside village where over ninety % of the people were without work and many were homeless. We pulled up to a large group of 100+ people of all ages attracted by the free cataract screening, sponsored by UFS, USA poster hung from the front of a small, one-room schoolhouse. We set up shop with our bags of donated glasses and proceeded to screen patients for cataracts and hand out glasses to those who needed them.

One patient was an elderly gentleman who was completely blind due to bilateral senile cataracts. He had not been able to afford the two dollar rickshaw ride into the city and so had not had proper vision care. With the help of Unite For Sight, this patient was scheduled for cataract surgery the following day.

Day 5

Today we started the day in the OR with Dr. Sinha, who performed two cataract surgeries. The first patient received sutureless small incision cataract surgery in which a scleral tunnel was made and the cataract removed with much less chance of astigmatism than with traditional cataract surgery. The second patient was the elderly gentleman from the charity clinic yesterday, and he received the traditional limbal incision for his cataract removal. Since this patient's cataract was more mature, Dr. Sinha wanted better access to his anterior chamber in case a complication arose. An interesting case from clinic today was a six year old patient with microphthalmia, microcornea, and retino-choroidal agenesis.

In the afternoon, we visited another charity clinic in Patna city, the site where Patna was first founded along the banks of the Ganges thousands of years ago. Now the city is the site of extreme urban poverty, with people residing in makeshift huts made of a brick floor and some tarp for a roof built on the side of extremely congested, polluted roads. Amidst the chaos, we pulled up to a tiny storefront, smaller than most bedrooms in America, filled with about 30 patients, and 30-50 more waiting patiently in the mud outside. Here we began visual screenings and donated about a dozen glasses. Then, an elderly, emaciated man with veins and bones visible beneath his skin, walked up to us. He was found to be completely blind due to mature bilateral cataracts that had become so swollen as to block his canal, leading to an intraocular pressure greater than 50 and ultimately permanent blindness due to the pressure exerted on his optic nerve. He had known about his eye problems, but did not have the time or money to get them treated properly. This man's story is a sad story about the devastating effects on poverty on visual health, but also on that shows the potential that a program like UFS has to figure out better ways to make cataract surgery more available to the poorest people throughout the world.

Day 6

Today was Saturday and was spent seeing all the patients from the charity clinics Monday-Friday who either needed refractive correction or access to more specialized diagnostic techniques. We saw about 75 patients during the day today. One patient was seen with angle closure glaucoma, and he was treated with high dose timolol and ALT.

Overall, my experience in Patna was an incredible experience. I enjoyed being part of the UFS program in the effort to help eradicate preventable blindness in the world. I also enjoyed working with and learning from the Sinha family, as they were incredible doctors and great teachers. I also enjoyed being immersed in Indian culture and look forward to returning to India to assist with visual care in the future.