High-Impact Volunteering Abroad in Dhenkanal, India

By Pallavi Basu
Cornell University Student
Global Impact Fellow

According to the World Health Organization, 80% of blindness is preventable, and thirty-six million people today are needlessly blind. Unite For Sight has become one of the leading NGOs to remedy the preventable blindness that affects so many in rural, developing countries. To date, Unite For Sight has sponsored over thirty-five thousand surgeries and helped a million patients worldwide. Kalinga Eye Hospital and Research Centre (KEHRC), centered in Dhenkanal, India, provides UFS-sponsored surgeries to Indians from the entire state of Orissa. Through the work of three ophthalmologists, as well as optometrists, and several paramedics, Kalinga delivers high-quality eye care to those in need. When I heard about the opportunity to volunteer here, two factors drew me in the most. While I had spent six years of my life in Kolkata, a metropolitan Indian city, I had never been to rural India, and I was eager to learn more about my own culture. Additionally, as a pre-med and global health minor, I knew that volunteering in Dhenkanal would be an incredible way to learn about medicine and healthcare as it operates outside of the U.S.

Prior to work in the field, UFS requires its volunteers to go through comprehensive training to thoroughly prepare them for high-impact volunteering in a developing country. Even before getting to India, the crash course in global health sparked my interest, curiosity, and concern about the vast barriers to international healthcare that exist today. Additionally, several resources linked to information about Indian cultural norms and practices to immerse volunteers in the social and medical environment in India. To further prepare, I shadowed an ophthalmologist in the Los Angeles area and expanded my knowledge of eye anatomy, disease, and technology needed to treat such disease. Within a few days, I was able to observe how refractive error, cataract, and glaucoma were diagnosed and treated. The doctor in Los Angeles even allowed me to use the ophthalmoscope to identify the distinct opacity of a cataract patient’s lens, and I was shown how to recognize different forms of conjunctivitis, keratitis, and diabetic retinopathy.

Upon arriving at Kalinga Eye Hospital during the hot and humid Indian summer, my stay primarily consisted of traveling to outreach camps, working in outpatient diagnosis, and pursuing my own projects. Outreach camps were a fundamental aspect to KEHRC’s mission. In order to maximize community outreach, paramedics, ophthalmologists, and volunteers would go by bus to village outreach clinics and screen patients in the area. If cataract surgery was deemed necessary by Kalinga Eye Hospital's doctors, the patient would be transported back to the hospital, given food and lodging, operated upon the following day, and finally transported back to their village by bus.  When the patients returned to the hospital for a check-up, it was incredible to see how pleased they were with their newly recovered vision. One carpenter emphatically reiterated his excitement to get back to work and spend time with his grandchildren. To complete the process for newly healthy eyes, patients were instructed in proper eye drop use and post-operational care.

During the eye camps, my knowledge of Bengali, a language very similar to Oriya, allowed me to roughly communicate with patients. Within a few conversations, it became clear to me that the nature of the pathology encountered was completely unfamiliar to them. Cataract surgery has a very high success rate, but even then, many patients were reluctant to make the trip to the hospital’s operation theatre. Wariness of modern medicine was visible through the severity of their symptoms – most patients had mature cataracts and severe eye infections. The wide range of pathology is something most doctors and students do not encounter in the U.S. because such diseases would undoubtedly be treated before progressing to a stage of near blindness.

While working in the hospital's outpatient diagnosis, my tasks were mainly to improve healthcare management, assist in marketing, and film for my photojournalism project. By helping the hospital create a new system of keeping medical records, not only were management tasks facilitated, but marketing strategies were refined. Since Kalinga relies on a number of paying patients to help keep its charitable sector running, marketing is of the utmost importance. By keeping medical records more efficiently, hospital staff could bring back paying patients for regular check-ups.  To maintain hospital resources, the other volunteers and I independently collected hundreds of eyeglasses from the U.S. for storage and later distribution during refractive error eye camps.

It is an accounting requirement that UFS-sponsored surgeries are observed and recorded by at least one Global Impact Fellow volunteer. I had never been in or outside an operation theatre, so being able to see a surgery up close rather than on YouTube was truly fascinating. What stood out to me the most was the efficiency and tirelessness of the surgeons and surgical nurses. No matter how many patients required surgery, Dr. Tripathy, Dr. Acharya, and Dr. Pathy would continue uninterrupted, careful work in order to complete twenty to thirty cataract surgeries in a single day! The surgical team included nurses who would instruct post-operation patients on appropriate measures for eye care, and another staff member then dispensed sunglasses to protect the newly recovered vision. The overall teamwork, efficiency, and care shown by the surgeons and nurses were inspiring in a rural region where modern medicine is still very novel.

One of the main things that I took away from my whole experience was the many unresolved issues in global health. I am proud to say that I worked for such a dedicated organization like Unite For Sight, and I see that members of developed communities must be further mobilized to assist in global healthcare delivery. I believe that programs for proper hygiene and health education must be developed. During my time at Kalinga, there was one child patient who had photophobia – in other words, his vision, due to hygiene-related bacterial infections, was extremely sensitive to light. As a result, he constantly kept his head down, drew his shirt over his eyes, and struggled in the presence of light. Knowing that such situations are preventable through good hygienic practices and adequate instruction, implementation of low-cost, high-efficiency education programs can go a long way.

Another barrier that education can eliminate is the distrust of modern medicine. Many of the patients believe that it is god’s will or imbalanced karma that causes their disease. In such cases, patients will often reject modern medicine, go to a traditional healer, or reject all possible treatments altogether. During one eye camp, an elderly male patient was diagnosed with cataract, and as I proceeded to mark the eye for surgery, the patient suddenly jerked his head away from my hand. With a firm and frightened expression, he explained to me and the doctor that he was old, prepared to die soon, and he did not want to disrupt his old age with modern surgery and medicine.

The entire experience foremost reminded me of how much more there is in India than simply the metropolitan town where I had spent my infancy and so many of my summer vacations. Rural India has its own beautiful culture, pace of life, and people, and I am so fortunate to have been able to experience a lifestyle entirely different from the one I have lived in Kolkata or the U.S. I gained a vast basin of knowledge not only about eye health, but also on the healthcare infrastructure, patient interactions, and management systems of the developing world. When verbal exchange was difficult, I learned to use other forms of communication than language, incorporating expressions and gesticulations. Most importantly, the workplace and social environment trained my patience and adaptability; in developing areas, the range of pathology is so wide and each situation so novel that having such adaptability is a requirement. Further along in my medical education, I know that my volunteer experience in Dhenkanal will allow me to adjust to unfamiliar situations and perform well. Reading about health issues in the news or in class became stark reality during my summer in Dhenkanal, and I now aim to reinvigorate my efforts to study and contribute to the field of international health. Over the course of my career, I hope that I can one day return to India as a doctor and remedy the health inequalities that remain ever-present on a global scale.