Presentation on theme: "May 19-29, 2012 CATARACT SURGERY MISSION Then his eyes were opened, his sight was restored, and he saw everything clearly. Mark 8:25."— Presentation transcript:
May 19-29, 2012 CATARACT SURGERY MISSION Then his eyes were opened, his sight was restored, and he saw everything clearly. Mark 8:25
The Team Daniel Gradin, MD Dr. Gradin is a General Ophthalmologist at the Casey Eye Institute, Oregon Health & Science University in Portland, Oregon. He is one of six consultant ophthalmologists at a referral center serving East Africa, and has spent many years in Nairobi practicing ophthalmology to the indigent patients there. Amy Gradin, BA Daughter of Dan Gradin, Amy has a heart for missions as instilled by her parents. As her college graduation gift, Dan and his wife Sally provided the funding for her mission trip to Congo with the cataract team. She eagerly participated as the surgical tech assisting her father in surgery. Judith Ingalls, MLS Judy is an ASCP- Medical Laboratory Scientist, presently working for Christiana Care Health Systems in the Hematology and Chemistry laboratories. She has participated in missions in Congo and Honduras. Donna Baker, APRN, MS, ACNS-BC, CNOR Donna is a Perioperative Advance Practice Nurse currently working as a Clinical Process Consultant at Picis, implementing software in high acuity hospital departments such as the Operating Room, Recovery Room and Intensive Care. She has participated in multiple medical missions in Africa.
But, more importantly, our Lord was there!
Daily Worship at Mpasa
Accomplishments Lots of prayers Beautiful worship experiences Founding of new friendships and relationships and the strengthening of existing ones Creation and implementation of a model for future cataract surgery missions
Accomplishments Continued… Patients screened 761 Surgeries performed 117 Cataracts 2 Chalazion (small bump in the eyelid caused by a blockage of a tiny oil gland.) 2 Carcinoma 24 Pterygium (non-cancerous growth of the clear, thin tissue (conjunctiva) that lays over the white part of the eye (sclera) Total Surgical Procedures = 145
Evaluation Mpasa provided very adequate operating room and storage space. Dr. Yohadi allowed multiple nurses to observe and assist in the operating room so that they could be trained and available for future ophthalmologic surgery at Mpasa. Communication that the clinic was to be held at Mpasa must have been more than adequate as close to 800 patients were screened in the 15 days that the Congolese and/or US teams were present.
Evaluation Continued… Although the electricity was quite adequate and reliable, when the power outages occurred, the existing generators could not supply adequate power for all of the equipment needed for the surgical experience (microscope, keratometer, A-scanner and sterilizer). Patient identification proved to be quite difficult due to communication barriers, especially when a translator was not available to be present during the scanning procedure. Travel to and from Mpasa was considered nonproductive time (other than glimpses of the culture, the city and team recap, devotional and planning time).
Dr. Dan adjusting the microscope
Dr. Dan interviewing patient
Visual Acuity testing
John, Sylvie (and Stanley) testing
Screened patients awaiting surgery
Preoperative local anesthesia
Removal of instruments from sterilizer
Patient exits the OR
Post operative Day 1
Removal of eye shield
Happy Smiles and Hallelujahs!
Dr. Yohadi personally carried her
To her mothers arms
Recommendations for Future Missions Planning Stages Review the supply, equipment and medication list with the accompanying US surgeon for their approval and determination of the need of additional items. When communicating with SEE, Alcon or other vendors and suppliers, use written documentation, such as . Consider contacting the Mission Aviation Fellowship for assistance in transporting supplies to Kinshasa from India and other Asian countries where pricing is much lower and would lower shipping costs, as well.
Recommendations Continued… Surgical Clinic Rather than escorting patients seeking consultation into a small room one-by-one, consider organizing them in rows of seating and the physician walking up the row screening patients quickly. This would occur after visual acuity is assessed by the team. Provide long tables for use in the OR for nonsterile supplies. Provide small baskets and/or boxes to organize supplies on nonsterile tables in the OR for better accessibility.
Recommendations Continued Surgical Clinic Use a triage process to ensure blind patients are treated in priority. Obtain inexpensive reading glasses for distribution to patients who sought consultation but only required sight magnification, rather than cataract surgery. As part of the medication supplies, make additional eye medications available for patients with several allergic responses.
Recommendations Continued Surgical Clinic Consider purchasing a generator with increased fuel efficiency and greater output. Obtain patient bracelets for careful and safe patient identification. Purchase a keratometer and A-scanner to be left at Mpasa. Create a screening form with date, time, name, age, sex, preop visual acuity, K1, K2 readings and IOL for each eye.