TO get to the International Conference Centre in Berlin from my hotel, I had a choice of taking the underground train, a taxi or the city bus. I could also walk but it could take me about an hour. I opted for a bus ride so that I could have a good glimpse of the famous city. In less than 15 minutes, I was at the conference centre. I made straight for the huge exhibition hall so I could see the vast array of modern ophthalmic equipment and instruments.
I moved from one stand to another admiring the newest items of equipment and instruments designed to give better and more precise care for the patient and make the work of an ophthalmologist easier. After about two hours, my feet were tired. I decided to sit down in one of the lobbies and rest a while.
Within a few minutes of relishing the comfort and beauty of the environment, I lapsed into a trance. I found myself as a special guest in the ward of a hospital. “Where are all the patients?”
Just two in a ward of 30 beds! They had been admitted for cataract surgery the week before and placed on low residue diet. Now they were awaiting an enema so that the lower intestine would be washed free of faecal matter.
“Why are you still doing this,” I asked? “After surgery, these patients must lie still in bed and on their back for about 10 days. They cannot afford to strain to pass faeces otherwise the surgical wound would open up and the contents within the eye would come out,” the nurse replied. “Don’t you suture the wound after removing the cataract?” I asked again. “We put just one or two sutures. They are large threads if we put too many they’ll cause severe irritation after surgery with serious consequences,” replied the nurse obligingly.
I followed my guide to the operating room. I was amazed at the sight that met my eyes. The surgeon was operating with naked eyes! I waited for him to complete his surgery. Then he got up and picked up what looked like a pair of funny glasses – the loupe. “I use this once in a while to give me some magnification,” he said. “Where is the microscope?” I asked. “What’s that?” He asked in return.
I shook my head in disbelief. He had never heard about an operating microscope! No wonder surgery took such a long time to complete and it was difficult keeping the patient still. I wasn’t therefore, surprised that the wards were empty. Who would like to go through all these gruelling steps to have a cataract removed?
Just then a Brazilian colleague I hadn’t seen in 25 years shouted “Ben!” Her shout ended my dream and jolted me back to reality. We exchanged pleasantries and as we walked from one booth to another, recalling old times, we marvelled at how technology had transformed our profession.
Many of our patients for cataract surgery now have it done as an outpatient procedure. Surgery can be completed in 10 minutes. There is no need for them to alter their diet before or after surgery and an enema before surgery would be absurd. We now insert intraocular lenses and the days of thick cataract glasses are over. With the available technology, we can ensure the ability to see distance clearly and read without glasses.
“Look Ben!” shouted Norma, pointing at the latest models of microscopes, “glaucoma” monitors, special retinal cameras and lasers. The sales reps tried to convince us about the need to change our old equipment to the latest. Norma and I looked at each other in the face and smiled. When we were out of earshot we both echoed, “if only he knew we were two steps behind the latest technology!”
It isn’t just about money; the more sophisticated the more critical repair and maintenance support needed. These, unfortunately, are not available in our third world. I once lost a new $15,000 equipment to a power surge at installation.
Brazil like Germany has a functional mass transit system with big buses, underground and “overground” trains. Going to Lagos from Ibadan to catch my plane I had just two choices – travel by road or walk. I chose the road and a 100-km journey took me over six hours. Next time I will trek!
It’s time the government allowed the private sector to provide us alternatives. Why do we flutter about like a hen when we can soar to the heights of an eagle? Why is an A student happy consistently scoring an E?
The answer is blowing in the wind.
and then