An Enhanced Perspective: El Progreso, Honduras

January 2016 | Stories from the field

By Lara Rich

Former SBVC Coordinator

When I found out earlier this year that I would be taking part in one of SEE’s international programs in El Progreso, Honduras, I was ecstatic. I have worked at the organization for just over three years and this was going to be my first time witnessing our work in a developing country. However, I am no stranger to seeing the benefits of our work first hand. As the Coordinator of the local Santa Barbara Vision Care Program, I work closely with patients here in our community. Through the local program, low-income and uninsured patients receive free and low-cost vision care including comprehensive eye exams, eyeglasses, medications, and surgical procedures.

If we are making this big of a difference here in Santa Barbara, I could only imagine what we were accomplishing worldwide.

It is extremely rewarding to witness how our services improve the lives of so many local individuals, with many patients coming back to show us their new glasses, calling in to tell us how they are doing following surgeries, or sending in sweet thank you notes. Still, I have always hoped to take part in one of our international surgical programs. If we are making this big of a difference here in Santa Barbara, I could only imagine what we were accomplishing worldwide.

Arrival

I was especially thrilled when it was decided that I would be traveling to Honduras for the clinic. I had always hoped to visit Central America and it would be a great opportunity to practice my Spanish! Upon my arrival in San Pedro Sula, the large city near the clinic’s location in El Progreso, I was met at the airport by Dr. Paul Hiss and a woman named Carmen. Dr. Hiss is an ophthalmologist from Reno, Nevada who had traveled to Honduras on behalf of SEE to perform the free cataract surgeries on in-need patients.

Carmen, I was soon told by Dr. Hiss, was considered the “mother” of the El Progreso clinic. She was the head surgical technician, but fulfilled many other duties as well. Dr. Hiss was extremely pleasant from the beginning and I learned that this was his second time visiting this clinic. I don’t think I could have been paired with a more kind, skilled and patient doctor. I was also very pleased to find out he was practicing his Spanish as well.

Once at the El Progreso Clinic, formally named Centro Cristiano de Servicios Humanitarios de Honduras (or CCSHH), everyone was so welcoming and went out of their way to make us feel comfortable. I settled in easily. Also, I was soon told by one of the women who worked at the clinic that she really appreciated that Dr. Hiss and I made an effort to speak Spanish as it wasn’t very common amongst volunteers. This was both surprising to hear and very assuring that we were doing our part to make them feel as comfortable with our presence in the clinic, as we felt being welcomed in.

The Clinic Screenings

When it came time for the clinic doors to open to patients, everyone got down to business. The clinic waiting rooms were filled wall to wall with patients as early as 6:30am each morning. CCSHH has a very well equipped clinic consisting of a waiting room, a large refraction room, several smaller exam offices, an operating room and a small optical shop. Although, in the U.S. a clinic of this volume would likely be twice the size, CCSHH does a great job of working with the space it has and maintaining a high standard for quality of care.

 

For the first two days, I assisted with basic refractions and pre-screenings of prospective surgical patients. During this time, I had the opportunity to speak with several of the patients. I learned that the majority of patients had to travel an average of 2-4 hours to the clinic. Several individuals informed me that they had come from as far as 8 hours away!

When asking the patients their reasons for traveling so far, even though some had vision clinics closer to their hometowns, many said they that besides the low cost of the services at CCSHH they had also come for quality of care. Apparently CCSHH has a very good reputation for both quality of services and how they treat their patients, no matter who they are. It was very clear to me why this reputation exists when observing the care the staff took with patients. Many of the visits ended with hugs and very sincere gratitude radiating from the patients.

I was impressed with the staff’s interactions with all patients, but I found one case particularly moving. One patient was a very small and elderly woman who was led into the exam room by her granddaughter, with two other women following close behind (and whom I assumed were her daughters). The woman had completely blinding cataracts in both eyes as well as very little hearing left. It was obvious by the way she moved (as well as by the care with which her granddaughter led her in) that she was in constant anxiety of what was in front of or around her. She didn’t appear to relax a bit until we comfortably seated her. Even then, you could sense her nervousness.

Dani, the technician, was quickly able to make her smile and calm her with his warmth and manners. I could immediately feel a change in both her and her concerned family members. After the exam, the patient and her companions all left the room smiling. The medical team decided that she would receive cataract surgery later that week.

In the Operating Room

I spent my last two days in the clinic observing Dr. Hiss in the operating room. At first, I was a bit apprehensive of how I would handle watching cataract surgery. I had never watched a surgery first hand in my life. I have to admit, I felt a bit unnerved at the thought of seeing surgeons cut into eyes. However, it was fascinating!

Dr. Hiss was very accommodating and took the time to explain the whole process to me as well as answer any questions that I had. His ability to perform surgery with precision, while communicating with me all at the same time, was amazing. He was performing two different types of cataract surgery, Phaco and Manual Small Incision Cataract Surgery (MSICS). Doctors use Phaco machine on patients with less dense cataracts. The machine basically uses a small vibrating instrument to break up and suck out the cataract. Dr. Hiss is very skilled with the machine. At CCHHS, the staff calls him the “Phaco Master”. The MSICS surgeries tended to be more complicated and take more time as the cataracts were much more dense in those cases. Between the two methods, Dr. Hiss completed 15-20 surgeries a day with few breaks between.

During my time observing cataract surgery we saw several different patients with completely blinding cataracts. Dr. Hiss told me that these cataracts were likely 10-20 years old. Doctors in the U.S. rarely encounter cataracts of this maturity, as most individuals here have them removed much earlier. These aged cataracts were mostly in older patients. However, we also saw seriously debilitating cataracts in much younger patients. One patient in particular was a 34 year old woman with entirely blinding white cataracts in both of her eyes.Dr. Hiss said that he had never seen someone so young with such dense cataracts, in both eyes no less. It was quite tragic to see someone so young being led into the operating room, with no ability to see what was in front of her.

After seeing such severe cases of cataracts coupled with the obvious economic poverty of many of the patients, it was clear what kind of impact these surgeries could make in improving the lives of the recipients. On my last day in the clinic, I shadowed Dr. Hiss while he did post-op checks on surgical patients from the day before. Just one day previously, many of these patients could barely read the number of fingers on the technician’s hand. Now they could read letters at 20/50 and 20/40 (with the likelihood of much more improvement.) Each patient left the room smiling and eagerly thanking Dr. Hiss.

Though I have been lucky enough not to suffer from any form of vision impairment in my life, it is not difficult to empathize with individuals who are losing one of their most used and prominent senses. Too frequently, we take for granted certain aspects of our lives that have always been there. I see the power of sight being no different. Giving that ability back to those who have lost it was an eye opening experience. In short, the patients were not the only ones to leave the clinic with an enhanced perspective.

I couldn’t be more proud to work for an organization making such a clear and measurable impact in people’s lives.

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