How does a group of volunteers from disparate professions and locations deliver cohesive eye care services in a developing country? mivision went
behind the scenes with Cambodia Vision, to look at the planning that goes into eye care outreach trips.
Thida Yang is neither an ophthalmologist nor an optometrist. In fact, she has no health care training at all. Yet she has probably done more to restore sight to people blinded by eye disease and cataracts than most others who are eminently more qualified.
Ms. Yang is one of a core group of individuals, who are the backbone of Cambodia Vision, a non-profit organisation that works with small provincial towns in Cambodia, focusing on blindness prevention and basic medical healthcare.
“It’s more than my fulltime job,” Ms. Yang laughs when asked about her volunteer workload with Cambodia Vision.
…she has probably done more to restore sight to people blinded by eye disease and cataracts than most others who are eminently more qualified
“My whole life is Cambodia Vision. It’s a full-on thing.”
Ms. Yang is not exaggerating. She has two young children, and is the primary carer of her elderly parents. She has a full time paid job in the NSW public service and puts a similar number of hours a week into her unpaid role as NSW Secretary for Cambodia Vision.
She is central to Cambodia Vision’s major fundraising activities – this year the organisation held banquets in Sydney and Brisbane, for 560 and 400 guests respectively.
Like all the other volunteers with Cambodia Vision, she pays her own way on outreach trips to the southeast Asian kingdom, using her annual leave in the process.
“It is very tiring, and I sometimes overwork myself. My family tells me to slow down but I can’t. Everyone – the whole team – relies on me. It’s not just our team though, but the expectations of our patients, the people who want to see.”
A survivor of Pol Pot’s murderous Khmer Rouge regime, Ms. Yang endured life in “one camp after another” before being accepted into Australia in the 1980s as a teenager. Despite being unable to speak English, and “copping a fair bit of racism” during what she describes as the “Hanson years”, Ms. Yang assimilated well into Australian culture. So much so, that she felt a disconnect from her country of birth. Indeed, she describes her first return trip – for family reasons – as “traumatic”.
She was recruited into Cambodia Vision soon after it was founded in 2007, by Dr. Peter Wong, who founded Cambodia Vision with Mr. Ming Ly, the organisation’s Chairman.
Mr. Ly – who was also displaced by the Khmer Rouge regime – is the General Manager of ABC Tissues, one of the leading manufacturers of tissues and toilet paper in Australia. The company is one of the major sponsors of Cambodia Vision and Mr. Ly and his family have an extremely ‘hands on’ involvement with the organisation’s humanitarian work.
Cambodia Vision 2012
Last month (October), Cambodia Vision sent a team of eye health professionals to the Cambodian province of Kampong Spue in central Cambodia.
Like much of the country, this is a rural area. Desperately poor, it is best known for its palm trees and rice crops. The Cambodia Vision team of about 40 people, included ophthalmic surgeons and nurses, optometrists, general medical practitioners, and other general volunteer staff. If past visits are anything to go by, they would have removed more than 250 cataracts, conducted more than 850 eye tests, handed out 4,000 pairs of sunglasses, 1,500 spectacles, and provided thousands of meals for patients and their carers.
They work 12 to 15 hour days for 10 days, in tropical heat, in (by Australian standards) the most basic conditions. And they love every minute of it.
The infectious nature of the work is perhaps exemplified by Glen Moorley – the husband of one of the nurses, who one year, tagged along for a holiday. After helping move some stock on the first day, he was hooked. He’s now the team’s maintenance man/handyman/storeman. Like most of the others, he went back for more this year.
Ms. Yang says once the mission begins, she is a “float”. She is in charge of public relations and liaises with the media and local officials, acts as an interpreter, and helps with patient meals. She’s on call
for everything from smoothing out cultural misunderstandings to grabbing a mop for the floor.
Advance Team
Even before the team packed its equipment and headed back to their normal lives in Australia, planning for the 2013 Cambodia mission is well underway.
As most of the volunteer staff headed home, Ms. Yang and other core members of the team travelled to Pursat Province.
“A few of us stayed behind and visited the hospital for next year. We assessed the area to see what we’re going to need. We needed to make sure the facilities we’ll be using are safe and have the basics – things like a generator, operating room, consultation room, patient waiting area, patient pre and post recovery rooms, storage, cleaning and toilet facilities and air-conditioning.
“We work out how many volunteers will fit into the hospital – whether we need one or two rooms. We work out what supplies are left over and whether we can store them adequately,” Ms. Yang said.
Ms. Yang expected that the trip to Pursat would be a particularly emotional one as it’s the area she lived in after being evacuated from her home province of Battambang during the Pol Pot regime.
Sponsorship
One of the priorities for a group such as Cambodia Vision is finding sponsors. It’s a job taken on by Eileen Betts, a registered nurse with a passion for ophthalmic surgery. Now living in Queensland, Ms. Betts has also been with the team since 2007.
She said it was crucial to develop genuine relationships with sponsors.
“They are very generous sponsors but you do need to chase them up – they are so busy and there are so many demands on them. I’ve developed many contacts (in the eye health community) over the past 40 years.”
Cambodia Vision has almost 30 sponsors, “all of them crucial”, Ms. Betts says. They range from individual surgeons and surgeries, to optical and medical companies, and general manufacturing organisations.
“In November each year I begin writing to medical companies for donations of surgical and medical items, informing them of our mission… and our outcomes.
“I have a break over the Christmas and New Year and resume writing to more companies in February and revisiting the ones I had written to. I concentrate on companies giving the heavier, bulky
items for sea transport first.
“Our departure is usually in August, therefore the items to be transported by boat need to be itemised and boxed by the end of March.”
She said the whole Cambodia Vision team hops in for this mammoth task, which is held in the Wetherill Park warehouses of ABC Tissue.
“In the meantime, the nursing team asks for support and donations from our favourite doctors, company representatives and friends. We also ask other ophthalmic theatres for items that become unsterilised (and can’t be resterilised for use in Australia) to be kept and collected for us. The surgeon I worked for gives us the use of his sterilising unit to resterilise these items and our instruments and trays.
“When the boat cargo has been sorted it is back to the computer to write to the companies who generously supply the eye drops and medication. These are taken in the air cargo with us. Follow up of emails and letters with phone calls is necessary as a way of personal contact,” said Ms. Betts.
July finds the whole team again at ABC Tissue packing and itemising the cartons for air cargo.
“Before leaving Cambodia, supplies are itemised, boxed and sorted into those which are stored in Cambodia and those which are to return to Australia. Back in Australia, we need to return loan equipment, itemise and store away unused supplies for next year, and then go back to work feeling that we have done a great job…”
Ms. Betts said it helps to have an understanding boss, but her involvement with Cambodia Vision required “quite a bit” of planning and compromise.
“If you want something done, ask a busy person and they will manage it. If you want to go, you just have to prioritise it, and you organise your work and family around it.
“I do enjoy it. The Cambodians are beautiful people and I enjoy the camaraderie of Cambodia Vision. It’s like a very friendly family.”
Long-term Strategies
Leading Sydney ophthalmologist Dr. Kim Frumar is a relatively new recruit for Cambodia Vision, having joined the organisation last year. While his considerable surgical expertise is put to use during the volunteer trips to Cambodia, as the Vice-Chairman, he also plays a crucial role in strategic long-term planning and the ongoing development of the organisation. Duties such as liaison with government
and medical authorities fall within his ambit. He is also heavily involved in fundraising activities.
Dr. Kumar said Cambodia Vision is “much more than just cataract surgery”.
“It’s a big operation. We have a cohort of about 50 people. There are the surgeons and nursing staff. We have optometrists who will go into the schools and screen children, we have general medical practitioners and nurses and people who practise Chinese herbal medicine.
“We work with local cataract surgeons and medical students from Cambodia, providing support and teaching and supplies.
“These people in Cambodia have no medical services. We go over and our work has a small – almost infinitesimal – impact on the health system. But it has a massive impact on individual lives.”
One of the projects that obviously excites Dr. Frumar is Cambodia Vision’s work on an Australian-designed high-tech, lightweight modular structure that will allow the team to set up its own clinic facilities.
“It is early days yet but we are looking to design a kit that can be easily transported and set up when we arrive. Eighty per cent of Cambodians live in the country, where there are no hospital facilities.
“Instead of requiring them to travel for days to see us, we could set up in different locations,” he said.
The “Meccano-like” structure could then be used as a surgical facility, or as a general medical or paediatric facility, Dr. Frumar said.
Dr. Frumar said Cambodia had a “low profile” in Australia, and most people don’t recognise the dire need in the country.
“Most people in Australia will remember the floods in Thailand earlier this year, but it was even worse in Cambodia where 1.7 million people were displaced,” Dr. Frumar said. (As a side note, Cambodia Vision and ABC Tissue initiated fundraising activities in Australia and partnered with other Australian-Cambodian organisations and religious institutions to purchase 621 tons of rice, which were then delivered to more than 13,500 families in nine provinces along the Tonle Sap River.)
“When you visit the ‘Killing Fields’ museum in Cambodia, you start to understand how much these people have been through.
“Pol Pot killed 95 per cent of the professional people. It takes a long time to rebuild that expertise in the country,” Dr. Frumar said.
“The Cambodians among us (Cambodia Vision) work tirelessly. I’m honoured to be a part of it.”
