Mission Trips

[jc812]

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I'm trying to gather some info on Optometric mission trips. Have any of you been on any mission trips? Who did you all go through?

 

[EyeBaller]

I'm trying to gather some info on Optometric mission trips. Have any of you been on any mission trips? Who did you all go through?

Are you an OD student? I did a mission trip in January with VOSH (I think almost all schools have student chapters). I'm going on another in August with a different VOSH group, but all through our SUNY SVOSH chapter.

 

[prettygreeneyes]

I went on a trip to Baja, Mexico in January with Amigos, Pacific's chapter of student VOSH.

 

[IndianaOD]

FCO offers missions trips at many of the schools.

I've been to Honduras

 

[jc812]

No. i am not an OD student. I was just wanting to do something productive in the year between graduating and going to Opt school.
I'm just seeing what options are out there..

 

[xmattODx]

No. i am not an OD student. I was just wanting to do something productive in the year between graduating and going to Opt school.
I'm just seeing what options are out there..

I know you're asking for "options" but I'll give you an opinion. Typical optometric missions are not productive. They do nothing to develop eye health care in developing countries and are not in accordance with global eye health care initiatives (vision 2020). Volunteer at a local free clinic and you'll accomplish more than 5 years on a typical optometric mission.

Are you really in Atlanta? I'll be home, Atlanta, in a month after 6 months away. Never thought I'd miss Atlanta.

 

[IndianaOD]

I know you're asking for "options" but I'll give you an opinion. Typical optometric missions are not productive. They do nothing to develop eye health care in developing countries and are not in accordance with global eye health care initiatives (vision 2020). Volunteer at a local free clinic and you'll accomplish more than 5 years on a typical optometric mission.

Are you really in Atlanta? I'll be home, Atlanta, in a month after 6 months away. Never thought I'd miss Atlanta.

Hmm. Have to disagree. We provided exams to ~300 people per day. None of whom had ever seen a doctor in their lives. (Hard when you live 3 hours down a dirt road and make $10 a week or less) We provided specs to a large number of them allowing them to resume reading and do other jobs. Treated some foreign bodies and set a lot of them up for cataract surgery. There are so many programs to help Americans if they have enough drive to find them. I think my outrageous taxes pay for some of this.

 

[EyeBaller]

I know you're asking for "options" but I'll give you an opinion. Typical optometric missions are not productive. They do nothing to develop eye health care in developing countries and are not in accordance with global eye health care initiatives (vision 2020). Volunteer at a local free clinic and you'll accomplish more than 5 years on a typical optometric mission.

Are you really in Atlanta? I'll be home, Atlanta, in a month after 6 months away. Never thought I'd miss Atlanta.

Have you ever been on a mission to another country? There is no way you have any idea what you are talking about. In January we saw 2000 patients in the optometry clinic in 4 days. 2000. I.. in the middle of my third year.. was able to see about 30 patients a day. Most of these patients have had little or, in most cases, no previous eyecare.

Imagine giving a 5yo accommodative ET some plus lenses so her eye can be straight and she won't become amblyopic. Imagine a 70yo grandmother who hasn't been able to read or do any near work for 30 years because she never had a pair of $5 WalMart +2.50 OTC readers.

I helped many people just like that in just 4 short days, now tell me I didn't accomplish anything? Or that our mission wasn't productive? And you know what? Every single patient was so appreciative of the help they were getting, they couldn't thank you enough and were truly grateful even after lining up for hours to see you. There's nothing like the feeling of helping these people. You should try it.

(Sorry if that was a mini rant but I really can't believe people think these missions are worthless)

 

[xmattODx]

Have you ever been on a mission to another country? There is no way you have any idea what you are talking about. In January we saw 2000 patients in the optometry clinic in 4 days. 2000. I.. in the middle of my third year.. was able to see about 30 patients a day. Most of these patients have had little or, in most cases, no previous eyecare.

Imagine giving a 5yo accommodative ET some plus lenses so her eye can be straight and she won't become amblyopic. Imagine a 70yo grandmother who hasn't been able to read or do any near work for 30 years because she never had a pair of $5 WalMart +2.50 OTC readers.

I helped many people just like that in just 4 short days, now tell me I didn't accomplish anything? Or that our mission wasn't productive? And you know what? Every single patient was so appreciative of the help they were getting, they couldn't thank you enough and were truly grateful even after lining up for hours to see you. There's nothing like the feeling of helping these people. You should try it.

(Sorry if that was a mini rant but I really can't believe people think these missions are worthless)

I really don't have time to respond to this. I'm sitting in a plaza in Bucharest, Romania burning my retinas trying desperately to see the monitor on this laptop.

Yes I have been on optometric missions. Most likely more than anyone else on this board. I have put much more thought into optometric missions than most people and, in fact, wrote a thesis about them.

Bottom line, take it or leave it, you may help an individual on an optometric mission but YOU WILL NOT help populations and you hurt the development of sustainable care within that community and country. This is poor public health work and should be eliminated.

What happens to your estrope when their glasses break? and they will. Who will replace them? What did you do to build optometry and optical care in that country? Your patients "appreciated" you? Since when is that evidence based decision making?

Check out my blog for a little history about what I do and what I feel (except skip the rants about Bucharest, it has been hard adjusting after our time in Palestine). My beliefs are shared by others. Many public health minded optometrists feel the exact same way. Check out Vision 2020 and the Durban declaration for some light reading on the subject.

And that my friend is my rant.

 

[prettygreeneyes]

Have you ever been on a mission to another country?

Check his posting history. If there is anyone who can speak with some authority on the realities of vision trips, it is him... Master's in Public Health (in addition to his OD) - thesis on optometric missions, and currently teaching optometry to students in a foreign country.

 

[IndianaOD]

I really don't have time to respond to this. I'm sitting in a plaza in Bucharest, Romania burning my retinas trying desperately to see the monitor on this laptop.

Yes I have been on optometric missions. Most likely more than anyone else on this board. I have put much more thought into optometric missions than most people and, in fact, wrote a thesis about them.

Bottom line, take it or leave it, you may help an individual on an optometric mission but YOU WILL NOT help populations and you hurt the development of sustainable care within that community and country. This is poor public health work and should be eliminated.

What happens to your estrope when their glasses break? and they will. Who will replace them? What did you do to build optometry and optical care in that country? Your patients "appreciated" you? Since when is that evidence based decision making?

Check out my blog for a little history about what I do and what I feel (except skip the rants about Bucharest, it has been hard adjusting after our time in Palestine). My beliefs are shared by others. Many public health minded optometrists feel the exact same way. Check out Vision 2020 and the Durban declaration for some light reading on the subject.

And that my friend is my rant.

These third world countries are run by a bunch of corrupt officials who will never set up a health care system. They don't have access to PCPs let alone eye docs.

 

[jc812]

I really don't have time to respond to this. I'm sitting in a plaza in Bucharest, Romania burning my retinas trying desperately to see the monitor on this laptop.

Yes I have been on optometric missions. Most likely more than anyone else on this board. I have put much more thought into optometric missions than most people and, in fact, wrote a thesis about them.

Bottom line, take it or leave it, you may help an individual on an optometric mission but YOU WILL NOT help populations and you hurt the development of sustainable care within that community and country. This is poor public health work and should be eliminated.

What happens to your estrope when their glasses break? and they will. Who will replace them? What did you do to build optometry and optical care in that country? Your patients "appreciated" you? Since when is that evidence based decision making?

Check out my blog for a little history about what I do and what I feel (except skip the rants about Bucharest, it has been hard adjusting after our time in Palestine). My beliefs are shared by others. Many public health minded optometrists feel the exact same way. Check out Vision 2020 and the Durban declaration for some light reading on the subject.

And that my friend is my rant.

Interesting. I've never seen it from that perspective. I just want to help people...

 

[xmattODx]

These third world countries are run by a bunch of corrupt officials who will never set up a health care system. They don't have access to PCPs let alone eye docs.

I appreciate the idea that all developing countries lack health care and other necessities due to "corrupt" governments. It is such an easy excuse. They have nothing because they are evil. They have nothing because they are less civilized than we are.

If we consider the idea even for the briefest of moments we will realize that this is blatantly untrue. Is there corruption in developing countries? Of course. Is everyone corrupt and there is no hope for development? Of course not.

I also appreciate the idea that there is no healthcare systems in these countries. Also, however, untrue.

There are eye care practitioners in many of these places. Some are trained, others, of course are not. Your going to these communities undermines their businesses and interferes with the development of optometry.

What can you do? Go and teach. Go and help develop health care (specifically eye health care) systems. Don't go and give used glasses to 3000 people when 150 million are wanting. You don't even put a dent in the problem.

Lend your skills to building systems that will reach the millions.

Do some research. The World Health Organization Refractive Error Working Group strongly discourages the use of recycled spectacles. The Durban Declaration and Vision 2020 call for infrastructure and human resource development - the core of public health work.

I appreciate all those optometrists and optometry students that realize disparity exists in this world and that the disparity includes access to simple refractive care as well as more complex care but I ask those same people to stop and consider the care you give. Is it sustainable? Is it quality? Do people have access more than once every few years? Do you maintain records? Do the patient's receive education on their problems? Who sees the follow-ups? What happens when their glasses break? What happens when the need an updated prescription? What happens to the optical store in town when a group of Americans descend handing out free glasses? How can they then charge even small amounts for their glasses? And so on and so forth.

Question yourself. Question your teammates. If you're happy with the answers more power to you. I bet, and this comes from experience, that you won't be happy with the answers. If this is the case seek ways to make the answers better.

 

[IndianaOD]

I appreciate the idea that all developing countries lack health care and other necessities due to "corrupt" governments. It is such an easy excuse. They have nothing because they are evil. They have nothing because they are less civilized than we are.

If we consider the idea even for the briefest of moments we will realize that this is blatantly untrue. Is there corruption in developing countries? Of course. Is everyone corrupt and there is no hope for development? Of course not.

I also appreciate the idea that there is no healthcare systems in these countries. Also, however, untrue.

There are eye care practitioners in many of these places. Some are trained, others, of course are not. Your going to these communities undermines their businesses and interferes with the development of optometry.

What can you do? Go and teach. Go and help develop health care (specifically eye health care) systems. Don't go and give used glasses to 3000 people when 150 million are wanting. You don't even put a dent in the problem.

Lend your skills to building systems that will reach the millions.

Do some research. The World Health Organization Refractive Error Working Group strongly discourages the use of recycled spectacles. The Durban Declaration and Vision 2020 call for infrastructure and human resource development - the core of public health work.

I appreciate all those optometrists and optometry students that realize disparity exists in this world and that the disparity includes access to simple refractive care as well as more complex care but I ask those same people to stop and consider the care you give. Is it sustainable? Is it quality? Do people have access more than once every few years? Do you maintain records? Do the patient's receive education on their problems? Who sees the follow-ups? What happens when their glasses break? What happens when the need an updated prescription? What happens to the optical store in town when a group of Americans descend handing out free glasses? How can they then charge even small amounts for their glasses? And so on and so forth.

Question yourself. Question your teammates. If you're happy with the answers more power to you. I bet, and this comes from experience, that you won't be happy with the answers. If this is the case seek ways to make the answers better.

I understand where you are coming from and it makes some sense. However, the docs we were with were full time ODs in Honduras. They thought the trips were useful because there is NO alternative. There were a couple of opticals in the capital city but that was it for millions of people. Basically the rich people went there. I think there is a huge difference between "2nd world" countries like Mexico and third world countries like Honduras and Haiti (#1 and #2 poorest in western hemisphere). The one medical clinic we were at (which they said was one of the nicest) had no electricity and dirty needles everywhere.

I think you would like IU School of Optometry's Mexico clinic much more. There we have 2 ODs and 4 students year round. Problem is its subsidized by the American students and the Mexican government. This would never happen in other poorer countries.

 

[xmattODx]

I understand where you are coming from and it makes some sense. However, the docs we were with were full time ODs in Honduras. They thought the trips were useful because there is NO alternative. There were a couple of opticals in the capital city but that was it for millions of people. Basically the rich people went there. I think there is a huge difference between "2nd world" countries like Mexico and third world countries like Honduras and Haiti (#1 and #2 poorest in western hemisphere). The one medical clinic we were at (which they said was one of the nicest) had no electricity and dirty needles everywhere.

I think you would like IU School of Optometry's Mexico clinic much more. There we have 2 ODs and 4 students year round. Problem is its subsidized by the American students and the Mexican government. This would never happen in other poorer countries.

Thanks for understanding where I come from. You miss the point, however. The Honduras ODs thought your trip was useful because their was no alternative. THAT is the problem, there is no alternative. Rather than continuing to spend bad money after bad money on vision camps we need to come up with the alternatives. Training mid-level practitioners who can do quality exams and developing distribution networks for inexpensive spectacles is one approach that should be tried... and is being tried around the world. Are you familiar with this work?

I've been to Honduras. I'm embarrassed to say I was a member of a vision camp there. We went to areas no other team has ever gone to. No team has probably gone since. We slept in tents. We ate rice and pasta sauce after the rest of our food was stolen. What did we accomplish? I would bet nothing but no one does studies on the results of vision camps. Anecdotally the results seem poor at best. You are a big proponent on research and evidence based treatment. What are the long term results of your work in Honduras? How many people were still wearing their spectacles 1 month later. 3 months? 6 months? A year? How long did the spectacles last? Was there a quality of life improvement? What were the exiting VAs compared to entering VAs? What was the outcome of your foreign body removal? Did you encourage and provide low cost safety glasses? What is the epidemiology of vision loss in Honduras? Do they need refractive care or is cataract and other causes of vision loss more important? Where do Optometrists in Honduras receive their training? Can more training be provided? Could nurses or medics receive short term training to pick up the slack in available eye health care?

These are but a few questions that need to be answered when developing eye health care in developing countries. Did your team ask any of them? Do you ask any of them? If you don't please start. I strongly believe that western optometry has a great opportunity to structure eye health care in developing countries if we step away from vision camps and work in a unified fashion to prove to governments the economic and quality of life implications that correctable vision loss place on their populations. We can change the face of eye care in the developing world if we are willing to sacrifice the short-term joy we feel providing direct care and replace that work with the more mundane task of policy work.

Join me.

 

[IndianaOD]

Thanks for understanding where I come from. You miss the point, however. The Honduras ODs thought your trip was useful because their was no alternative. THAT is the problem, there is no alternative. Rather than continuing to spend bad money after bad money on vision camps we need to come up with the alternatives. Training mid-level practitioners who can do quality exams and developing distribution networks for inexpensive spectacles is one approach that should be tried... and is being tried around the world. Are you familiar with this work?

I've been to Honduras. I'm embarrassed to say I was a member of a vision camp there. We went to areas no other team has ever gone to. No team has probably gone since. We slept in tents. We ate rice and pasta sauce after the rest of our food was stolen. What did we accomplish? I would bet nothing but no one does studies on the results of vision camps. Anecdotally the results seem poor at best. You are a big proponent on research and evidence based treatment. What are the long term results of your work in Honduras? How many people were still wearing their spectacles 1 month later. 3 months? 6 months? A year? How long did the spectacles last? Was there a quality of life improvement? What were the exiting VAs compared to entering VAs? What was the outcome of your foreign body removal? Did you encourage and provide low cost safety glasses? What is the epidemiology of vision loss in Honduras? Do they need refractive care or is cataract and other causes of vision loss more important? Where do Optometrists in Honduras receive their training? Can more training be provided? Could nurses or medics receive short term training to pick up the slack in available eye health care?

These are but a few questions that need to be answered when developing eye health care in developing countries. Did your team ask any of them? Do you ask any of them? If you don't please start. I strongly believe that western optometry has a great opportunity to structure eye health care in developing countries if we step away from vision camps and work in a unified fashion to prove to governments the economic and quality of life implications that correctable vision loss place on their populations. We can change the face of eye care in the developing world if we are willing to sacrifice the short-term joy we feel providing direct care and replace that work with the more mundane task of policy work.

Join me.

There is no doubt that an infrastructure is far superior to the hit and miss trips. The group I have worked with (FCO) has estabilished these types of programs in different areas. The problem is it takes huge amounts of money that is difficult for smaller organizations to come up with. I think its also worth noting that for many people on these trips there is a bigger cause than just delivering eyecare.

 

[xmattODx]

There is no doubt that an infrastructure is far superior to the hit and miss trips. The group I have worked with (FCO) has estabilished these types of programs in different areas. The problem is it takes huge amounts of money that is difficult for smaller organizations to come up with. I think its also worth noting that for many people on these trips there is a bigger cause than just delivering eyecare.

I understand the desire for missionary healthcare but that should be the last thing to stand in the way of human resource and infrastructure development. If an organization doesn't have the funds to provide proper and correct care (in my mind that direct care needs to be coupled with infrastructure and human resource development under the national vision 2020 plan and with government input) they shouldn't be providing assistance at all.

 

[cookyncreame]

Hey, I went to your blog but didn't see much on this topic. Is your thesis posted somewhere, by any chance?

 

[xmattODx]

Hey, I went to your blog but didn't see much on this topic. Is your thesis posted somewhere, by any chance?

Look at the post from May 9. Remember that my "blog" is not academic writing. It is writing for fun and to keep friends and family up to date on what I'm doing. If we ever run into each other in the "real world" keep that in mind.

If all goes according to plan my thesis should be in a major journal in the next 6 months - I am revising my submission now. Another journal will, hopefully, be publishing on the same topic in a similar time frame. Keep your eyes peeled.

 

[cookyncreame]

I read your entry, thanks for sharing! I appreciate your thought and passion for public health. I'm very interested in missions around the world, whether medical or other. Can I ask you, why you want to help people so much? For example, is it linked with your religious beliefs?

I've never been on an optometry mission trip. Don't they usually have teams return to the same locations to follow-up on previous visits? Do you believe these trips hinder eyecare development in the locations or that efforts should just be redirected?

On an individual level, what do you think are good ways to help people in economically disadvantaged areas directly (achieving eyecare but also interacting on a personal level.. you mentioned the trips being like an assembly line) without hindering development?