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Completion of Day 4: Clinic, Granada, Nicaragua

Our eye care team ended the day with five last minute walk in patients. Despite the fact that we had packed our gear up for the day, we had no hesitation in accommodating these last minute stragglers, knowing we wouldn’t be back for at least one year. The last patient I examined was a young lady of 22 who had lost one eye due to a previous machete accident and reported that her remaining eye was blurred at distance and always felt scratchy and irritated. She presented with myopia in her eye which was also chronically dry. We were able to give her glasses which corrected her to 20/20 and I supplied her with sunglasses as well as 6 months worth of lubricating eyedrops ( we still had many drops left over from the week, despite having dispensed over 1000 bottles).

Our team of 3 eye doctors, 6 students and two assistants, including my son Ben examined over 700 patients over the four clinic days. We dispensed over 1400 pairs of glasses, over 1000 bottles of eyedrops, diagnosed, treated and referred numerous pathological conditions including glaucoma, diabetic retinopathy and mature cataracts.

Our wonderful team leader, Dr. Joe D,’Amico and Ann May will be staying on to conduct two more clinics at an orphanage and women’s cooperative in the capital city of Managua.

The softly spoken thank you’s, gentle hand shakes, occasional hugs and oft spoken blessings are heartfelt and humbling to say the least. . . I am leaving Nicaragua with a familiar feeling of warmth and gratitude. It has been a privilege.

Read Dr Feifke’s previous posts from Nicaragua:

Eye Clinic Volunteer, Nicaragua Nicaragua Volunteer Optometrist

2nd Day’s Clinic in Grenada, Nicaragua

Started off the day with no running water in our room, which eliminated the likelihood of an early am jog. Had a hearty breakfast at our usual haunt, Kathy’s and then headed out to the clinic.

Patients were lining up as we arrived. We had a steady flow from start to finish. In all we saw 183 patients today. Saw quite a few pediatric cases today. One particularly rewarding case was an elderly women who had had cataract surgery in one eye four years ago and she claimed she was still unable to see. Her other eye was legally blind due to an advanced cataract. She presented with an extremely high astigmatism correction which improved her vision to 20/20. She chose frames, her lenses will be made for her back in Boston. I look forward to her seeing properly again in about 3 month’s time.

IMG 0069Lastly I was proud to present a portable auto refractor to Dr Rudy Vargas for use in the Granada clinic. I will be spending the next 2 days training the nurses how to use it and it’s correct application.At the end of the day, Ben and I rented bikes. Riding along the water front as the sun was setting was exhilarating.All in all another productive day. Looking forward to tomorrow..

1st Day’s Clinic in Grenada, Nicaragua

Nicaragua is changing. While still one of the poorest countries in the Northern hemisphere, there seems to be a small, but tangible improvement in the economy. This is evident in the increased number of cars on the roads ( much improved infrastructure,especially since my first trip in 2002), increased sophistication and prices of the local restaurants, more tourists, cleaner streets, and newer stores. Poverty and unemployment are still at very high levels though.

Dr Feifke nicaraguaThere is a general lack of resources and lack of government funding for healthcare in general, especially for the underprivileged. Ophthalmic problems are rampant in Nicaragua due to environmental influences, poor hygiene and lack of income for preventative care.

This particular mission is headed up by a wonderful endocrinologist and ex patriate Nicaraguan by the name of Rudy Vargas We are part of a team which includes cardiologists, ophthalmologists, orthopedic surgeons, anesthesiologists, nurses and other specialists.

Dr Fiefke Nicaragua2The clinic is held at a local hospital, where unfortunately there still is no running water or flushing toilets. Lines at the clinic were relatively long today and our eye care team was able to see 149 patients. The overwhelming number of people we saw, simply required glasses in order to see normally. There are currently over 20 million people in the third world who are legally blind based on the fact that they simply do not have eyeglasses to correct their vision.

We also encountered patients with diabetic retinopathy, glaucoma, ocular injuries and advanced cataracts. All in all a tiring, but extremely rewarding day as always. What made it more special was having my son Ben with me. His Spanish prowess was indispensable in helping translate today. We returned to a general power outage in the town, and decided to go for an evening trek up the extremely active Masaya Volcano. What a sight to see the oozing lava in the steaming crater below us- awe inspiring!

Looking forward to a great day tomorrow..

Costanza, Dominican Republic Eye Care Mission

Costanza, Dominican Republic Eye Care Mission Report May 17-23, 2014

This was my third trip to Constanza in the beautiful North Western mountains of the Dominican Republic. I accompanied a Medical team from the South Shore Hospital, South Weymouth, Mass, which included three medical doctors, a Pediatric nurse practitioner, nurses, assistants as well as in-country Peace Corp volunteers. As the only optometrist, I was fortunate to have the help of optometric technician and aspiring OD, Matt Bruns.

We were officially welcomed at the Sunday morning Church Service, followed by the perfunctory Sunday tour of The Constanza Hospital.The Hospital appears to be better equipped and more efficiently run than on previous visits. The improvements in care at the hospital are quite tangible, as a result of recent equipment donations and upgrades. Accommodations were comfortable as always at the “ Hotel Constanza” and we were well fed for the duration of the trip by the Sisters at the local Convent.

We held clinics over four days in the outlying villages and districts. The clinics were set up in such a way, that patients were first triaged and then directed to the appropriate medical station. There was a high demand for eye care as expected. A second OD would have made a significant difference to the total number of patients who needed eye examinations.

I examined a total of 165 patients over 4 days of clinics. We dispensed 139 pairs of plus prescriptions, 15 minus prescriptions and numerous sunglasses. 10 pairs of high minus astigmatic glasses and bifocals will be made up by my lens lab and shipped down to Constanza. One surprising anecdote on this trip was that the vast majority of astigmatic refractive errors were against the rule.

Pathologies encountered on this trip included glaucoma, chemically scarred corneas ( primarily from insecticide exposure), cataracts, pterygia, keratoconus, and foreign bodies. I have 12 patients from this trip who along with 35 others from previous missions who are awaiting cataract extractions. We are anticipating that an ophthalmologist will be going down to the area in January 2015 to perform the necessary surgeries.

All in all it was another productive mission. The trip would be better served by more than one OD and hopefully, this can be addressed on future trips. I look forward to the Ophthalmologist taking care of our awaiting cataract patients in January.

Derek Feifke ODBurlington MA