Reflection from Haiti, April 2-10, 2010
The University of Miami’s Medishare Field Hospital is providing excellent emergency general medical and surgical care for the local population. The ophthalmic problems encountered are those expected for a large urban emergency center. I would recommend obtaining a dark room, Snellen chart, slit lamp, direct and indirect ophthalmoscopes, tonometer, ophthalmic drops, operating microscope, and basic ophthalmic surgical instruments and supplies, if the ophthalmology patients are to be treated onsite instead of being referred to HUEH in Port-au-Prince.
The proposal for diabetic screening using a non-mydriatic camera operated by a non-ophthalmologist seems to be an excellent idea, in view of the far-advanced diabetic retinopathy I saw in Dr. Taverne’s (Haitian ophthalmologist) retinal practice. The difficulty will be in finding a mechanism for encouraging the local ophthalmologists to evaluate the photographs and convey the results to the diabetes clinic for referrals to a retina specialist.
The proposed common clinic for use by ophthalmologists who have been displaced from their practices seems to be an excellent idea. The difficulty will be in deciding how to charge the patients enough to meet the overhead expenses to allow continued operation of the clinic.
Robert W. Butner, M.D.
Retina specialist from University of Texas at Houston