Imagine a place where there is only one ophthalmologist for a population of 2 million
individuals. A place where 7.1% of the world’s blind population resides, and 50% of this blindness is preventable, cured by a simple cataract surgery that takes at most 30 minutes to complete. It is hard to believe that such a place exists in the seemingly well-advanced world of today, but Ghana is one example of such an area. In the northern region of Ghana, one doctor and his team of ophthalmic nurses run the eye clinic at Tamale Teaching Hospital, and this group is responsible for overseeing the eyecare of millions of individuals in the this part of the country. When I heard about the opportunity to go volunteer at this clinic through Unite For Sight, a non-profit organization that partners with eye clinics in developing countries to combat preventable blindness, I jumped at the chance. I am pursuing a future career in medicine and am considering ophthalmology as a possible field, so I thought the internship would give me hands-on experience dealing with eye health and patient care, as well as open my eyes to see how the healthcare system works in a different country.
            To prepare for my work in Ghana, I shadowed an ophthalmologist at Stanford
Hospital for two weeks during July. In those two weeks I learned how to diagnose different types of cataracts and corneal infections, how to identify glaucoma, how to recognize trachoma and trachiasis, and how to use a slit lamp and ophthalmoscope. In addition to learning all about eye anatomy and diseases associated with the organ, I was able to observe the manner in which the physician interacted with his patients.
The ophthalmologist was also kind enough to allow me to assist him in some of his minor eye surgeries; I was allowed to give local anesthesia to a patient before he underwent a tarsorrhaphy, a procedure that improves eye closure by decreasing the distance between the eyelids.

         This internship not only taught me about eye care and working with patients brought up in a culture completely different from mine, it also opened my eyes to the
glaring health disparities existing in the world between developed and developing nations. Probably a third to half of the children I saw at the villages all exhibited swollen bellies with inside out belly buttons, a sign of protein deficiency in their diets. This condition, called kwashiorkor, made the kids lethargic, and the only time I saw them get really excited was when I gave them all the clothing I had brought with me on my trip. I had heard about this malnutrition problem in my Human Biology class last year, but actually seeing these kids made me realize just how much work still needs to be done to improve health care in these developing countries. The eye clinic is in desperate need of new equipment, especially ophthalmoscopes; the current one all the nurses share is being held together with masking tape. One of the ophthalmic nurses
told me that though they have penlights but no batteries. Oftentimes, the nurses would spend money out of their own pockets buying batteries, and these weak African batteries have extremely short battery life. The Tamale Teaching Hospital does not even have a generator, so when the power goes out every couple of days, any electrically powered machine becomes obsolete. Equipment can’t be sterilized, all the patients are plunged into darkness, and surgeries are forced to a standstill while the doctors and nurses scramble to find flashlights or light candles. The education of the villagers is an entirely different issue altogether. Most of them do not think going to the hospital is necessary; they say that if they go blind, “Inshallah” (“It is God’s will”). Even if they seek help, most of the time, their injuries or eye diseases have already progressed to such a state that their vision cannot be fully recovered.

            My Unite For Sight internship is an unforgettable experience that has only renewed my passion for medicine. I learned about not only eye care but also about
interacting with patients in a completely unfamiliar setting. The language barrier was frustrating at first, but it trained my patience and forced me to learn how to communicate through other means. I observed and learned to respect the great influence culture has on individual approaches to health care, and this lesson is one I think I could only have learned in a country completely different from America. I actually saw eye diseases in the villages at such advanced stages that I only heard about or saw pictures of online while shadowing my ophthalmologist. Global health care issues were no longer stories I heard in class or read about in books. Going to the villages and seeing the state of things made these problems real, and only after I saw everything did the impact of the work we have yet to do finally hit me. I hope that one day I can go back to Tamale as a doctor, and
actually do surgeries and diagnose patients, helping to bridge the gap between the health disparities that still exist in the world today.