The Middle East / October 2007
By Larry Luxner
ALEPPO, Syria — The muezzin's afternoon call to Islamic prayers drifted through the open window of Aleppo Eye Specialist Hospital, as Dr. Joel Weinstein examined 25-year-old Gina Khachadoarian with an ophthalmoscope.
The young woman, who'd been complaining of double vision, waited patiently as Weinstein discussed her case with a local doctor. On this particular day, half a dozen other people also hoped to see the Chicago-born physician, including an elderly man with cataracts and a father whose baby boy had been involved in a car accident.
"I've seen a lot of people coming in with end-stage glaucoma who should have been examined years ago," Weinstein explained in between consultations. "This girl Gina probably has multiple sclerosis. Had she been born in the United States, she would have had one or two MRI scans by now."
In a country with only one ophthalmologist per 26,000 inhabitants — and where more than 900,000 people suffer from blindness or low vision — specialists like Weinstein are in hot demand.
The ophthalmologist, a professor at Penn State University, was one of 15 medical specialists who recently traveled to Syria with Orbis International, a New York-based nonprofit organization that operates the world's only airborne ophthalmic surgical and training facility. The April mission to Syria marked the third for Orbis; both previous programs — in June 1997 and September 1998 ó focused on Damascus.
"When you're actually here, you realize what a big difference you can make," said Dr. Andrew F. Phillips, a cataract and glaucoma specialist from California who spent a week in Syria. "Even in the first few days, there's so much they can learn."
The Orbis Flying Eye Hospital is a converted DC-10 aircraft equipped with operating, recovery, sterilization and laser treatment rooms, as well as audiovisual and conference facilities. During the three-week Orbis program in Aleppo, more than 190 local eye-care professionals and 370 patients participated in the training and treatment program.
More specifically, 15 local ophthalmologists, 14 nurses and two anesthetists received hands-on training at the Flying Eye Hospital, working side-by-side with Orbis volunteer specialists.
Orbis says its mission is "to eliminate avoidable blindness and restore sight in the developing world, where at least 90% of the blind and visually impaired reside."
In the Middle East, cataracts account for nearly half of all blindness, followed by corneal scars and glaucoma. Diabetes, which can lead to blindness, is also a serious problem in Syria — whose president, Bashar al-Assad, happens to be an ophthalmologist.
"Throughout the program we have been very impressed by not only the high level of eye care in the country, but also the enthusiasm and dedication shown by our hosts towards patient care and further advancement of eye care in Syria," said Drew Boshell, director of the Orbis Flying Eye Hospital.
Orbis made all the difference for Dalal Meesho, a humble mother of six whose entire family is crammed into a one-room apartment in the al-Fardoos slum of Aleppo.
One evening, her 10-year-old daughter Bayan heard some teenagers fighting in the street below, and to the balcony to see what was going on. The little girl was struck in her left eye by a stray bullet, and she was rushed to the Aleppo Eye Specialist Hospital to stop the bleeding. But the surgery Bayan needed to restore sight to that eye would have cost the equivalent of $1,000 ó far more money than Meesho had ever seen.
"We are very poor. My husband is a shoemaker, and we could not afford the surgery," she said. "One of the doctors recommended my case to Orbis. I took her to the hospital because I couldn't stand to see my daughter crying."
Orbis decided to operate on Bayan, leading her exuberant mother to say, once the surgery was over: "Orbis doctors are the best. They're more experienced than our local doctors. I consider myself in another country right now."
Since 1982, when the Flying Eye Hospital took off on its first sight-saving mission, some 154,000 doctors, nurses and other health-care workers in 85 countries have enhanced their skills thanks to Orbis.
Programs utilize both the DC-10 aircraft and eye hospitals in host countries whenever possible, and doctors volunteer their time in exchange for airfare, hotel accommodations and all meals while on the program.
But just because it's based in New York doesn't mean Orbis only works in countries that have good relations with the United States.
In addition to missions in Syria and Cuba — both of which are listed by the State Department as state sponsors of terrorism — Orbis was also the first international health NGO to bring its Flying Eye Hospital to Libya, back in September 2005.
"I think the difference Orbis can make is not so much in the number of surgeries, but in passing on knowledge to our doctors," said Dr. Harout Balian, director of the Aleppo Eye Specialist Hospital. "We benefit from the experience and knowledge of these very specialized people, who bring us the latest in ophthalmology and surgical procedures."
Ahmed Gomaa, an Egyptian ophthalmologist in charge of a program to screen Syrian schoolchildren for eye diseases, said health care in Syria is improving. "The hospital we are working with has good equipment. Having a specialized eye hospital in the city means that the level of eye care is good. You donít find that everywhere."
Adds Luis Herrero, a staff ophthalmologist from Paraguay who began working for Orbis nine months ago in Vietnam: "Normally, in all the countries we visit, the level of ophthalmology is good. But we try to put emphasis on what they lack. Here in Syria, they are limited by a lack of technology."
Part of the problem is that because of the Assad regimeís support of terrorist groups, Washington sharply restricts the export of technology to Syria — and that includes medical equipment used in ophthalmology.
For example, in the United States, a new microscope costs $10,000, while a phaco machine — which allows an ophthalmologist to use lasers to destroy a cataract without having to make large incisions — cost around $25,000. If Syria had easier access to used American equipment, prices would drop, there would be fewer barriers to access and eye care would benefit as a result.
Politics aren't the only barriers to better eye care. Sometimes, religion gets in the way too — especially when it comes to organ donation.
During the Orbis mission in Aleppo, the city's grand mufti, Sheikh Ahmad Hassoun, visited the Flying Eye Hospital and suggested that cornea donations not only don't contradict Islam but support its values.
"A lot of people have died, and yet their heart still beats in the body of another person. We need a new mentality which encourages organ donation because giving away your heart, kidneys and eyes is the greatest donation a person can make," said Hassoun. "We have good hospitals, an eye bank in Damascus and now we need people to donate their corneas. I hope to begin a donation campaign in the mosques, churches and schools."