I’ve been to Ghana, Rwanda and Botswana in the past seven months and had the great fortune to again deploy to Africa for a humanitarian assistance mission.
This time, I was heading to the Central African Republic with a four-person team. And, I have to admit that I had to look up CAR on a map.
***image1***A quick Google search left me a little leery for several reasons. Geographically, CAR is not in the most peaceful place in the world. It’s approximately the size of Texas and bordered by Sudan, Cameroon, Chad and the Congo. There is an ongoing conflict in the northern part of CAR toward the Chad border, as well as unrest that spills over from the Darfur region of Sudan.
Politically, CAR has a tumultuous past, most recently illustrated by a military coup in 2003 led by now President Francois Bozize. Tension is high – with some of the crime and corruption being perpetuated by uniformed CAR security and military personnel. Needless to say, I had a healthy dose of concern at the start.
Meeting the other members of my team eased my mind. It was clear from the beginning that we would make a good team – a dentist, two family practitioners and myself, an optometrist.
As in previous deployments, it felt remarkably like a reality TV show. We all stayed in one house on the U.S. Embassy compound in Bangui, the capital of CAR. So, our reality show was a cross between The Amazing Race, Big Brother and M.A.S.H – and perhaps also The Osbournes.
For the first two days we met with the CAR military doctors to exchange information on medical topics such as field medicine, medical standards and tropical diseases. It was evident that these doctors were not lacking in knowledge, but rather critical resources, such as equipment, supplies and funds.
This was the first military-to-military exchange in CAR since 1996 so it was quite a historical event and I felt honored to be a part of it.
Over the next few days, we examined more than 550 patients and saw a variety of conditions from malaria to scabies to a golf-ball sized cyst our dentist removed to many HIV/AIDS patients (the HIV rate in CAR is an astounding 13 percent of the population).
The majority of patients I examined simply needed reading glasses, although there were a good portion of glaucoma, cataracts and trauma-related conditions. I brought a few hundred pairs of donated Lion’s Club glasses and adaptive eyewear (glasses with which you can adjust the prescription by injecting an amount of refractive gel-like material). There are no optometrists in a country of four million people. Needless to say, patients were ecstatic with a short exam, and any medications and glasses I was able to give them.
There were several memorable cases. One was a precious albino toddler who has a very blonde fundus (retina). Because of this, her eyes are very susceptible to UV light damage. I was thrilled to be able to fit her with a cute pair of children’s sunglasses, which seemed to suit her.
I am excited to help any patient but it is particularly rewarding to help the children because they don’t know that they can’t see well.
We helped a patient who had recently been in the conflict in the northern region of CAR and returned with a severe infection in both eyes. He was in danger of losing that eye without treatment. I saw him again the day after giving him the proper medications and he was on his way to recovering, although he has a long way to go.
The last day of patient care was tough. We were exhausted but we knew there were many people left to treat and our time was limited. The central Africans also knew we were about to depart.
As the morning progressed, tension rose among the mob of people outside the clinic. Finally, the patients rushed the door to my make-shift optometry clinic. I fled through the back door and my colleagues quickly controlled the situation.
We wanted so much to stay and help everyone, but it just wasn’t possible. The thing is, if I was in their shoes (or lack thereof), I might have rushed the door to get an exam and glasses.
All in all, my concern at the start of the trip gave way to an incredible experience. It was a great team (including the superb U.S. Embassy staff), a productive mission and a country in dire need of aid and attention.
This CAR deployment was the latest episode of my African reality show. I can only hope that it wasn’t the finale.