Friday, April 26, 2013

Sankara Nethralaya has a very organised system that worked very well for their high number of patients - Report from UK Volunteering Student at Sankara Nethralaya

Sankara Nethralaya has a very organised system that worked very well for their high number of patients.

My experience at Sankara Nethralaya was both educationally stimulating and inspiring into the cultural community of India. During my two months there I had the opportunity to visit and observe many different areas of the hospital, which allowed me to develop my knowledge about ophthalmology and the working system of international hospitals. One thing that struck me most about Sankara Nethralaya was the free services that they provided to patients was couldn't afford basic eye care treatment- from check up, to surgeries and glasses where provided for them, all funded by the organisation. Working alongside the opticians allowed me to realise the vast number of patients and cases that come through Sankara Nethralaya door every day, with opticians seeing up to 100 patients daily. This shows the high flow of patients that come to the hospital from all over India to receive their warm hospitality and brilliant service.

I had the great opportunity of observing several surgeries whilst on my visit in Sankara Nethralaya from basic cataract to complex retinal surgeries. I was able to observe how nurses and doctors prepare the patients for surgery and how all precautions are hygiene standards were met to the highest standard before the surgery is commenced. Physicians examine patients to make sure that they are fit for surgery by checking their blood pressure, pulse, to note down any allergies and other general health checks. Watching the surgeries and how the doctors reassured  patients during and after surgeries allowed me to real how many highly qualified professionals Sankara Nethralaya has and how they are all  very committed to their jobs. I also had the opportunity to see the LASIK machine and how it worked. There were several background checks and examinations needed to be done to make sure that the treatment was right and safe for the patients using the most state of art equipment. Emergency surgeries also took place at the hospital where a consultant would be available 24 hours a day. After surgeries patients were taken to the wards where they were kept up to 2 hours, where the nurses would check their vital signs and after examination they were able to leave the hospital on the same day after their surgeries. Sankara Nethralaya has a very organised system that worked very well for their high number of patients.

During my time at Sankara Nethralaya I also went along to the campsites. They went 3-4 times a week, where they visited different village around Chennai checking peoples eye sights, but normally never went back to the same village, this shows the vast number of rural villages and the large amount of poverty. It struck me as shocking as how many of the patients in the villages was unaware of both their ages and names. Going to the villages gave me the ability to see the true poverty of India and how people survive with the bare minimum and how healthcare and hygiene are something of a myth to them. A large majority of them where illerate and didn't no how to read, so the opticians would use the direction of lines to examine the patients eye sight. Opticians showed patience's  and sincerity when dealing with them. Most of the elderly villagers had cataract and eye problems worse than those people who live in the urban areas , due to the high UV sun rays of light in India and the lack of proper eye protection available to these people, a lot of them developed cataract and other more severe eye problems, some at even a young age. This made me realise how precious and delicate your eyes are and how they needed to be looked after to prevent damage. Patients at the village who needed further treatment would be taken back with us on the bus to the main hospital where they would receive their treatment and glasses all free of cost and also given transport back to their village.

On another day I was posted in the Jaslock community centre, this building was available just for the free service patients who couldn't afford to pay for any of their eye care treatment. I was posted with a group of post graduates and fellowship students, which allowed me to gain insight into their studies. Patients who come to Jaslok get the same treatment  and service as the main Sankara Nethralaya hospital, showing the compassion of the professionals who work there to treat and give the same service to all their patients no matter of their income.

Another day was spent in paediatric ophthalmology, many children and babies are referred to Sankara Nethralaya for treatment as paediatrics is their speciality and it is a tertiary trust. Doctors stay with the same patients throughout their treatment and care, this gives the patients the opportunity to bond with the doctors and for the doctors to be able to have sufficient knowledge of the patients to be able to treat with the right procedures. I learnt that many child are born with or develop a squint at young age, meaning that the eye with the squint is used less and the other eye used much more, so doctors cover the 'good' eye to help give strength back into the muscles in the eye that squints. Also many children in India may catch illnesses such as meningitis, which could damage the optical nerves, although physiotherapy and glasses can help improve conditions that are already there, the child may not respond to light and could end up with vision not returning to them due to the pressure within the head, effecting the pressure in the eye causing continual damage to the eye. Many children can also develop cataract at a young age, due to this their lens need to be removed and a replaced of a silicon faux lens, although this removed the cataract, glasses will still be needed lifelong.

The ultrasound department was another part of the hospital I was able to visit.  Here I observed  how a consultant saw within the eye, as the ultrasound produced a picture of the retina and the different layers of the eye to see detachment or where damage has occurred in the different mass or density of the tissues. Doctors can show a comparison of the normal eye compared to the damaged eye, this helps doctors to identify tumorous cells and helps the doctors to see the shape and size of the eye ball for surgical usage.

Sankara Nethralaya also has a low vision clinic within the hospital which is used for patients who do not have much eye sight and need much longer, more intense glasses for both long and short eyesight. These patients find everyday life hard and simple things like using a computer or reading becomes very difficult. Sankara Nethralaya provides services to these patients to help them deal with their poor eye sight. The optician teaches them tips to use on the computer to help eye sight, devices which help patients to read and colours helping the patient to identify objects. I learnt that the opticians needed a lot of patience's and time to find how much the patient can see by using eye sight charts for both long and short distance reading.

Ophthalmology photographs are also used in Sankara Nethralaya to capture the retinal area of the eye using a zoom camera and different coloured filters. Patients are injected with a dye, which helps to see if there is any leakage or damage within the capillaries in the eye and is taken every 3 seconds to see the different layers of the eye. The camera has to be focused and pictures taken fast as the dye only lasts for about 30 seconds in the eye. This devices helps as if there is no dye that flows into the eye, this shows potential blockage of an artery or a vein. Another machine used is the slit lamp, this enables the doctors or opticians to examine the outer eye, such as the cornea and lens. These pictures and devices allow the consultants to have detailed pictures of the eye, enabling them to make an accurate diagnosis.

In Conclusion, my 2 months volunteering experience in India was amazing and fulfilling. Sankara Nethralaya allowed me to experience real India and allowed me to realise the vast majority of poverty and the large number of different rare eye cases. During my time I also visited research labs, where a lot of research and work goes in to discovering new cures. I talked to a group of training nurses, telling them about hospitals in England and the differences that I could see between healthcare in England and India. Sankara Nethralaya taught me a large deal about eye and how they are such a vital part of our body.  I learnt that a lot of problems within the body can be discovered by examination of the eye such an diabetes and also many other issues effect our eyes as well, such as heart problems, family history and allergies. What I learnt most from Sankara Nethralaya was how they give such brilliant service  and patient care and allow all people of all backgrounds and ages into their hospital. By throwing myself into the environment of the hospital, I was put out of my comfort zone, challenging myself to deal with new situations and absorbing new information daily. Sankara Nethralaya taught me the meaning being 'The Temple Of The Eye', allowing me to understand the value we should all have for our eyes and the value we should all have for each other. Their warm service and brilliant facilities showed me how the work of Doctor Badrinath SS has had such an impact on eye care in India. I truly had an amazing time working and observing in Sankara Nethralaya and I am very thankful for all the people that helped me while I was there will be hopefully be returning in the future.

Ms Cassie Rao – London
27th April 2013


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