Postcards from the Field

Thimpu, Bhutan

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Cataract Surgery Success even in Earthquake Aftermath

Himalayan Cataract Project affiliated ophthalmologist Dr. Robert Hoffman is making quite an impact on eye care in Bhutan. In late May, Dr. Hoffman concluded his annual visit to the Jigme Dorji Wangchuck National Referral Hospital in Thimphu to provide an ongoing mentorship to Dr. Dechen Wangmo, Bhutan’s only pediatric ophthalmologist.

The now very active clinic includes a pediatric anesthesiologist and two new ophthalmology residents.

In fact, Dr. Wangmo’s practice has become so busy, the hallway is regularly lined with patients. The progress over the past three years is certainly due in part to Dr. Hoffman’s dedication and leadership. “He is a great mentor and there is always something more I learn each time he visits,” says Dr. Dechen. “Due to the support of HCP and Dr. Hoffman, our costs for referral of these cases to India has vastly reduced. I am very grateful to HCP and its consultants who have made such a difference in eye care in Bhutan.”

Postmark: May 18, 2015 | Thimpu, Bhutan

Our original intention for this outreach was to visit both Nepal and Bhutan. We had planned to start in Kathmandu to begin formal training with pediatric eye fellows in conjunction with the Tilganga Institute of Ophthalmology. 

Our plans changed, however, as a result of the first earthquake. The visit had to be cancelled. We would later learn that the second earthquake struck just two hours after we were scheduled to land. Our hearts go out to all those who are dealing with the devastation of these quakes. 

Although we did not make it to Nepal, my wife Carolyn and I did set off for Thimpu, Bhutan, to work with Dr. Dechen Wangmo and her colleagues at Jigme Dorji Wangchuck National Referral Hospital.

– Dr. Robert Hoffman

Postmark: May 21, 2015 | Thimpu, Bhutan

It is a very busy time at the hospital. There has been a steady lineup of patients waiting for care. We’ve reviewed more than 100 clinic patients that were selected by Dr. Dechen over the course of two days. There are a mix of complicated strabismus (a misalignment of the eyes), tough pediatric eye issues, and retinopathy of prematurity (a disease that occurs in premature babies and causes abnormal blood vessels to grow in the retina). 

It is very encouraging to see the excellent outcomes and the great follow-up post discharge from the NICU. We’ve also had the new ophthalmology residents in clinic with us.

– Dr. Robert Hoffman

Postmark: May 22, 2015 | Thimpu, Bhutan

I delivered a new set of strabismus instruments to Dr. Dechen on behalf of Moran International Outreach. We used them on our OR days and we know moving forward they will be put to good use. We’ve operated for two-and-a-half days now and Dr. Dechen has completed most of the surgeries. 

We spent part of one day in the NBICU doing hands-on screening exams for retinopathy of prematurity (ROP). The NICU staff was excellent and very helpful.

We also had an education session with the entire department including the residents. This was a first, and hopefully a sign of things to come.

Dr. Dechen is doing a great job in pediatric ophthalmology. She still benefits from periodic support with difficult cases and advice about ROP.

The next adventure in eye care in Bhutan is training residents in ophthalmology. This represents a huge step for the country and is an opportunity for all of us to help.

– Dr. Robert Hoffman