84 Eye Surgeries Done; All 100% Successful

The Blind Can See Again

In a one week eye expedition to the isolated Line Islands in Kiribati last month, 84 eye surgeries were performed and more than 200 islanders were examined in Pacific Islands Medical Aid’s latest humanitarian campaign.

“What a joy it is to watch the blind see again. Many older blind islanders can see their grandchildren for the first time now,” said Carlton Smith, of Pacific Islands Medical Aid (PIMA).

Surgeries Underway: Surgeries get underway, two by two. Note the second operating table, a desk raised just enough by four thick medical books. During one very long day, 29 eye surgeries, mostly for cataracts, were completed. At left is Dr. Paul Jorizzo's son, Matt; Dr. Jorizzo; then Dr. Paul Imperia at the makeshift operating table, and Paul's assistant Max." alt="Surgeries Underway: Surgeries get underway, two by two. Note the second operating table, a desk raised just enough by four thick medical books. During one very long day, 29 eye surgeries, mostly for cataracts, were completed. At left is Dr. Paul Jorizzo's son, Matt; Dr. Jorizzo; then Dr. Paul Imperia at the makeshift operating table, and Paul's assistant Max.

Surgeries Underway: Surgeries get underway, two by two. Note the second operating table, a desk raised just enough by four thick medical books. During one very long day, 29 eye surgeries, mostly for cataracts, were completed. At left is Dr. Paul Jorizzo’s son, Matt; Dr. Jorizzo; then Dr. Paul Imperia at the makeshift operating table, and Paul’s assistant Max.” alt=”Surgeries Underway: Surgeries get underway, two by two. Note the second operating table, a desk raised just enough by four thick medical books. During one very long day, 29 eye surgeries, mostly for cataracts, were completed. At left is Dr. Paul Jorizzo’s son, Matt; Dr. Jorizzo; then Dr. Paul Imperia at the makeshift operating table, and Paul’s assistant Max.

It was months in the planning, but well worth the effort, led by volunteer ophthalmologists Dr. Paul Jorizzo and Dr. Paul Imperia of Medical Eye Center in Medford, Oregon.

“Hat’s off to Drs. Paul and Paul and their hard-working team who worked long hours each day of their stay on Christmas Island in the Line Islands group,” Carlton said. Team members, in addition to Drs. Paul and Paul, included optometrist Dr. Rory Murphy, surgical technician Max Lenfer and Dr. Jorizzo’s adult children, Kristen and Matt.

“Logistics was a great challenge”, Carlton said, involving transportation provided by supply ship for patients from the outer islands, camping out and meals for several weeks on Christmas Island for 100 patients and their caretakers awaiting the team’s arrival; medical supplies and surgical equipment prepared and shipped in advance to Christmas Island by air cargo flight from California, Texas and Honolulu; transportation and lodging for team members on Christmas Island and an agreement for all patients to be returned to their home island by the Honolulu-based sailing vessel Kwai, which was scheduled to be in Line Islands waters.

“It was a team effort”, Carlton said, requiring timely coordination to bring the patients from the outer islands of Teraina and Tabuaeran to Christmas Island at a time when the surgical team could be there. The Kiribati Ministry of Health paid for supply ship transportation and local housing, the medical team donated all their time and effort, and all surgical supplies and equipment was donated and/or loaned by Surgical Eye Expeditions, International (SEE) in Santa Barbara, California. “SEE has been a fantastic partner”, Carlton said.

Work to restore sight for the blind and nearly blind on the isolated outer islands of Teraina and Tabuaeran began last November when optometrists Dr. Scott Pike and Dr. John Jolley and their wives, sponsored by PIMA, sailed from Christmas Island to the outer islands on the 100 foot long sailing vessel Kwai to examine eye patients and recommend those needing surgery. “They were able to examine hundreds of islanders, dispense eye glasses and refer patients for eye surgery”, Carlton said.

Culmination of the effort was in watching so many islanders be able to see again. It was a great and successful program, Carlton said. Below is Dr. Paul Jorizzo’s summary of the trip, followed by Dr. Paul Imperia’s ‘memorable moment.’

By Ophthalmologist Dr. Paul Jorizzo

Returning to Christmas Island is always a joyful reunion. This year, our return would not have been possible without significant efforts pre-screening patients by Dr. Scott Pike and Dr. John Jolley and their wives; patient transportation and housing aid from the Kiribati government; supplies provided by Surgical Eye Expeditions International (SEE) and of course Pacific Islands Medical Aid, Inc. Huge Cataract: Some of the cataracts removed were huge. Here is one removed from blind lady from outer island of Teraina. She can now see again.

Huge Cataract: Some of the cataracts removed were huge. Here is one removed from blind lady from outer island of Teraina. She can now see again." alt="Huge Cataract: Some of the cataracts removed were huge. Here is one removed from blind lady from outer island of Teraina. She can now see again.

Huge Cataract: Some of the cataracts removed were huge. Here is one removed from blind lady from outer island of Teraina. She can now see again.” alt=”Huge Cataract: Some of the cataracts removed were huge. Here is one removed from blind lady from outer island of Teraina. She can now see again.

Thanks to these great efforts, joined by Dr. Paul Imperia and our team from Medical Eye Center in Medford, Oregon, we were destined to have a very successful campaign.

Optometrist Dr. Rory Murphy and my daughter Kristen, with help from local nurses, saw well over 200 patients in clinic. They did all the pre-operative measurements and intraocular implant power calculations, treated an array of ocular conditions and dispensed glasses to patients from Christmas Island (Kiritimati), Teraina and Tabuaeran.

Their hard work allowed Dr. Imperia and surgical technician Max Lentfer, my son, Matt and wonderful local nurses to spend a majority of our time in the operating room.

We were able to overcome some equipment challenges thanks to Dr. Murphy and Dr. Imperia and performed 84 surgeries, including 74 cataract procedures and 10 pterygium repairs.

All patients requiring surgery were treated, and all did well.

A Precious Memorable Moment…

By Ophthalmologist Dr. Paul Imperia

There were so many memorable moments, but for me there was one that stood out. It was an elderly woman from Washington Island (Teraina) whom I had done cataract surgery on the day before.

She sat slumped in her chair outside the waiting area. She was blind in both eyes and we had done one of her surgeries at that point.

I helped her get up from her seat. See seemed very frail and unsteady, groping out with her arms to avoid bumping into anything, shuffling very slowly and uncertainly. I thought that, besides from being blind, she must have advanced arthritis or some neurologic condition, perhaps a previous stroke.

I took her patch off, she looked around the room, her face went from depressed to bright and a smile appeared.

She read the eye chart, her eye looked great, and I gave her the universal thumbs up.

Before I could reach to help her move to the post-op area, she popped up out of her chair and walked strongly and confidently out of the clinic. The difference in the way she walked before and after really surprised me.

It drove home how debilitated so many of these people had been, how far they had come, how long they had stayed away from home to get help and how much it was all worth it.

Miracle Surgeries for Tieraa; Shriners and PIMA Join Forces

Before: Little Tieraa Viala fell into her mother's cooking fire on Christmas Island when she was just one year old, damaging her wrist and fusing her fingers together. When she was burned, there were no pain medicines on the island to help her, and she suffered for many months." alt="Before: Little Tieraa Viala fell into her mother's cooking fire on Christmas Island when she was just one year old, damaging her wrist and fusing her fingers together. When she was burned, there were no pain medicines on the island to help her, and she suffered for many months.

Before: Little Tieraa Viala fell into her mother’s cooking fire on Christmas Island when she was just one year old, damaging her wrist and fusing her fingers together. When she was burned, there were no pain medicines on the island to help her, and she suffered for many months.” alt=”Before: Little Tieraa Viala fell into her mother’s cooking fire on Christmas Island when she was just one year old, damaging her wrist and fusing her fingers together. When she was burned, there were no pain medicines on the island to help her, and she suffered for many months.

When Tieraa Viala was one year old, she fell into her mother’s cooking fire and severely burned her hand and wrist, locking her scared wrist in a tight downward position and fusing her fingers together.

Tieraa suffered greatly for many months, with no pain medicines available then on the central Pacific island called Christmas (Kiritimati).

Now, after two surgeries at Shriners Hospital for Children in Honolulu, Tieraa is returning home with full use of her wrist and with her fingers separated.

“We are overjoyed. Thanks to God and everyone involved,” says her mother. After: Now ready to return home from Shriners Hospital in Honolulu, Tieraa and her mother are thrilled that she now has full use of her hand and wrist, following two significant surgeries, thanks to PIMA’s donors, the Kiribati Ministry of Health and Shriners Hospital.

After: Now ready to return home from Shriners Hospital in Honolulu, Tieraa and her mother are thrilled that she now has full use of her hand and wrist, following two significant surgeries, thanks to PIMA's donors, the Kiribati Ministry of Health and Shriners Hospital." alt="After: Now ready to return home from Shriners Hospital in Honolulu, Tieraa and her mother are thrilled that she now has full use of her hand and wrist, following two significant surgeries, thanks to PIMA's donors, the Kiribati Ministry of Health and Shriners Hospital.

After: Now ready to return home from Shriners Hospital in Honolulu, Tieraa and her mother are thrilled that she now has full use of her hand and wrist, following two significant surgeries, thanks to PIMA’s donors, the Kiribati Ministry of Health and Shriners Hospital.” alt=”After: Now ready to return home from Shriners Hospital in Honolulu, Tieraa and her mother are thrilled that she now has full use of her hand and wrist, following two significant surgeries, thanks to PIMA’s donors, the Kiribati Ministry of Health and Shriners Hospital.

Tieraa’s surgery was made possible by Shriners Hospital ‘adopting’ young orthopedic cases in Kiribati in an agreement with Pacific Islands Medical Aid, Inc. (PIMA), and the Kiribati Ministry of Health in which Shriners provides all medical care without cost, PIMA takes care of housing, meals and transportation while patients are in Honolulu and the Kiribati Ministry of Health pays for air fare.

“Tieraa’s first surgery in 2014 straightened her wrist and the second surgery now has separated her fused fingers,” said Carlton Smith, PIMA president.

“A huge thank you is due everyone at Shriners Hospital,” Carlton said. “The outcome is remarkable.” Also to be thanked are members of the Honolulu host family, including Kaitibo Timon and his daughter Etita, who have housed Tieraa and her mother, provided meals and all local transportation, Carlton said.

“There are currently eight more island children on the Shriners surgery list. Please help us continue this great collaboration by donating to PIMA to help the children of Kiribati in this wonderful program,” Carlton said.

PIMA Team Sees 100 Patients; Performs 11 Urgent Surgeries

By Dr. Lydia Lam, MD FACS,

Dr. Shalini Sharma, MD MPH

Medical care in Kiribati is limited due to the lack of physicians available in the country. And, unfortunately, primary care and surgical specialties are unavailable despite a baseline necessity.

Cardiologist Dr. Vivian Mo of the University of Southern California saw more than 70 patients during her week on Christmas Island, some with critical cardiac conditions." style="margin: 0px 0px 10px 10px; float: right;" alt="Cardiologist Dr. Vivian Mo of the University of Southern California saw more than 70 patients during her week on Christmas Island, some with critical cardiac conditions.

Cardiologist Dr. Vivian Mo of the University of Southern California saw more than 70 patients during her week on Christmas Island, some with critical cardiac conditions.” style=”margin: 0px 0px 10px 10px; float: right;” alt=”Cardiologist Dr. Vivian Mo of the University of Southern California saw more than 70 patients during her week on Christmas Island, some with critical cardiac conditions.

We at Pacific Islands Medical Aid, Inc. (PIMA) have been fortunate to have developed a good relationship with the Kiribati Ministry of Health and the Kiribati people and have been providing specialty care for several years now.

We were personally fortunate to have been on a PIMA surgical team in 2011, and have been continuing our efforts with various specialists since that time.

Our first trip to Christmas Island (Kiritimati) proved fruitful since there were many patients requiring surgical intervention. Our subsequent trips helped us realize that specialty care, while critically important, was overshadowed by the need for consistent primary care.

This became more evident when the PIMA-sponsored pediatrician, Dr. Kathleen Smith, saw more than 600 patients in basic well child care during her visit to the island.

On this trip, we focused on overall wellbeing and specialty care. Our team consisted of a general surgeon, anesthesiologist, a cardiologist and plastic/hand surgeon.

Dr. Vivian Mo is a cardiologist knowledgeable in heart failure and echocardiography. In addition, her internal medicine skills were essential during the trip. During our week on the island, she saw more than 70 patients, some with critical cardiac pathology and others with benign medical issues.

Dr. Joseph Carey, a multi-talented surgeon trained in plastic, reconstructive, burn and hand surgery, helps a Kiribati patient." alt="Dr. Joseph Carey, a multi-talented surgeon trained in plastic, reconstructive, burn and hand surgery, helps a Kiribati patient.

Dr. Joseph Carey, a multi-talented surgeon trained in plastic, reconstructive, burn and hand surgery, helps a Kiribati patient.” alt=”Dr. Joseph Carey, a multi-talented surgeon trained in plastic, reconstructive, burn and hand surgery, helps a Kiribati patient.

Critical patients identified on previous trips also received the follow-up they needed. Just an important, Dr. Mo was able to allay the fears of many with benign conditions. Dr. Joseph Carey is a multi-talented surgeon trained in plastic, reconstructive, burn and hand surgery. Many patients presented during the week with various conditions, including suspicious skin lesions that were removed. Dr. Carey was also able to save the damaged hand of one young man, a policeman on the island, who will now be able to keep his job and have optimal function of his hand.

All in all, the team saw more than 100 clinic patients and performed eleven surgeries, while identifying those who will need follow-up in subsequent visits.

We were proud and honored to put together this group of physicians to provide these basic needs to the people. Our goal has been, and continues to be, the support of logistics and medical care to further the resources available to the islanders and to share knowledge with the local medical staff.

Upcoming Trips to Help Islanders

August 5-12, 2015 – Our six-person eye surgery team is underway now and scheduled to perform more than 120 cataract surgeries August 5-12, 2015 at Ronton Hospital on Kiritimati (Christmas Island) in Kiribati for islanders from three area islands, Tabuaeran, Teraina and Kiritimati …brought to the hospital by government supply ship and now anxiously awaiting our arrival. Many of the island patients have severe cataracts in both eyes, and are blind. Many will soon be able to see their grandchildren for the first time.

In October – Our Women’s Health Team, led by Dr. Theresa Woehrle of Southern California, together with OB/GYN Dr. Judy Chen from Los Angeles County Hospital/University of Southern California, will examine and treat Christmas Island women with cervical pre-cancer and will continue their education of local medical personnel so that new patients may be treated after the team leaves. Last year, Pacific Islands Medical Aid, Inc., sent its first Women’s Health Team to this isolated island to treat pre-cancer patients and for teaching. We donated cryotherapy equipment and supplies to medical personnel there. The cryotherapy process kills pre cancer cells by freezing, helping prevent the future growth of full blown cervical cancer.

In late October – Members of Shriners Hospital for Children in Honolulu will make a second visit to Christmas Island to evaluate orthopedic needs of children there. In an agreement with Pacific Islands Medical Aid, Inc. and the Kiribati Ministry of Health, Shriners in Honolulu takes care of all childrens’ orthopedic surgery needs, we at PIMA provide housing, meals and transportation in Honolulu for patients and their caregivers, and the Kiribati Ministry of Health provides air fare. There are currently eight children on the Shriners’ list awaiting surgery in Honolulu. Please help us with the cost of this program.

In November – Noted cardiothoracic surgeon Dr. David O. Moore from Baylor Heart Hospital in Plano, Texas, will travel with his team to Christmas Island in November to examine heart patients there in anticipation of bringing the most severe cases back to the U.S. for heart surgery. In the past, a large number of young adults there have been found to have heart disease, likely the result of undiagnosed and untreated rheumatic fever. The lives of more than 15 islanders have been saved by virtue of successful open-heart surgery at Baylor and Dr. Moore and his team continues this wonderful program. We need donations to help with the cost of patients’ transportation and housing and meals while in the U.S.

In addition – We have been asked by the Kiribati Ministry of Health for help in the islands with an urology team, pediatrics, a pulmonary specialist to address serious problems with COPD, asthma and other breathing issues and diabetes, where more than 30 percent of all adults suffer with adult onset diabetes.