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Journey to Cambodia

Dr. Lee Wan’s face lights up when he talks about the recent week he spent  at a Phnom Penh, Cambodia charity hospital training local doctors in advanced eye surgery techniques.

For the Coastal Eye Medical Director, the trip was all about the people: the enthusiastic, eager-to-learn young surgeons; and above all, the patients, poorest of the poor in material resources but rich in humanity. Many would be enabled to see clearly again for the first time in years.

Dr. Wan’s journey was under auspices of Surgical Eye Expeditions (SEE) International, a Santa Barbara-based nonprofit that organizes and deploys small surgical teams worldwide to restore vision to underserved populations. SEE’s volunteer doctors donate their time and pay their own travel expenses.

Working with SEE and suppliers such as Bausch and Lomb and Alcon Surgical, Dr. Wan gathered donations including lens implants, surgical supplies and instruments, disposable packs, and other surgery essentials that are hard to come by in Cambodia. Thankfully, the three large crates made it aboard Dr. Wan’s plane to the destination.

Along with Dr. Keith Pince, an Orange County retina specialist, Dr. Wan served at the Children’s Surgical Centre (CSC) in the nation’s capital city. The facility actually provides care to patients of all ages with a range of specialized surgery. All care is provided free of charge, a vital service in a very poor nation. CSC is supported by private donations from around the world.

Elevating surgical skills

Dr. Wan worked closely with six young local doctors, most of whom understood and spoke some English. They are considered ophthalmologists-in-training, but have had little of the formal specialty training that doctors in residency programs in more developed countries get. For the most part, they get on-the-job training from senior ophthalmologists at the hospital, and visiting surgeons such as Dr. Wan.

Dr. Wan’s primary objective for the week was to teach these young doctors advanced cataract surgery skills. He ended up doing that and more.

He started out doing some surgery cases himself with the doctors watching him, as he explained his various moves. Then for the rest of the week, the trainees performed the surgeries with Dr. Wan watching and assisting.

“I showed them little tricks here and there, giving them pointers on how to handle more complicated cases or how to do surgery more efficiently and safely,” he recalls. “There were a few times when I had to step in on a case to show them a particular step or maneuver they were having trouble with. But I was impressed with their basic skills, and was happy to see them improve these skills on each case. They are smart and talented, and I know they will continue to develop as surgeons, and provide much-needed care to their patients for many years to come.”

He brought with him an aid he uses in teaching ophthalmology residents at USC: an iPad with surgery videos. He made good use of that in the CSC OR.

Memorable, inspiring people

Dr. Wan also spent half-days with the local doctors in their eye clinic, coaching them on managing a variety of eye problems — touching on diagnoses, medical and surgical treatment, and laser techniques.

It was in the clinics that the patients presented with various and sometimes tragic eye problems — infections, inflammation, and eye trauma, including devastating land mine injuries; as well as very advanced, severe cataracts, the likes of which are seen rarely in the U.S.

“What was hard was seeing the things we couldn’t do much about, injuries that were so severe, with scarring and such extensive damage to the eye, that there was really no way we could fix it,” he recalls.

The patients, some of whom made their way over considerable distances to Phnom Penh for eye care, touched Dr. Wan’s heart. They camped out in a large room with their own blankets and pillows, waiting their turn to be seen, sometimes for days in a row. They would sleep on the floor overnight after surgery, before being released to travel back to their homes in the provinces.

“The people were very friendly. There was never a complaint about waiting or being uncomfortable,” he recalls. “In surgery we would numb the eye for the operation, but the patients did not get the sedation that we use here to make it an easy experience. They didn’t flinch or wiggle; each one was cooperative and appreciative.”

‘Give a man a fish’

Dr. Wan gets the greatest joy in performing vision-saving surgery himself, directly making a real difference in each patient’s life. But as a teacher, he’s well aware of the old proverb “Give a man a fish and he’ll eat for a day; teach him to fish, and he’ll eat for a lifetime.”

“It makes a lot more sense to leverage my skills and experience, to spend the time training other doctors in skills and knowledge that will benefit patients for the rest of their careers,” he says. “And teaching often makes me improve my skills as well, which is one of the reasons I love doing it.”

On the long flight back home after a demanding week, Dr. Wan was thinking about how eager the young doctors were to learn and how much they appreciated all he could share with them. “It felt like we could make a difference for every patient these doctors will touch for the rest of their careers. It felt like this was something I was meant to do.”

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