PSU Magazine Winter 2001

The medical ship Carlos Chagas was eagerly awaited in ports along the Amazon. A helicopter and motorboat were used for difficult locations. population along the Amazon River. From Manaus we traveled down the Amazon to our first destination, Oriz– imina, where at 7 a.m. 200 patients awaited our arrival. We worked around the clock to meet their health needs. I had previous training in giving eye exams, assisting with cataract surg– eries, and performing diagnostic tests. Dr. Karanjit Kooner, an ophthal– mologists from University of Texas, performed the first operation on board-a complicated case of glau– coma and cataract surgery. Rehder and Sobral operated late into the night on an additional 14 cases. 0 ne of our first patients had traveled for an entire day to reach the boat, which she called "the boat sent from God." A woman in her seventies, Antonia was virtually blind due to cataracts in both eyes. The operation is usually not per– formed on both eyes at once, so she could have only one eye operated on. Antonia's operation was successful, and Rehder gave his postoperative advice, "Do not touch your eye, refrain from heavy exercise, and when you go to bed make sure that you don't sleep on the side of your operated eye!" "But I don't know how to sleep in a bed," she replied. "I have never slept in a bed. I can only sleep in ham– mocks!" In fact, when we visited Antonia at home after surgery, she was relaxing in a hammock. She was excited to see us. Although she had not yet fully 14 PSU MAGAZINE WINTER 2001 regained her vision, she was on her way to recovery and hopefully will be able to have her other eye operated on next year when "Amazon Vision 2000" returns. What would she do when she regains her vision? "Well, I'll sit on the plaza and watch the guys!" Our journey took us to Porto de Moz and Senator Jose Porfirio, two vil– lages on the Xingu River. The river reached international prominence when the Kayapo Indians who live upstream successfully fought the con– struction of a hydroelectric dam that would have destroyed their land, cul– ture, and ultimately their lives. We embarked on a speedboat with all our portable equipment to reach a little village on the Xingu, Vila Nova, embedded in the midst of the jungle. We passed island after island, swamp after swamp, until the jungle closed in on us. Suddenly our engine sputtered and stopped working. This moment of silence gave us time for reflection and allowed us to observe the wildlife that we had missed: great blue herons, egrets fish– ing in the shallow water, and red– headed vultures in the crowns of the trees drying their wings in the sun. After several tries the engine came back to life. Relieved, we continued our journey to Vila Nova. At the same time some of our colleagues had flown by helicopter farther up the Xingu, where waterfalls make the river impos– sible to navigate. A month's end, we had performed 77 ophthalmologic operations-an amount that pales in comparison to the number of people in need of surgery. In many cases patients have to be turned away in favor of those with more promising outcomes. Such difficult decisions were necessary in order to maximize the impact of our mission. Regardless, we witnessed many memorable, life– transforming moments as bandages were removed and patients experi– enced restored vision. Although as many as 16 percent of the population we served suffered from cataracts in at least one eye, pterygium was clearly the most prevalent eye dis– ease, affecting 44 percent of the peo– ple. The high prevalence of both cataract and pterygium is most likely due to exposure to UV irradiation from the sun. Since many of these individuals work outside, it is difficult to avoid exposure to sunlight; how– ever, it might be possible (with appro– priate funding) to provide the population served by Carlos Chagas with sunglasses to reduce damaging UV exposure. We also performed 2,405 eye exams. Fifty percent of the population suffered from hyperopia and from astigmatism and were to receive glasses within a few months from the government. Through this floating hospital I met the local population and saw parts of the Amazon secluded from the outside world. I con ider it a privilege to have been able to encounter this rich cul– ture, one with a lifestyle based on laughter and happiness despite all the challenges and difficulties in their lives. I also saw tremendous grace, patience, and pain tolerance among the patients, and dedication, commit– ment, and hard work among the doc– tors. While restoring vision for some of these individuals, they also taught all of us to see the world in a different light. D For more information about Vision 2000, or to contribute financial support for the health mission in the Amazon, please contact: ONG Brasil Visao 2000; Rua Funchal, 19-5 andar-Sao Paul-Brasil CEP.04551-060; tel.: 55 11 38457007; e-mail: brasilvisao2000@uol.com. b_r