Author: sygpark

Reverse culture shock and moving forward with Unite For Sight

One of my top reasons for choosing to volunteer at Kalinga Eye Hospital at Orissa was the pediatric ophthalmology services it offered. As an aspiring pediatrician, I was curious to learn more about how ophthalmology services were delivered to children, and how children and parents would evaluate the overall experience at the hospital. When I was given the tour of the hospital for the first time in India, I was surprised. Kalinga Eye Hospital had a room dedicated to children as a playing and a waiting room, yet it did not have appropriate toys or staff to work with children the room. Moreover, even when the children were sitting in the waiting area with their parents, no staff directed them to the children’s room. This underutilized room was beautifully painted in local cartoons and languages, and it had a separate door to the pediatric ophthalmologist’s office. It hosted a small plastic playground for children to go down the slide and ride the rocking horse. During my observation, however, I was baffled by how no staff took children patients to the doctor’s room through the directly connected door. Curious to understand the reasons for such underutilization of this playing room despite the high number of children patients, I’ve asked administrators, Director Samal, and paramedics. Their responses varied. The administrators were aware of the lack of attention to the children’s room, but as the hospital puts its priority on functions of the operating theatre and generation of sufficient revenue to sustain their humanitarian efforts, there was less emphasis on service quality in comparison to actual treatment. Moreover, there was no set protocol for children patients, so there was a big separation between treatment and service because it was culturally accepted that there was simply no need to incorporate service into children’s care. The paramedics explained that they simply do not have the money to staff the room and make best use of the room. So the room served as an accessory to the hospital, but not an integral part of the hospital experience for the intended user: the children.

The room is painted beautifully with local cartoons
We need new toys for children at the hospital! Exhibit A: the eyeless Mr. Rabbit

On one hot day at the hospital, I noticed two adorable boys sitting on the bench with other adults in the waiting room. Many minutes had passed, yet no one has suggested to them that they can go play in the children’s room. I nudged my dear friend and hospital paramedic, Trupti, to offer them a playing room while they waited for their turn to see the ophthalmologist. The boys lightened up at the paramedic’s good news and widened their eyes when the room light was turned on. There, my paramedic friend and I played with the children and watched the father smile at his boys’ smiles and laughter. A few paramedics passed by and watched us play with the children, and watched how happy and energetic the children were with a few toys and a simple welcoming gesture to the children’s eye care room.

A boy and his father playing in the children’s care room
A child patient at Kalinga Eye Hospital having fun while waiting
A child patient and the children’s eye care room

Watching these two children has inspired me to make another suggestion to the Kalinga Eye Hospital: why don’t we revamp the children’s room so that not only children can have a smooth, fun experience at the hospital, but can also increase patient satisfaction for both the child and the parents? Since this room has not been used for a very long time, it also motivated the paramedics to turn this place into a gem one day. After explaining my thoughts to Director Samal, he agreed to accept donations of environmentally friendly toys and story books for children from future volunteers from Unite For Sight instead of the required 600 eyeglasses (which are very difficult to fit into two suitcases along with other essential items). Moreover, a few paramedics have given me their word that with new supplies and toys, they will bring more children into this room and give them the vision that this hospital aims to provide for all generations. I left the place promising them that I will never forget about this experience at Kalinga Eye Hospital, and that I will continually serve as their ambassador in the United States and also in South Korea. I am happy to announce that I will be serving as Unite For Sight’s campus representative and am currently working to found a Unite for Sight chapter at Brandeis.

Prior to my trip to India, which would not have been possible without the generous support from World of Work, I was conflicted in choosing my career path: hospital administration/public health or becoming a doctor. I aimed to explore both aspects of health care in India, and I am so thankful for the opportunity I’ve had. I’ve conducted patient satisfaction surveys, brainstormed marketing strategies to sustain the hospital so that it can continue to provide services to the poor, and talked with the director of the hospital about health delivery and health disparities. Yet I did not feel as connected to those to whom I was reaching at outreach camps, ophthalmologist offices, and the hospital community. Encountering these children reaffirmed my decision to pursue attending medical school because I want to help children on a personal level. I’ve also developed a newfound interest in ophthalmology, because the joy and hope I witnessed when the patients restore their vision were so compelling and unforgettable.

The reverse culture shock I’ve experienced was none like any other culture shocks in the past. The average cost of cataract surgery at Kalinga Eye Hospital is $18, and it gave me a new perspective on my value system. $18 can mean a lot of things: four cups of coffee, a shirt, an eyeliner, and a surgery that saves lives. I will forever take this experience with me, and although my internship ended it really feels like a new beginning. I have a home in India to go back to one day, and it is time for me support the hospital’s initiatives and Unite For Sight’s objectives through my actions here in the states. If you would like to support me through Unite For Sight, please consider donating here, and if you would like to get more involved in other volunteer opportunities through Kalinga Eye Hospital and other sponsor organizations, please visit NYSASDRI website here . Thank you so much for reading!

-Gloria Park, ’13

“Sabuthik Acchi” (Everything will be okay)

Dear friends, my trip to India has been most memorable and unforgettable. Upon completion of my experience as a Unite For Sight volunteer at Kalinga Eye Hospital in India, the later half of my internship consists of creating a video film that captures the essence of volunteering at Kalinga Eye Hospital for my organization. I have been meeting with my faculty advisor, professor Laura Lorenz, to discuss how to make a compelling, powerful film to best describe my experience in India. I am currently developing a story board to effectively share my thoughts, and I just wanted to share a few memoirs that refreshed my memory through the raw footages.

As a Unite For Sight volunteer, one of my tasks is to observe cataract surgeries that my organization has sponsored through outreach camps. Inside the operating theatre, there are numerous activities that take place prior to the surgeries. Essentially, the camp patients are screened for free cataract surgeries at these camps and then are brought back to the hospital on the bus (under the sizzling weather and 3-hour long ride). After an hour of settling in, the female paramedics escort the camp patients to wait in line and perform local anesthesia on their eyes. Unlike the paying patients however, the camp’s patients do not receive pre-operative counseling due to the time constraint and therefore, are often very frightened by the surgeries themselves. Although everyone undergoes the cataract surgery and understands the sight-opening results of the sponsored surgeries, very little patients actually understand the details regarding the operation and what kind of processes are being done to their eyes. With little comprehension and almost no prior knowledge or experience with this type of surgery (or the eye hospitals in general), many patients, the majority of which are elderly, tremble in fear and desperately pray to their gods before the surgery.

With many patients to receive cataract surgeries in one day, the paramedics usually direct one or two patients to sit along the wall inside the operating room. Could you picture yourself, an elderly woman who has received very little education and is about to receive the first cataract surgery, sitting right across from the operating table, on which a patient is strapped down? Although one cannot see the details of the surgery from where patients would be sitting, this view seems to usually startle the patients even more, as they begin to frantically pray or completely freeze. Watching the patients and seemingly clueless paramedics and surgeons, I realized that I was experiencing a culture shock that I did not anticipate: compared to the “customer-is-king” mentality of the United States, such is not the norm at the hospitals in India. The situation also heightened the disparity between the paying and nonpaying patients, as the paying patients not only received higher quality operations, but also had gone through preoperative and post-operative counseling. Not knowing how to react, for the remainder of my first operation observation I remained silent. I tried to think about how to communicate to my paramedic friends the idea of why the hospital should try to make the camp patients feel comfortable with not only the surgery, but also with health care and hospitals in general.

One day, I asked a paramedic working in the OR how to say ‘everything will be okay’ in Oriya. After learning how to pronounce the phrase correctly, I held the hands of a trembling elderly patient and told her the words: ‘Sabuthik Acchi.’ However, the outcome was not what I had expected (the warm and fuzzy kind), because the patient was not able to hear me with the anesthesia and cotton swabs in her ears. And even if they heard me, I could not understand what they were saying in response to my encouragement. Learning that this was a job for the paramedics who speak the native language, I gave a powerpoint presentation regarding patient treatment that emphasized patient comfort, satisfaction, and future recommendations to other friends and family. With the help of the senior paramedic, Shanti, the words of my presentation were translated so that all paramedics could understand and discuss their perspectives, and we had lots of fun as I acted out the role of an elderly woman in the OR during the role simulation. And I was tremendously moved when during the next surgery observation, I noticed the loving, caring side of the paramedics when they directed the patients to the operation room.

I am writing about this experience because it has taught me a few things about volunteering overseas: first of all, there are still some things that you can feel past the language barrier, that make volunteering in foreign countries so heartwarming and compelling. I could never forget the smiles that I saw after the surgery and the gentle acknowledgement of the patients when they recognized me as a hospital volunteer. I could never forget the stories they shared with me during the interview, such as their fears of surgery, what they want to see the most when their sights are restored, the hopes upon regaining the control of their own lives, and the financial struggles that they will have to overcome for their spouse and family. But instead of focusing this post on what I did or what I have received out of the volunteering, I want to highlight how humbling it is to be a volunteer who can do very little on her own, but with the help of others and collaboration can achieve a lot for the community. There was nothing significant that I was able to do in the hospital setting where I lacked the technical expertise, the medical knowledge, and the ability to directly communicate with patients. I worked as the active observer. What I had hoped to do, I can only so do with the help of hospital staff and paramedics, and even so after spending a small amount of time with them, I will never know if my efforts were long-lasting. It is rather a privilege that they take the time to understand where I am from and listen to what I have to say, because I am a foreigner unaccustomed to their local traditions and dynamics. And I believe that the most important task of volunteering overseas is to respect the local customs and cultures and let them be the protagonists of their community. I am writing to describe my journey as I have seen, but this is really my take on the story of the Oriya people and how the Kalinga Eye Hospital aspires to provide affordable eye healthcare to the poor and neglected in the rural state of India. I will continue to play the role of a supporter and will share their perspectives and passions with my local people as they did with mine. With this thought in mind, I hope to amplify their humanitarian efforts of Kalinga Eye Hospital and Unite For Sight, and stimulate my peers to consider becoming part of this movement through my story and the resultant video film.

 

If anyone is curious about a video film taken by a previous Unite For Sight volunteer about Kalinga Eye Hospital paramedics, please click here. Also, please click here if you are interested in learning more about volunteering as a Unite For Sight Volunteer at Kalinga Eye Hospital. Thank you for reading!

– Gloria Park ’13

First week at Kalinga Eye Hospital and Research Centre in Orissa, India (Unite For Sight)

Namaskar! After 51 hours of traveling due to a series of delayed flights, I was so happy to finally arrive at my internship site for the summer, Kalinga Eye Hospital and Research Centre (KEHRC) in Orissa, India. I obtained this internship by becoming a Global Impact Fellow of a non-profit organization called Unite For Sight. One of my main reasons for applying was that a former Social Justice WOW recipient and Unite For Sight Global Impact Fellow, Samuel Icaza, told me about it.  He informed me about Unite For Sight programs and how the effort you put in to provide accessible medical services to people in need has a long-lasting impact on the community. At that time, I was going to Costa Rica and Nicaragua on a medical volunteer trip for 10 days that sought to provide basic physician services through free clinics and our donated supply of over-the-counter drugs while traveling to different villages. While the experience taught me invaluable lessons and gave me unforgettable memories, I realized that my efforts were not spent on working with the local infrastructure of the health care system to make sustainable changes in its access to health.

After being inspired by what I observed, I applied to Unite For Sight because instead of short-term relief mission trips, the organization collaborates with local eye clinics to provide outreach camps to villages without eye care facility, screen patients and provide corrective refractive glasses, and bring patients back to the hospital for cataract and other eye surgeries, free-of-charge. These surgeries are sponsored and paid for by Unite For Sight.  I helped contribute by fund-raising $1,800 prior to my internship so that 100% of the donations can be made to restore people’s eye sight without the barrier of high operation cost. Lastly, the average cost of cataract surgery through Unite For Sight is $50, which is incredible in that the price we pay for a pair of jeans in the US can help someone to regain eye sight and be able to connect with their family, friends, and the world.

I specifically chose Kalinga Eye Hospital and Research Centre among different Unite For Sight sites because this facility offers pediatric care and even has initiated a training for pediatric eye surgeons. At this hospital, as a volunteer and intern, I shadow ophthalmologists in the morning for about 4-5 hours, shadow and learn about basic visual acuity tests by engaging with optometrists, and work on hospital marketing and management projects of my choice. During outreach camps, I travel by bus for 4 hours to arrive at a remote village where I help contribute in the screening process (such as distributing eye glasses), help bring patients back to the hospital, and observe all cataract surgeries for non-paying patients (most from outreach camps). This is a protocol specified by Unite For Sight, as the organization needs to logistically track all the sponsored eye surgeries.

Currently, the hospital founder and president is abroad for conferences, but will soon return to Kalinga Eye Hospital. Based on my observations and ideas, I am currently working on a presentation to recommend some changes made to hospital marketing strategies and pediatric services here, as well as conducting a patient satisfaction survey for both non-paying and paying patients. I will also soon be writing letters to insurance companies to ask them to collaborate with the hospital, as KEHRC has not yet implemented a system where it accepts insurance plans (to facilitate patients’ hospital experience and also promote higher quality medical services).  Lastly, I will be finding a local baby to become a model for the hospital and design posters to improve the hospital’s image. Having run for the Student Union for 2 years, I have learned to enjoy the poster designing process and creating memorable slogans.

Finally, I will be recording a video about the patient’s perspective of Kalinga Eye Hospital, so that upon completing my hospital experience, I can edit the raw footage to best capture the essence of what KEHRC does and how Unite For Sight is involved.

I have learned so much already by talking to ophthalmologists.  Today I learned how to use the bio-microscopy machine (the eye machine in ophthalmologist’s office) and saw multiple layers of the eye through the instrument! Another interesting fact here is that many patients refuse to accept the concept of ‘no cure’ because the body will naturally heal itself, such as in cases of trauma. So often , doctors provide eye drops that do not directly ‘heal’ the symptoms but that serve as a psychological aid to patients’ worried minds (as they believe they will not heal without a medical ‘aid’).

If anyone is interested in knowing more about the Kalinga Eye Hospital, please visit the hospital website. Also, if anyone wants to learn more about Unite For Sight, please visit the organization’s website.

That is it for now, I am excited to update you more about my internship! Please leave any comment or questions if you’d like. Thanks for reading!

-Gloria Park, 2013