Ithemba liyaphilisa: “Hope causes one to live.” It’s a traditional saying in one of South Africa’s languages Xhosa (with the ‘xh’ being pronounced as a clicking noise). We can’t think of a better way to express the zeitgeist after we passed the halfway point of the 37th World Ophthalmology Congress (WOC 2020 Virtual®). The previous day’s statements of solidarity across ophthalmology in the face of coronavirus made us all feel the love.
The Media MICE team is still jamming the airwaves with ophthalmological outrageousness and we strongly recommend you tune in. On day three we’re flipping our focus to the anterior segment so keep an eye out for the latest edition of CAKE magazine. That doesn’t mean we were squinting for a few scarce or specific seminars; far from it, neuro-ophthalmology and the importance of clinical empathy all got our attention today.
There was even a moment of high drama as the Media MICE team discovered that our own, our precious, DJ Bananaman Mouse himself, Matt Young, has a doppelganger. The additional Jungian Young in question is Past President Matt Young of the Ophthalmological Society of South Africa (OSSA), and our Matt Young has been mistaken all digital congress long for the other in various online chats. We do hope there isn’t another DJ Bananaman Mouse at least . . .
Get to the Choppa!
After we figured out which Matt Young was ours, we invited Dr. Sergio Jacobovitz from Brazil to join us on the CAKE radio show. Dr. Jacobovitz is well-known for his Jacobovitz Multifunctional Chopper. This tool is a high-performance chopper characterized by its versatility and the reproducibility of its maneuvers.
The chopper is reliable and easily deployed in a variety of clinical facilities which makes it perfect for developing countries in Africa. DJ Bananaman Mouse put Dr. Jacobovitz to the test, quizzing him on this chopper. The doctor had 15 seconds to respond to each question, to get to the (heart of the) chopper, if you will.
“The instrument is really thin in its frontal aspect, and its lateral aspect is wider than a conventional chopper, which makes it easier to separate fragments,” Dr. Jacobovitz said.
“The copper uses less energy, which makes it safer, and it can be used for extra-capsular cataract surgery. This means we can use it in areas where there’s no access to phacoemulsification,” he added.
Moral Obligation – Business Opportunity
Countries like Ghana on Africa’s west coast are a good example of nations that need tools like the chopper. According to An Effective Model for Eliminating the Backlog of Cataract Blindness in Ghana (e-poster at WOC2020 Virtual®), if each of the country’s 74 ophthalmologists performed 1,000 surgeries per year, it would still take five years to clear the backlog of 187,500 when the study began. Small wonder then the poster’s authors wanted to find a way to treat cataract blindness more efficiently.
Beginning in 2018, 13 partners of Ghana’s national cataract outreach program received cataract outreach kits and 5,189 surgeries were performed. The study postulates that if every patient had insurance and each provider received $44, around $228,316 in revenue would be generated for future investments into eye care. That’s a potentially lucrative business opportunity for those also wanting to make a difference.
Indeed, Africa abounds with examples of how ophthalmology can make a real difference in society. Take Ethiopia for example. In 2014 the country had one of the highest rates of blindness in the world with a national prevalence rate of 1.6%. Strengthening Ethiopia’s Eye Care System (e-poster at WOC2020 Virtual®) examined how local and regional partnerships to strengthen eye care systems could improve this figure.
Under the study, 79,825 surgeries were performed between 2014-2019 with a 402% increase in cataract surgeries. The average cost per surgery was reduced by 41.4% — from $105 in 2014 to $61.58 in 2019, and health personnel training increased from 42 opportunities in 2014, to 654 in 2019, in tandem with the expansion of subspecialty fellowship training and in-country fellowships in cornea, pediatrics and glaucoma. Ethiopia is witnessing some really positive changes . . . “ithemba liyaphilisa” indeed.
I Am Because You Are
Positive change and cause for hope is something we can see from Cape Town all the way to the top of the continent. Dr. Alaa Eldanasoury of the Magrabi Hospital in Abu Dhabi, United Arab Emirates, reported about his success in treating children with myopia. Presenting during the Refractive Surgery: From Cornea to IOL, Complementary Rather Than Competitive session, Dr. Eldanasoury is a firm believer in ICL versus LASIK.
The doctor argued that the implantable collamer lens (ICL) is more effective than LASIK at preserving life span quality of vision and cornea biomechanics. He also argued that if cataracts arise they can be effectively treated with a state of the art IOL. Prof. Ahmed Elmassy of Egypt’s Alexandria University concurred with Dr. Eldanasoury, and went on to argue that IOLs can also play a therapeutic role in anisometropic myopic amblyopia in children.
Something we’ve certainly appreciated during WOC2020 Virtual® is the dynamic approach to ophthalmology in Africa and how it impacts on other disciplines. During the Neuro-Ophthalmology in Africa and Beyond session, we learned about how African philosophy can impact on ophthalmology. Dr. Sandika Baboolal at the University of KwaZulu Natal in Durban, South Africa, emphasized the value of enhancing empathy in ophthalmology, based on her experience in South Africa.
Giving the example of the term “ubuntu”, meaning “I am because you are” in Zulu, Dr. Baboolal argues patient-centered health care with high levels of empathy improves patient satisfaction and outcomes. This isn’t based just on emotional intuition, she said. She gave one example where a surgeon’s blase attitude to a patient’s care motivated said patient to pursue litigation. Therefore Dr. Baboolal argues empathy needs to be seen first and foremost as an essential competency for all practitioners, including emotional empathy as well as cognitive and applied empathy in care.
Talking about empathy, we can really feel you’re enjoying WOC2020 Virtual® and so are we! Frankly we’d be quite happy if the conference went on for days and days more, but sadly, all good things must come to an end. Don’t worry, we’re leaving the best to last so keep your eyes peeled for more stories and reports.