We made it inside the walls of a hotel compound that would be our home for the next four nights. It was 4:30 in the morning. Eighteen hours and 4,000 miles had passed between our departure in the Northern hemisphere and our arrival in the South, leaving an early Illinois spring to enter Peru’s newly arrived fall. There were strange figures kneeling, everywhere it seemed, on the hotel grounds. Spooky. Scores of hollow manufactured fiberglass statues would be revealed in daylight. Young people in tee shirts gave us room keys attached to wooden tags by leather thongs. Paper tabs bearing our names were stapled on them. The polite young hotel workers helped us find our quarters and we collapsed into bed. As I went to sleep I heard a rooster crow.
Because we traveled through the night many of us got a lot of sleep on the plane. We assembled as a group for lunch, the California volunteers who had arrived before us, the Illinois contingent which included optometry students from University of Missouri St. Louis, others from across the country. Nearly forty of us. Many were on their first mission. I think the Peru trip was my 25th. We introduced ourselves, some of us meeting for the first time. The group that would work and live so closely together was already beginning to gel.
Mercifully, we were not scheduled to see patients that day, having wisely given ourselves a day to regroup and set up clinic. After lunch we boarded a bus, the same bus we would ride every day, named “Ronaldo.” It was a converted school bus owned and operated I think, by a guy who took great pride in it. It was meticulously painted in red, green, and white. The driver washed Ronaldo’s many wheels every morning. It was not immediately clear if the driver was also named Ronaldo. But the identity of the bus was unmistakable.
Getting to this point took nearly a year. The germ of the idea for a trip to Peru, I Care International’s first to that country, was born late one night after dinner and beers at a beachfront restaurant in Trujillo, Honduras more than a year earlier. The mission in Honduras was over. We immediately set our sights on next year.
“Dena (an I Care member) has family in Lima. She’s already talked to them and they would be interested in helping.” That was Stephan talking, retired student activity coordinator at a central coast college in California. He would later emerge as the mission leader.
“We could combine a clinic with a trip to Machu Picchu.”
Machu Picchu had been my goal, my pilgrimage destination, when I set out from the Smoky Mountains to travel Central and South America in 1976. I got hung up in Ecuador and never made it. I thought about it for maybe a second.
“I’d be up for that trip.”
Of course it wasn’t a trip yet. Much thought and work goes into planning before a trip is declared a go. Who are our contacts in country? Who are they connected with? Can they help us with the bureaucracy that controls customs, are they respected and trusted enough in the community to produce a turnout of people for the clinic? Is the site safe? Is lodging available and workable? There is nothing worse than asking volunteers to spend their own time and resources on international travel, and putting together a stock of 6,000-8,000 used eyeglasses, only to have a disappointing number of people make use of the resource. It’s always a risk. And the first mission to any new country is an even bigger risk.
We hedged our bets by taking up the generous offer of an I Care board member who volunteered to act as a scout. Trish from California traveled to Peru in the summer of 2014 to meet our hosts, see for herself the worksite, gauge the strength of their connection to the community, visit the hotel, and make an overall assessment of the trip’s viability. Everything seemed positive. We began talking to volunteers about the possibility.
In order for a trip to be viable you must have eye doctors. Except for one exceptional trip, when we took a chance and operated a four day clinic with only one experienced optometrists and eight students, having plenty of experienced eye docs is an absolute necessity. We attracted interest from four experienced optometrists currently practicing. With the help of our four third year student docs, we were set.
If needed, all the other positions can be filled by volunteers equipped only with on the job training. That wasn’t necessary. We had an experienced optician, people who knew how to operate the sophisticated equipment we pack, plenty of Spanish speakers. It was a good crew.
Here’s the stations: registration, health (blood sugar and blood pressure assessment for those as risk), acuity (eye charts), auto refractors (measures the eye and provides a read out), eye exam by the docs, dispensing (selecting the closest match from the stock of used lenses, giving people their glasses and fitting them.) Sounds simple doesn’t it? It’s not. It’s a process. We make sure everyone goes through every step, no matter how well they see. Any eye doc looks at and in every eye that comes through the door. Depending on the size of the crowd it can take four hours or more to get a patient through the stations. And sometimes, fearing they won’t be seen, patients line up at the door up to four hours before the clinic opens to make sure they get inside.
Is health care in demand for the developing world? Yes. Glasses and eye exams cost as much or more there then here and most people earn no more than 20% of what we earn. Food and shelter comes first. Eyesight, along with other health concerns, is secondary. Americans take so much for granted. I ask every patient I see in dispensing, as I unwrap their glasses from inside their registration form, if they have ever worn glasses. The most common answer by far? Be they 6 years old, sixteen, 36, or 66 they typically respond
“Nunca.” (Never.)
In three and a half days we served nearly 1400 people in our free eye clinic in Pachacamac. 90% of them received glasses. 40 of them were diagnosed with serious eye conditions and referred for further service: glaucoma, cataracts, retina problems, a condition commonly found in the tropics called Pterygium, a tissue growth on the outside of the eyeball.
This clinic was aided by a significant donation from a Rotary Club in California. We were given $1500 to augment our normal services, to spend as we saw fit. We chose to buy sturdy new readers and sunglasses, and to establish a fund to make glasses for those whom we could not provide a suitable match from our stock of used glasses. These tend to be more difficult prescriptions. That donation was matched in part by the assurance from a large lens grinder in California that they would grind the lenses at cost, and put them into frames donated by yet another donor. I Care has made glasses on a limited basis before, perhaps up to ten times per clinic, but never had we been given the opportunity to do so on this scale. We are making 64 pairs of brand new glasses, many for young kids, and transporting them back to their community this summer. Because of how it fell together we were able to stretch that donation to cover so many needs. Let me give you an idea how it helped.
A middle aged electrician, his own businessman, came to my dispensing chair needing help seeing close up. He explained in Spanish that he was having trouble stripping wire, getting the right diameters without cutting the copper inside, and fitting them into the wire nuts. In addition he was unable to read his newspaper any longer at night. I gave him two sturdy pairs +1.75’s readers, one for his tool box and one for the house. When he put them on and I handed him a page of newsprint he immediately smiled. He asked if I was sure I had enough glasses to give him two pair. I assured him I did. It’s great having resources.
We look closely at the occupations of the people we serve. A number of men and women worked in the fields raising vegetable in that area. Nearly all of that work is done by hand. I saw very few tractors or even mules or burros in the fields. It was rows of people with hand tools. When they came through the clinic, regardless of their visual acuity, we gave them a pair of our new dark wraparound sunglasses, which will not only shield them from the tropical sun but also keep the dust out of their eyes. We gave away a lot of sunglasses. It’s such a pleasure to be able to do so.
Every mission trip is special. What made this one so? In addition to the donation of added resources, we worked in a single big room. It was hot, we brought fans each day from our hotel which had no air conditioning, in order to make it bearable, but we all worked together in one space. We’ve worked everywhere in all kinds of conditions during the life of I Care as an organization. We’ve worked totally outdoors. We’ve worked in places where every station was in a different structure. Best is to be in a big room, volunteers, patients, everyone.
Communication was excellent. When the docs had a special case they could walk over to dispensing and explain what they needed. If the auto refractor reading seemed askew you could walk a patient over there for a retest. The people choosing the glasses for a particular individual could look at the size of the head they were choosing glasses for to find something appropriate. When we were running short of glasses in the stock of a particular type we could have the docs over to explain our plight and help us brainstorm ways around it. It was an optimal clinic site. Hot but so very functional.
It was Father Oquendo’s church hall. The Main provider of social services in that valley, that community, is the Catholic Church. The have a small medical clinic staffed by a nurse open every day. Prior to our visit they made announcements of our clinic at masses for weeks. They communicated to neighboring parishes. Father Oquendo, who showed up the first day in a papal collar, ended up the last day in an I Care tee shirt dispensing glasses next to me. The community was into it, and we were into them. They were gracious and thankful people. It was a pleasure to help them.
Several things stood out. We made a point of having an evening debriefing meeting each night at the hotel so we could share concerns, problems, ideas, and successes. Each station reported on the day from their perspective. I think each volunteer gained an appreciation for the clinic as a whole that way. The communication made the experience better for everyone, especially the people we were serving. Each day we improved the service we offered the people.
We served two special populations, a boy’s group home and a girl’s group home operated by the Catholic Church in the region. Their counselors described the boys as “orphans, homeless, delinquent, abused, abandoned.” Evidently child welfare in Peru is little different than child welfare in the rest of the world. Those boys nearly scammed us out of the rest of our sunglasses, but we caught on before they did too much damage. To a boy they had never experienced an eye exam. Several had significant problems. We were glad to be there for them.
The girls were painted with a kinder brush, although I doubt their situations were in reality much different than the boys. The volume was a little higher when the girl’s entered the room, and the drama of encountering various styles of glasses much more intense. They came at the end of the day, and we realized they been brought by our same bus and driver to the clinic. We shared the bus back home. The girls and the staff serving them brought a whole bunch of energy to a tired group of volunteers.
Let me show you a couple of patients for whom we are making glasses. Both are from the group homes I talked about earlier. They were special patients for me because of my own history.
I flunked the eye test in third grade when the public health nurse came to school and had my classmates and I read a simple eye chart. I knew I was flunking it as I was taking it. I was making wild guesses. I couldn’t see the letters.
The nurse gave me a slip of paper to take home to my parents telling them the results of the test and suggesting they take me to an eye doctor for further testing. I didn’t give it to them. I hid it in my baseball cards. I didn’t want to wear glasses. Nobody else wore glasses except Jackie Holfred who crapped his pants in first grade during reading class.
Months later, late at night and consumed by guilt, I turned on the light in my room upstairs at the farmhouse and dug out the piece of paper. It was between Ryne Duren and Sherm Lollar. Crying, I made my way downstairs to my parents’ bedroom and switched on their light, holding the piece of paper in front of me, confessing the cover up through loud sobs.
My parents were shocked. My Dad was on top of my Mom with a sheepish grin. My Mom seemed upset and moved quickly out from under my Dad. I didn’t realize it till years later that I had walked in on them making love.
They were very forgiving about me hiding the truth about my eyes. We went to an eye doctor in Pekin and soon I had charcoal grey plastic frames holding fairly strong lenses for myopia. From the moment they put the glasses on my face I didn’t want to take them off. I could see so clearly. I could see every leaf on the tree. Mom would take them from me at the supper table and wash them in the kitchen sink. I would immediately put them back on. Putting my glasses on was the first thing I did in the morning and taking them off the last thing I did each night. I needed those glasses, and they became my constant companion.
These kids, each from the group homes we served, have similar if not worse eyes.
Like me they were lucky enough to have someone test their eyes at a young age. With the glasses we will make for them, providing the exact prescription they need, they will have years of clear vision during the growing up years when seeing the world for what it is means so much. I’m glad to be a part of helping them, as should everyone in the Pachacamac clinic and those back home who helped make the donations possible that funded the making of those glasses.
That’s what happens at an I Care clinic. You spend time and money, and put forth extraordinary effort, to give eyeglasses to people who have no access to them so they can see the world better. You and I expect and obtain eyeglasses easily as a matter of course. In Pachacamac, Peru and much of the world obtaining eyeglasses is an entirely different matter. At least last week, I Care International made clear vision a reality for 1400 people in a small community in Peru. We did the same thing earlier this year at clinics Mexico and Guatemala. It may not be the answer to the world’s problems but it certainly helps.
Thank you Dave for such a descriptive and "spot on" narrative of the workings of an I Care International Clinic. I volunteered in my first clinic last month in Santiago de Atitlán and can not wait to volunteer again.
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