Conveying the shape and feel of an I Care clinic is
difficult because the process is experienced by lots of people.
There are so many points of view.
Not everyone who contributes makes the trip.
We
have student volunteers from Morris,
Illinois and Paso Robles, California high schools that wash and clean random bulk
glasses received from members and friends of I Care and the Lions Club, and then assess
each one using a piece of equipment known as a lensometer.
Once the exact prescription is determined for
each eye it is written on a label on a plastic bag into which the glasses are
placed.
Some of those high school volunteers are “Dreamers,” and others
are first generation immigrants from Central America.
They have a purpose in helping I Care that
goes beyond filling volunteer hours required by their school.
Both those who donate glasses and those who assess them trust
their efforts will be rewarded when the glasses they processed are taken out of a bag by an I Care volunteer at a clinic in Central America and given to a
person who lacks the means to obtain their own.
We conduct these annual clinics to preserve that
trust.
Volunteers take bagged glasses, bifocal and single vision, minus
prescriptions for the near sighted, plus for the far sighted, corrected for astigmatism,
the whole range of corrective needs, and create a catalog of glasses that will
be used at the clinic site.
Over the
years, optometrists have determined the type and range of prescriptions that
will likely be needed.
Glasses are
sorted by type and then a wide assortment of prescriptions are placed in
cardboard sleeves in ascending order from the weakest to strongest prescriptions.
This becomes the stock from which the
prescriptive needs of individuals are matched to available used glasses.
Up to 6,000 used glasses may make the trip in black canvas
bags to a clinic site, carried by I Care volunteers who pay for their own travel,
lodging, and meals while performing the tasks needed to conduct a clinic.
Those volunteers are the people our patients
see, but they represent others who may never travel to a clinic yet are
indispensable to its success.
The single biggest cause of poor vision in the world is
caused not by glaucoma, or cataracts, or retinal disease, or other maladies of
the eye.
The biggest cause of poor
vision is the lack of corrective lenses.
That’s what we strive to provide, improved vision to those whose eye
problems can be improved with glasses.
I Care certainly doesn’t create and plan these clinics from the
United States in a vacuum.
Before
anything happens, we need to make sure people in the community we intend to
serve extend a formal invitation, provide local contacts, security,
recruit local volunteers, and do the hard
work of site selection and logistics. When we arrive in county we need help getting our equipment
through customs, transportation, meals, and more
details than any one of us fully understands.
We found the cooperation we needed and more in hard working members of a
Rotary Club in San Miguel.
Without them
the clinic would have never happened.
We
can’t thank them enough.
Twenty-seven volunteers from the USA, one from La Penita
Mexico, and two from Mexico City traveled to El Salvador to join with our
Salvadoran hosts in staging this four-day clinic.
They worked at six clinic stations.
Here they are briefly.
Registration-Our most fluent Spanish speakers converse
with each patient to determine basic demographic and personal information and gather
a self-report of visual difficulties.
They record that on an intake sheet that travels with the patient
throughout the clinic.
Nurses-Because high blood pressure and diabetes are
so closely correlated with vision problems, and vital information for our optometrists,
we refer likely candidates to a station where nurses take blood pressures and
determine blood sugar levels.
Acuity-Volunteers stand by eye charts on a wall pointing
at smaller and smaller descending lines of symbols.
Ten feet away volunteers with clipboards
listen to their responses and record the extent of their success; 20-20, 20-40,
sees fingers at three feet, whatever the outcome, for each eye.
They do this hour after hour, day after day,
for each and every person entering the clinic.
Auto Refractors-Two
volunteers operate the
most expensive machines on the trip, portable auto refractors which measures the
way each eye bends and receives light.
It gives eye doctors a powerful indicator of the type of prescription
likely needed best improve their vision.
Docs-We had six optometrists on our trip, plus two
last year optometry students from University of Missouri St. Louis.
That’s an abundance of professional volunteer
help.
For the first time in the
organization’s history, we believe, all of our optometrists and students were women.
By working well together they made the
clinic’s operation very smooth despite a high volume of patients.
Docs evaluate the health of each patient’s eyes,
diagnose eye disease if present and provide consultation and referral if
possible, and determine the prescription needed for glasses if any.
Not everyone needs glasses, but everybody
deserves a good eye exam.
Many get the
first of both in our clinics.
Dispensing-Two types of volunteers work in
dispensing, pickers and fitters.
Pickers
comb through the stock of glasses and select the closest match to the
prescription the eye doctor has written.
Once located they pass the glasses on to fitters who put them on the
patient, determine if the glasses work well for them, and then adjust them for a
comfortable fit.
Not every script works every
time.
The fitters are the end of the
line.
They ensure the process works for those counting on it for improved vision.
Together we served 1,707 patients in four days, an average
of 427 a day.
That’s a lot.
But all my observations so far are from the
perspective of the clinic volunteers.
What’s missing is the perspective of the Salvadorans we served.
I can’t speak for them of course, but I work as a fitter with
limited Spanish and was able to talk to a good many of those who received
glasses.
I want to tell you the stories
of two of them, in hopes of conveying the essence of I Care’s El Transito
clinic.
On a hot afternoon in a noisy crowded clinic I introduced myself
to Alma, a 9 year-old girl from a village near El Transito.
She came to the clinic on the first day, Sunday,
all dressed up.
She was accompanied by
her mother, who explained that Alma’s teacher suggested she see an eye
doctor.
Alma was really shy.
Her mother explained she was not sure she
wanted to come, and even more unsure about wearing glasses.
I looked at the prescription the doctor had written, and the
glasses the picker had chosen.
Alma required
single vision minus glasses.
Those are
designed for patients with myopia, which we know as near sightedness.
Her prescription was a -2.50 sphere.
Alma’s near vision was likely OK she but would
struggle to see things far away.
Her
teacher may have noticed that when she was trying to see chalk marks on a
blackboard.
That’s a moderate version of the kind of vision I have.
I got my first glasses at her age, also
reluctantly.
But after realizing how
well I could see with them I didn’t want to take them off.
The pickers had found a nice pair of small glasses, plastic
frames brown on the outside with pink on the inside.
“Alma, have you worn glasses before?”
I said that in Spanish knowing the answer but wanting to
strike up a conversation.
“No.
Nunca.”
Nunca means never.
It’s
the most frequent answer to that question every time, every year I make the
trip.
“Well these glasses should help you see things much better
at a distance.
I bet you can read well,
is that right?
You see words in a book
clearly?”
Alma just nodded.
Her
mother answered for her, proudly.
“Alma is a good reader.
She reads a lot.
Not a problem.”
“OK. Tell me what happens when you look through these.”
I unfolded the glasses and put them over her ears.
They settled down over her nose nicely.
“Ahora, mira aya.”
(Now
look away.)
I pointed across the room.
Alma looked over the crowd at the people doing acuity.
I saw her gaze shift up to the pigeons
sitting on a ledge above them.
I watched
her closely.
A little smile broke out on
her face as she gazed across the room.
“Como es?
Claro?” (How
is it?
Clear?)
I knew the answer from her smile, but I wanted her to tell
me.
“Si.
Muy Claro.”
(Yes.
Very Clear.)
She turned to her Mom and gave her a bigger smile.
Her Mom looked relieved.
I went into a little rap I have memorized in Spanish about
wearing the glasses every day, putting them on the first thing when you get up and
taking them off only when you go to sleep.
I advised that she may not need them to read and if it was more
comfortable to take them off while reading.
I cautioned both her and Mom that the lenses were plastic and
easily scratched.
They should be cleaned
with soap and water and wiped only with a soft cloth.
I gave
her one of the donated microfiber lens cleaning cloths some nice donor
furnished for us to distribute.
Her Mom put
it in her purse.
Before they left, I asked her Mom if it was OK to give Alma a
small gift.
I went to the table where we
kept our adjusting tools and selected something for Alma from a box.
I held a Pez dispenser in front of her.
At its top was the head of a white rabbit.
“Mira Alma.
Es un conejo.”
(Look Alma it’s a rabbit.)
I tipped the rabbits head back and a little Pez candy pushed
forward.
“Y es un dulce tambien.”
(And it’s a candy too.)
She smiled bigger than before.
I’m pretty sure the I Care clinic worked well for Alma.
She was able to get her vision corrected early
in her life, which will make a real difference in how she sees the world
growing up.
With any luck she and her
Mom will realize their importance and will find a way to get more glasses as she grows.
Myopia is not a condition that goes away.
But it is easily corrected.
Someone donated those glasses to I Care.
Others did the work needed to provide a good
eye exam and make those glasses available to benefit Alma.
I was just lucky enough to see that benefit
unfold firsthand.
We worry sometimes that our hosts do not take seriously the
task of promoting a clinic in their community.
In this case the Rotary Club of San Miguel teamed up with the city of El
Transito and simply broadcast over public media the dates and times of the
clinic.
That approach has not always worked
in the past.
This time it did.
It was our first time working with this Rotary
club, our first time in El Salvador.
We
should have trusted them to know their community.
The clinic was a madhouse.
Each day before we arrived, in order to keep waiting patients out of the
sun, our hosts packed the place with waiting people.
It was very difficult to walk through the
crowd.
We asked out hosts to create
aisles through the rows of chairs so we, and patients crossing to the next
station in the clinic, could make our way across the room.
The
clinic was the biggest thing in town.
It
attracted vendors. They balanced their wares on their heads.
Inside the all concrete structure the steady hubbub of the crowd
coupled with an amped up public address system and a woman with a microphone speaking into it with a shrill voice and it was damned hard to hear. We
leaned in closely to catch the responses of our patients.
I often asked the people who were receiving glasses from me how
long they had waited.
Some reported being
there over four hours.
You would never have
known that.
They were calm.
Families brought their children and
accompanied the elderly.
The locals managing the crowd were careful to give priority
to the handicapped, the frail, and those in wheelchairs.
I was impressed with the patience and kindness
they showed each other, and us.
I wanted
to return it.
I think each I Care volunteer
shared the desire to both reciprocate the welcome shown us by our hosts and reflect
the kindness we felt from the people we served.
When the fitters were backed up dispensing glasses, when too
many people crowded our waiting area, the pickers jumped in to help us.
My wife is a picker but doesn’t know as much Spanish
as she would like.
One of the good young
Salvadoran volunteers, Carolina Navarro, served as her translator.
She called out a woman’s name and an elderly woman was
helped to the front by her grand daughter. She walked with a cane.
Colleen looked closer at her intake sheet and
saw that she was 97. Her name was Victoria.
“I would never have guessed her to be that old,” Colleen said
later.
“She was so engaging.
And anxious to get those glasses.”
“Have you ever worn
glasses Victoria?”
Carolina translated Colleen’s
words into Spanish.
“Nunca.”
“She never has,” Carolina explained.
“Well here you go.”
Colleen unfolded the temples of the bifocals and tried to put
the glass on the old woman’s face, but she reached out quickly and put them on
herself.
We make assumptions about the elderly.
Colleen assumed she needed and wanted the
strong bifocals primarily for reading.
“Carolina, ask her how the letters look in this newspaper.”
Colleen handed the 97-year old Victoria a page of newsprint.
She brushed it aside and responded,
cheerfully
“No sabe leer.”
“What did she say Carolina?”
“She says she can’t read.”
The old woman straightened up in the chair and looked slowly
all around the clinic.
Smiling she
looked back at Carolina and my wife.
“Ask her what she sees Carolina.”
“Que ves Victoria?”
“Te veo, y eres hermosa.”
“What did she say?”
“She said she sees you, and you’re beautiful.”
When my wife heard Victoria’s words through Carolina, big tears came to her
eyes.
If you don’t catch the emotion
wrapped up in bringing improved vision to those who have never experienced it, you
miss the impact I Care has on people outside our borders.
Like Alma, the nine year-old girl we were able
to help, Victoria had just received her first pair of glasses, and with them a
new view of the world around her.
And in many ways, we Americans who made the trip to El
Salvador opened our eyes to a new world too.
