On Board The Flying Eye Hospital

Since I started volunteering with Orbis, I've been on six sight-saving expeditions - and the majority of these have been with their Flying Eye Hospital; the only ophthalmic teaching hospital on board an MD-10 aircraft.

I think if I wasn't an anaesthetist, I would have liked to have been a pilot. There's a lot of similarities, in terms of responsibility, it's a practical role, it's science based. In the end though - I like my patients. Most of my anaesthetic practice is with children. It's incredibly rewarding. Often they are unwell through no fault of their own, and they need life-changing surgery unfeasible without general anaesthesia. I like being an integral part of the team that makes that happen.

My job and my interest in aviation combine perfectly through the charity I volunteer for - Orbis, which fights avoidable blindness across the world, with its in-country programmes and unique Flying Eye Hospital. I first became involved with them because I respect their ethos and their values. They are non-profit, non-aligned, non-religious. I like that they focus on education and building strength, not dependency.

Blindness is an area where people can make a real difference to the needless suffering of millions of people. There are 285million people in the world who are blind or visually impaired, and 90% of these people live in developing countries where access to eye care is scarce. Blindness has far-reaching implications; children can no longer go to school, adults can no longer contribute to their families or communities. In some cultures, blind people are shunned or discriminated against or even left to die. And frustratingly, 80% of blindness is either treatable or avoidable.

Since I started volunteering with Orbis, I've been on six sight-saving expeditions - and the majority of these have been with their Flying Eye Hospital; the only ophthalmic teaching hospital on board an MD-10 aircraft.

The Flying Eye Hospital is more than just a high tech concept. The environment enables us to share knowledge and skills with local medical professionals in a totally unique way across the medical specialities; for example, the operating room broadcasts surgery to those we're training in the 46-seat classroom at the front of the plane, in 3D and in real time.

It enables us to go to places where other charities don't or can't. In the past it has been to Syria, Cuba and Taiwan. In its history, the Flying Eye Hospital has visited 78 countries on hundreds of missions. When we were in China recently, we were just 180 miles from the North Korean border. The plane itself is an ambassador and it attracts attention wherever we go. It gives us a spotlight to raise awareness and help prevent avoidable blindness. We often have visits from high ranking governmental officials who are keen to tour the plane and meet the crew and volunteers. I know that Fidel Castro spent time on board the Flying Eye Hospital during one of its visits to Cuba. There are even rumours that he dressed up in a bunny suit to entertain the children waiting for surgery - but of course we can neither confirm nor deny this.

I'm amazed by the people we treat. The children are always rewarding. They are usually very brave, many have not seen an aeroplane before, let alone an anaesthetist, yet very few cry or get scared. At the opposite end of the scale I remember anaesthetising one 82 year old lady in Cambodia which was unusual. She was remarkably stoical and sailed through her surgery and anaesthesia - proving that you have to be good to get to 82!

A few months ago, I was lucky enough to be a volunteer during the first programme of the new 'third-generation' Flying Eye Hospital which took place in Shenyang, China. Not only had the brand new plane only just launched in June, but it was the 40th Flying Eye Hospital programme in the country.

The anaesthetist that we were training during the programme - despite being qualified - had never had the opportunity to provide local anaesthetics for eye surgery. As the week went on she made rapid progress, eventually doing just that - and very successfully. Not only were these techniques safe, but crucially they are sustainable and used equipment from the local hospital. We always try and bear in mind that one size does not fit all, and we listen to local medical professionals and give them the training they need to work within their own environments.

One of the things Orbis always focuses on is teaching current evidence-based best practice, from maintaining hand hygiene to adherence to the World Health Organization (WHO) surgical safety checklist. In a lot of places we visit, teaching is given a back seat to service delivery. Medical professionals have a huge workload and don't get the time, funding and encouragement for professional development. Orbis helps change this, ultimately meaning that more people in more countries can access quality eye care.

I'm pleased to report there were surprisingly few teething problems with anaesthetising on the new plane. Everything worked well, and thankfully we didn't have to test out any of the state of the art resuscitation equipment! The only omission I could find was a decent cup of coffee - but I am assured that this is work in progress. I look forward to finding out when volunteering on my next Flying Eye Hospital programme! www.orbis.org.uk

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