Belize
Once we knew that there was naught for me to do in Guatemala City, the ICEE representative who is helping to organise my volunteering opportunities wrote to an outfit in Belize offering them my services. They were pleased to put me to good use (Belize is primarily an English speaking country), as such I headed for Belize pronto.
During this section of my trip I was being shadowed by an American student who is keen to practice optometry in developing areas once he has graduated optometry. He was full of youthful enthusiasm, spoke a little Spanish and proved to be good company.
The organisation that I was working with in Belize was the Blind Council for the Visually Impaired (BCVI), a not-for-profit organisation that has been in operation for over twenty years (for more information visit www.bcvi.org). Admirably, they exist to provide affordable eye care to the Belizean poor. The eye exams are free and the goods provided are heavily discounted. There is an ophthalmologist who works every second month in the Belize City clinic where there exists a BCVI surgical theatre used for cataract extractions. Additionally, the organisation provides all the services for children and adults who are blind or visually impaired. The week I was there they were running their annual week long camp for visually impaired children from all over the country (they are pretty sure they have found all the cases in Belize).
BCVI employs all the qualified optometrists who are currently practising in Belize; All four of them. Considering that the country has a population of around 300,000, it is safe to assume that the visual demands of the Belizean people is significantly lower than other areas (&/or there are other ways of getting your eye check &/or glasses). The optometrists are spread across the country. I was assigned to the optometrist who is responsible for the outreach clinics, and so each day of the week I was with him, we travelled out to regional areas to examine eyes in medical centres.
Despite the abovementioned numbers and their resultant ratio, we were not inundated with patients (primarily because it’s the rainy season here and Belizeans don’t venture out in the rain), which was really ideal as it allowed me time to observe the local optometrist and to take advantage of the many teaching moments that presented themselves (using my preferred action-reflection model for tuition). The optometrist that I was assisting graduated from the Guatemalan course two years ago and confirmed the story I had heard about the quality of training provided in that country by the conflicted teaching staff. I was able to help him perfect his refraction techniques and improve his ability to diagnose pathology; the three year course in Guatemala really only focuses on refraction. It was very satisfying to the see the advice that I was dispensing being put into practice immediately, saving the optometrist time and securing better results for the patients.
I also had the opportunity to straighten out some equipment in the consultation rooms. My best effort was returning a slit lamp to functioning order using a couple of elastic bands (which I only used because I could not lay my hands on any #8 wire).
I also made a visit to the optical lab they operate. They manufacture their own lenses (single vision and bifocals in CR39) and dispense their own prescriptions. It takes about a week to turn around a pair of glasses.
The major issue for BCVI appears to be a human resource issue. Two of the optometrists are in the late stages of their careers, as is the head of the organisation; and the ophthalmologist who is only available every second month has already retired from practicing in America. As such, young blood is needed to replace the aging staff members who hold key positions. Ideally the organisation would employ a full time ophthalmologist and five full time optometrists.
A related issue, also high on the scale of importance, is the educational issue discussed earlier. Belize is too small to train its own eye specialists. Optometry students from Belize must therefore study oversees, Guatemala and Cuba being the best options (both countries run their classes in Spanish). Not only are the costs of training delegates abroad high, it can be hard enticing the students back to Belize when their training is completed. And, as has already been indicated the training is not of a high quality, focussing little on pathology despite being three (or more) years in length.
A final difficulty, which may soon be the biggest issue for optometry in Belize, is financial. Sightsavers will shortly begin phasing out the funding that BCVI has been receiving for many years (in order to redirect funds into Africa), as such BCVI (which is the only one employing optometrists and providing low vision services in the country) is either going to have to cease providing services, &/or increase the cost of their goods & services unless financial support can be found elsewhere. It is likely that support will be sought in the Americas rather than from Britain (Belize was part of the British Empire). It would be a great shame to see an organisation that has done all the hard work of setting up the infrastructure to deliver quality eye service at affordable rates needing to limit its services (rather than continuing to expand) because the relatively small amount of money it requires to function could not be found.
Next stop: the Caribbean.
Kind regards,
lucas
PS: Photos are attached; The first 5 were taken inGuatemala, the second five were taken in Belize (and include one that proves that you get to do some things in foreign settings that you would never get to do at home, like wearing your cap – backwards – while digging a metallic foreign body and its’ rust ring out of a patients eye with no magnification device (good thing I’m young, fit and pre-presbyopic)).
