8 December 2009
The VOSH International representatives who live in Managua organised for a three day seminar to be delivered to the optometry students at the UNICIT university, which is the only place that optometry can be studied in Nicaragua. Because it is a private university, the only entrance requirements to the four year degree program are a desire to study optometry & the means to pay the tuition fees (which are prohibitive for most Nicaraguans). We had twenty-eight students at the seminar from all four years, which made for a wide spread of prior knowledge.
I delivered two days of lessons on the topics of binocular vision, ophthalmoscopy, & ocular pathology, before being joined by Dr Nelson Rivera (ICEE co-ordinator for the Latin America region) who lectured on the final day (in Spanish, much to the students’ relief). It was the first time I have taught through a translator and I must admit to finding the experience even more difficult than I had expected, for a variety of reasons, some of which I will spell out now. It was nigh impossible to ask questions of the class (which I love to do when teaching) as the point of the question seemed to inevitably get muddled in the transition to Spanish, and so too the responses on the way back to English. Unfortunately, my young translator, who was training to be a pharmacist, was not at all familiar with optometric terminology. At one point on the first day I was simply explaining the next concept to the translator who then passed it on to the class in his own manner. This upset the few English speaking students in the class who made the request during a break that I speak louder to the translator so that they could hear what I was saying. They indicated that they found my explanations in English (when they could hear me) easier to follow than the translator's corresponding explanation in Spanish. In hindsight it may have been better to have used one of the fourth year students with good English skills as the translator. Charisma was also nullified by working through a translating mediator. Any attempt to include humour in the presentations only served to produce confusion rather than laughter. As a result, the lessons were heavy on information and slow going. I should add that it must have been more difficult for the students than it was for me. They were very patient through the whole affair and even managed to express their appreciation for my efforts at the end of each day in thoughtful ways.
Dr. Melissa, the local Nicaraguan lecturer (trained in Costa Rica) and solo member of the teaching faculty, was keen to generate some marks from the seminar. In order to comply with her request, I prepared a short exam for the students which they took first thing on the third & final morning. The exam conditions were easily the most relaxed I have seen at the tertiary level (I may or may not have seen a lot of sharing of answers during the exam). The results gave me a way of measuring (albeit imperfectly) my success in communicating over the previous two days; they indicated that slightly more than half of my most important points had made it across the language barrier and lodged in the minds of the students present.
The first set of optometry graduates from UNICIT will complete their training before Christmas. They should all find work, some in the private sector (many of the students are the children of those who have established practises in town) and the rest in the public health system.
Optometry is not currently regulated in Nicaragua (the old laws, that are technically still in effect, were relaxed after most of the educated elite left the country in the 1980’s after the 1979 ‘Sandinista Revolution’). Next year will see the introduction of the new laws to restrict the practice of optometry to those who are appropriately trained and licensed. There are only 12 qualified optometrists in the country at present; another 50 ‘opticians’ operate family owned businesses in the dispensing industry. There are also what are called ‘empirical optometrists’, optometrists who registered with the health department during the shortage of the 1980s. Some of these people were trained as technicians in Cuba, others simply had years of experience working in an optical chain setting. Many of the refractionists currently employed by the optical chains in Nicaragua are 'empiricals'.
