~ Dr. Anthony Maida, Coordinator, #BOLDR project, Cochabamba, Bolivia
For this outreach, on May 12, 2018, we had the chance to interact with the community of Sacaba, a city located 13 kilometers east to the city of Cochabamba. It has a population of 172,466, according to the last census in 2017.
We made an arrangement with one of the biggest clinics of the city, the Arevalo Clinic, a private clinic directed by Dra. Patricia Lopez, a Gynecologist, who has been managing the clinic for almost 30 years. She was kind enough to provide the facility for our outreach, including the desks and other materials.
The outreach started around 8:30 in the morning, with those patients who required a check of their blood sugar undergoing the test in the clinic laboratory. After the blood test, the patients were guided to the visual acuity testing booth, where three ophthalmology residents performed visual testing with Snellen’s charts, checking patients’ uncorrected and best corrected visual acuity. The results were documented on the patient chart.
After the visual acuity testing, those who were diabetic (any age) and those over 49 years old had their eyes dilated for a fundus examination by ophthalmologists with binocular indirect ophthalmoscopes.
The results of the glucose examinations were retrieved by the medical students and documented on the clinical record. Unknown diabetics is a big problem all over, and in this outreach, we found 3 patients who were unaware they were diabetic.
While patients were waiting for the dilatation, medical students, trained as part of the outreach, started working with patients to fill the information sheet that detailed their history and any previous treatments. Some of the patients spoke the original language, Quechua, and some of the medical students and residents were able to interact with the patients in that language.
We also had the pleasure to interact with a young endocrinologist, Dra. Cardozo, who works at the clinic. She was kind enough to lecture the waiting patients on diabetes, putting emphasis on control, education and prevention of complications. That lecture was followed by other lecture by an ophthalmologist, about diabetic retinopathy, prevention, education, consequences and therapies.
Once the patients were sufficiently dilated, they were helped to the fundus exam booth, where two ophthalmologists (Dr. Rodrigo Cortes and Dr. Anthony Maida) performed retinal exam using binocular indirect ophthalmoscopes and +20D lens. If the patient had diabetic retinopathy, it was graded according to the international classification. Patient was informed about the need for regular check up or therapy needed according to each individual case. Everyone, including the ophthalmologists, ophthalmology residents and medical students, as well as Dra. Cordoza, patiently responded to any questions the patient or family had.
After that, the patients were guided to the last station, which was the orientation booth, where Dra. Paola Zurita, an ophthalmologist, reviewed patient’s history and cleared any doubts or questions, schedule treatment (panretinal photocoagulation or vitrectomies) and referred patients to the endocrinologist in case it was required.
Overall, it was an amazing experience, where we had a chance to interact with doctors from the clinic as well as people from the city, who were very appreciative of the project and what we were trying to achieve. We saw quite a number of interesting cases with other ophthalmologic pathology as well. We plan to return to the clinic in another few weeks, hoping to reach out to more patients between now and then.