WHEN optometrist Shane Higgins packed his bags and headed off on a charity mission to Cambodia earlier this year, he had no idea the impact his work would have on patients – or himself.
The head optometrist with Kingsbridge Private Hospital in Belfast travelled to Phnom Penh with a group of fellow healthcare professionals from Belfast and Derry, all ready to carry out life-changing work in free clinics facilitated by Cambodian charity, Khmer Sight Foundation.
Over the course of five days the team carried out 184 operations – mostly cataracts but also removal of pterygium fatty tissue which grows over the cornea – successfully restoring sight and transforming lives for more than 200 people.
"It was amazing to be part of something that was so simple and yet so transformative for the poorest of people," says Shane.
"The need is huge throughout Cambodia where 90 per cent of blindness is avoidable and where sight problems impact employment opportunities and put families at risk of destitution."
The team dealt mainly with very dense cataracts in mostly older patients pre-selected at earlier assessment clinics organised by Khmer Sight Foundation, but some younger patients were also seen, including a young woman in her 20s with scarred corneas and a 24 year-old man who was totally blind due to diabetes – the condition has a similar incidence rate as in the UK, but often goes untreated due to medication costs.
"The success stories of the cataract surgeries stay with me, but some people we sadly couldn't help," Shane says.
"The young woman who came in with cornea scarring – something she had in both eyes since a child – had significantly reduced vision, but, sadly, the only treatment option would have been a corneal transplant.
"Unfortunately, she would have had to fly to a different country which has a much better healthcare system and where she could be offered corneal transplant surgery. It made me think of the different outcomes for people at home – here, there is always an option; there is always a clinic you can send someone to. The waiting list might be long, but there is somewhere to send people to. In Cambodia, there is nothing."
Problems, he says, go back to the brutal regime of the Khmer Rouge which ruled Cambodia under military leader Pol Pot from 1975 to 1979 and resulted in the deaths of up to two million people – as well as the near-extermination of the country's professional and technical workers.
"I had a chance to visit some of the genocide museums and it was horrendous what went on in the country at that time," says Shane.
"The consequences of that regime can still be seen today in the lack of medical facilities and lack of medical practitioners.
"There is something like 38 ophthalmologists – and only 23 are surgically trained – to cover the entire country which has a population of nearly 17 million.
"Many provinces have no eye service at all, so the work of charities like Khmer Sight Foundation is vital. It does phenomenal work on the ground and also in training medical students to continue the work."
Lack of preventative care and harmful UV rays from the Cambodian sun contribute to eye problems – according to figures from sight loss charities, around 200,000 Cambodians are blind. With this in mind, UV sunglasses were also provided by Shane and the team to help reduce risk of pterygium and cataract, both of which are linked to long-term UV exposure and reflecting light from the paddy fields.
Yet, for all their challenges with poverty, health and past traumas, those who stumbled or were led through the doors of the "well-equipped" house gifted to Khmer Sight Foundation (the garage had been converted to a theatre), were happy and grateful just to be there.
"The cataracts we saw were post-mature and had a higher surgical risk which meant a longer time in surgery," says Shane, who was in scrubs and ready for work at 7am each morning due to the extreme heat.
"But patients were very appreciative of the care they received and were exceptionally stoical, lying motionless during the operation.
"Many arrived with eyesight so poor they had to be guided in, but they left with happy smiles, many seeing properly for the first time in their lives. It was a fantastic to be part of that."
Some were "real characters" – one woman in her 70s with white cropped hair arrived at the clinic wearing fake Louis Vuitton pyjamas and fake Ray-Bans. By the end of her cataract treatment, she was laughing loudly with the interpreters and joyously shouting over to Shane that she could now see everything - including him.
"When this woman arrived, someone was holding each hand because her vision was so bad," Shane adds, "but after having one eye treated, she stood up and happily walked out by herself.
"Hopefully, at another outreach clinic in the future, her other eye will be treated, but having sight restored in even one eye means an indescribable difference for people who can work again, provide for their families and lead their very best life. These are the memories that remain."
