She shuffled into the exam room in La Clinica Maxeña in Santo Tomas La Union, Guatemala, slowly and supported by her parents. She is a 24 year-old Mayan woman named Catarina, but looked much younger. For the past few months, she could only see light, and couldn’t recognize movement or anything else. I looked into her eyes, and noticed that her pupils were completely white, and suspected that cataracts had stolen her vision. She was diagnosed with diabetes several years ago, and had had difficulty controlling her blood sugars. This had gotten worse since she could no longer see her insulin bottles to dose her insulin. She lives in an indigenous, rural village in the mountains of Guatemala with no access to an ophthalmologist. I knew that we needed to remove her white cataracts and replace them with clear intraocular lenses, and fortunately this was exactly what we were in Guatemala to do.
In July, I got a call from Chris Engelman, my former Chief Resident at Stanford. He needed another cataract surgeon to join a team of eye care specialists going to Guatemala, and I promptly joined the team. La Clinica Maxeña was founded 50 years ago by Catholic missionaries from Montana. There is a full-time, native family practitioner at the clinic, but no full-time specialists. About 20 years ago, a group of ophthalmologists decided to begin La Jornada de Ojos, in order to provide eye care to the indigenous people of this region. It grew over the years, and this was the 37th Jornada de Ojos (Expedition of Eyes). Now a group goes every 6 months to perform about 40 cataract surgeries, some laser procedures for glaucoma, and see hundreds of patients in the clinic. Martin Fishman is the fearless leader of our trip, and does an amazing job every year of coordinating this complicated trip.
We flew into Guatemala City, then took a 4 hour bus ride on an extremely bumpy road past several volcanos, rubber trees, and coffee plantations. The countryside, isolation, and poverty reminded me of the movie Romancing the Stone. We arrived Sunday afternoon to a warm welcome at La Clinica Maxeña, and immediately got to work setting up the operating room and clinic, as well as examining the patients that arrived early like Catarina. We slept in comfortable little rooms on the campus of the clinic, and were fed 3 meals a day by the staff.
Monday morning, the impressive third world operating room was ready to go thanks to our team, and Catarina was brought in obviously nervous, but completely trusting. She only spoke her native language of K’iche’, so my Spanish was of limited use. Fortunately, the local staff was extremely helpful translating my Spanish to K’iche’. “Utz” was the only K’iche’ word that we learned, which means “good.” Her cataract was removed without complication, and the smile on her face immediately after the surgery was priceless. I suspect my smile was just as big.
We rotated between the operating room and the clinic every day through Saturday morning. We then examined the last post-operative patients, closed up the clinic and operating room, and headed to the colonial capital of Antigua for a little sightseeing and a hot shower. The days were long and the eye pathology was impressive, but the experience was unforgettable. Utz!