Like a Huge Stone Over the Edge of a Very Large Hill

Stepped off the plane two days ago into the warm, uncomfortably humid weather of Guangzhou. This feels familiar, I think to myself as I feel the perspiration gathering already. A short while later I’m back in the same apartment, surrounded by the same rubble from the demolition that’s been going on for a year and seems to be postponed indefinitely.

It’s been two days in Guangzhou already, but I’d like to take this opportunity to recap the two weeks I spent in Chengdu. Exciting developments are underway, huge developments, and I’m not quite sure how much detail I can share here and how much is still “under the lid” but I think the image of a huge stone being tipped over the edge of a very large hill aptly sums it up.

This is the house at the epicenter of the 2008 earthquake in Sichuan, in which the rock purportedly bounced the man out of his bed, allowing him to escape relatively unscathed. I hope our rock has just as much karma.

Dr. Farris and the team from DMEI has been coming to Sichuan for more than 10 years now. And despite the immense dedication, there’s been a fair amount of head-scratching and soul-searching regarding the best way to move forward.

But something made the planets align this year, and we are now moving full speed ahead. For us, those planets include recent policy changes in China, a very well-time presentation by the ZOC’s Dr. He, and perhaps most importantly, the people. A special shout out to the business team from Oklahoma University, five very talented undergrads who may have been the tipping factor in all of this. For according to Dr. Wei from SPPH, she believes the main difference this year is that they came with a plan, complete with numbers, that brought the dream one step closer to reality.

In the end, I’ve come away from the experience hearing one thing over and over. The biggest challenge moving forward is not necessarily going to be training of doctors, or equipment, or cost. It’s going to be generating patient demand. Well trained doctors with the best equipment money can offer aren’t much good if they spend most of their time sitting around. A sustainable business model depends on generating a high enough volume of surgery to stay in the green; without it, the entire model falls apart.

Current blindness prevention networks rely on communication between a large city “anchor” center and numerous county-level hospitals, where cataract surgeries take place. Some county hospitals have begun carrying out screening outreach in vans, stopping off in townships (and rarely, villages) to screen as many people as they can in 2-3 hours’ time. It’s certainly effective—up to a point—but it takes doctors away from their operating rooms, and fails to maintain close contact between patients and health care providers.

There is currently no working model in China to effectively bring village health workers into the blindness prevention network.

And that’s what brings me to Guangzhou this summer.

(Note: Since my camera was stolen back in South Africa, none of the pictures above were taken by me. I got them from other members of the team, including Dr. Farris, Dr. Hildebrand, and Barry Conrad.)

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