A congenital defect makes it difficult for May Thet Swe to see. The
4-year-old’s eyelids don’t open normally, so to look at something in front
of her, she has to tilt her head up to the sky.

But she already has ambition: The spunky preschooler, who loves playing
football and riding her bike, wants to be a doctor so she can help other
children.

And she understands why her grandfather recently paid a small fortune to
bring her to a flying hospital staffed by an international team of doctors
and nurses: “They are going to repair my eyes and make me pretty like
other children.”

Thet, the type of child who brings happiness to those around her, was one
of 191 patients helped on a recent mission by the Flying Eye Hospital, a
converted DC-10 aircraft operated by the nonprofit ORBIS International.
The aircraft travels to developing countries to train local doctors,
nurses, and biomedical engineers, as well as treat patients with vision
problems.

I recently spent two weeks with the group, screening patients, helping
with their treatment, and training local healthcare providers to do the
same procedures we did, to the same standards. As an anesthesiologist with
an expertise in eye surgery, I was one of three physicians from the
Massachusetts Eye and Ear Infirmary on the mission.

Despite the violent suppression last fall of a pro-democracy rebellion in
Burma, we saw little sign of trouble during our stay. We had no
difficulties traveling in the area, though we did notice police barricades
and sand-bagged gun emplacements in the capital city of Rangoon. Had I not
heard of the events last fall I would not have thought anything had
happened in Mandalay. We were, however, encouraged by our team leader and
our assigned translators not to discuss political issues with our
patients, nor seek their opinions.

Our operating room was parked on the tarmac of Mandalay International
Airport, about an hour south of the city, on a broad, flat, arid plain
that resembles western Texas or New Mexico. The beautiful terminal and
grounds are well kept, but it was largely empty during our stay.

We rode by bus from our hotel every day, watching the scenery change from
small villages to rice fields and mango plantations. We passed children on
the way to school, businessmen headed to the office, and farmers headed to
the market. Many women and young people had covered their faces and arms
with a pastel yellow paste derived from the thanakha tree, as a decorative
sun block.

Thet, my first patient, was one of the ones who made the trip worthwhile.

Her operation went very well - the surgeon was able to raise both of her
upper eyelids and use sutures to secure them to muscles in her forehead.
Thet and her parents, who had ridden the bus for 170 miles for the
treatment, spent the night in the local hospital. Her father held her
throughout the night while her mother slept at the bedside.

Upon awakening, she played with a green bunny one of our nurses had given
her. She named him Yon Ka Ley - “rabbit” in Burmese. Almost as soon as she
was able to get up from her bed, Thet went over and started playing with
our next patient, a 12-year-old girl named Chan Lin Mon.

When she is at home, 700 miles away, Mon entertains herself by imagining
she is the chef in her own restaurant. She dreams of becoming a writer
someday, and has been keeping a diary for several years, a little red book
that contains her most cherished memories, hopes, and dreams. Watching
Thet enjoy her family, Mon seemed a bit detached and quiet - she had lost
her own parents in the car accident that left her with damaged vision. But
she brightened at the attention the younger child gave her.

Both girls had made it past one of the most difficult parts of an ORBIS
program: screening day. That’s when we examine the patients who have come
for care, ensure that we can help them and prioritize them as surgical
candidates. Needs are always far greater than what we can provide, and at
times we must make difficult decisions about which patients to treat.

A 2-year-old suffering from a traumatic cataract will have priority over
an 80-year-old with a mature cataract, because the toddler will benefit
longer. Patients must also have conditions that can be treated locally
with the proper training and direction. Teaching is absolutely essential:
Our goal is not to do the most sophisticated procedure, but to demonstrate
a technique that local doctors and nurses can learn, and repeat
themselves.

When we arrived for our first screening day, more than 100 patients were
already lined up in the hallway of the local host hospital. We would see
patients with glaucoma, corneal diseases, and those needing plastic
surgery around their eyes.

As I walked down the hallway, I was struck by one young mother holding an
infant who appeared to be about a year old. He had a large marble-sized
tumor suspended from his left upper eyelid. It was attached to his cornea
preventing him from closing that eye.

Every time I walked by, the mother would turn and look at me as if to
plead for something to be done for her son. It was difficult to look away.

The boy was finally selected for surgery the second week. There were 20
ophthalmology trainees in the operating room observing his three-hour
procedure. At the end, the room filled with applause. Words cannot
describe the mother’s smile when she saw her son. He was as beautiful as
she imagined.

Dr. Bil Ragan is an anesthesiologist at the Massachusetts Eye and Ear
Infirmary.