The Butterfly Effect

Now that we have completed our surgeries and started training the Mongolian surgeons in cornea transplant techniques, it is time for an important part of our mission: teaching the Mongolian surgeons about corneal disease, in the classroom and in the practice lab. They must also learn to evaluate the donor corneas; this will be particularly important in the future if they plan to have their own Mongolian eye bank.

Our partner SightLife Eye Bank generously supplied us with 10 non-transplant grade corneas to use for teaching. We packed enough old instruments and supplies to plan what we call a ‘surgical wet lab’, or practice surgery experience, for our Mongolian colleagues. Sixteen surgeons, including those from the First National Hospital, as well as two from the remote countryside, came to learn surgical techniques. We used the corneas to simulate the full experience of performing a cornea transplant, beginning with cutting the donor cornea with a ‘corneal punch,’ then proceeding to removing the diseased cornea from the pretend patient (pig’s eye) and suturing the new, clear cornea into place with 16 microscopic stitches.

Lectures are also an important part of our time here. We prepared a variety of lectures on eye disease and asked our colleagues to choose their preferred topics. Doctors from across the region came to attend our lectures and to ask questions and present challenging cases for our input. We couldn’t have been happier with the exchange and engagement with our new friends and colleagues, and we look forward to returning soon with more to teach and more to learn ourselves as well.

It was touching that so many Mongolian surgeons put in so much of their time and traveled so far to join us. Their work in the teaching lab and our discussions during the lecture sessions showed us once again that the Mongolian people are truly ready, willing and able to end preventable and reversible blindness in their country if we can transfer the needed skills and infrastructure. The butterfly effect refers to the concept that a small event can have a large effect – we have seen that as long as we continue to teach, the small progress we make during our stay here will be amplified as these 16 Mongolian surgeons begin teaching others what they have learned. The next steps to ensure the sustainability of this process of skills transfer will be to establish a pathway for donation and banking of corneas in Mongolia – so we have our work cut out for us in the next year!

We want to thank all of our partners who made this work possible:
The Virtue Foundation
SightLife Eye Bank
See international
Alcon
Karl Storz
Katena
Moria
Samsonite