Optometrist Volunteer - Sue Strachan

There is much talk of India becoming more wealthy and technologically advanced, however, in reality little has changed for the masses of people living in the parts of rural India whom Equal Health sees. So, there is still a huge need for programs such as Equal Health's in India and this is why I have just returned from my sixth trip to India, with my first being in 2002.

Arrival in India is always a shock to the senses. Chennai is the fourth largest city in India with a population of more than 7 million. So there were plenty of people, and plenty of traffic noise from the incessant honking of horns, plenty of colour from the amazing saris worn by the ladies as well as from the signs plastered seemingly on every possible wall or building everywhere. As well as plenty of animals - cows are still seen wandering along the busy Chennai streets seemingly oblivious to the chaotic traffic.

Our team stayed at a base camp in Urapakkam, about an hour south of Chennai, and travelled out to a different village each morning. While heading out to the villages there is still always something amazing to see and experience every day - more variety of animals - goats, pigs and dogs rummaging through the street side litter as well as the sacred cows. But also beautiful lush green rice paddies and fields of yellow sunflowers, fish markets sandwiched between the railway line and the main busy road, ox drawn carts, thatched roof huts and always lots of people!

A typical working day in India includes an early breakfast and then loading up our suitcases of specs and other gear on to our bus and heading off around 8:00am. Our road trip - an adventure in itself due to the apparent lack of road rules - generally lasts between one to two hours, but it's never boring - there is always something amazing to see out the window of a bus in India!

When we arrive at our village there is generally a long queue of people waiting for our services, but before we start we are given a ceremonious greeting by the village head. We often set up camp in a school, so lots of curious children may be seen looking in the windows as we work.

Whilst the other teams often set up a lovely cool outdoors clinic, the optometrist needs a dark room so we are usually in a small dark space with intermittent power for fans and lighting, so it's always hot, and it can get very steamy with interpreters and patients crowding in.

We generally work steadily until lunch time, with food provided by our local hosts, then back to work until pack up time, between 4:30pm and 6:00pm, depending on the crowds and how long our homeward journey is. Often the optometrist will see over 200 people in a day - basically just doing retinoscopic refractions to determine if the person would benefit from glasses out of our 'stock supply' of suitcases loaded full with glasses of different optical powers. If glasses are indicated, the optical dispenser will find and fit a pair to suit the individual. A big smile and wobble of the head generally indicates that the patient appreciates their clearer vision with their new glasses! This is always very rewarding, particularly with elderly aphakes (a basic form of cataract surgery where the lens is removed and not replaced with a prosthesis) who have either lost their glasses or whose old glasses are so badly scratched that they were not able to see out of them anyway! But, it is always frustrating that there are many people with badly scarred eyes or severe cataracts for whom glasses are of no help whatsoever.

When we get back to base camp, each team sorts out its gear - the optical team does a stock take of specs distributed and restocks the bags accordingly. The team 'debrief' before dinner is an important Equal Health tradition - each member says a few words about their day and housekeeping issues are discussed. Then it's usually a pretty early night for most exhausted team members. However, this year we had to fit in our Bollywood Dance rehearsal each evening since the challenge had been issued by one of the other Equal Health teams based in Trichy for our last night party in Chennai.

Cataracts is the most significant problem facing the optical teams. In India, age-related cataracts seem to develop at a much earlier age than in Australia - it's not uncommon to see advanced cataracts in people aged around 40. We offer free cataract surgery to many people as Equal Health has associations with some Indian ophthalmologists who generously donate their eye hospital's staff and services. However, it was frustrating that so many of the elderly people with mature cataracts refused our offer, being fearful to travel away from home to the city for surgery.

On a typical day in the village we see the full population spectrum but generally more people in the over 40 age bracket. The majority are illiterate outdoor workers, but many still appreciate being able to see clearly for near activities like sorting their grains and sewing. We also see the teachers at the schools where we set up camp - a pair of reading glasses can often make a huge difference to them. Sunglasses or 'cooling glasses' as they are referred to in India are highly appreciated by the many field and construction workers and drivers.

Living conditions in the villages tends to be very basic still, with many living in mud brick thatched roof huts and water pumped from wells. The schools that we set up camp in are usually extremely basic, with minimal visible evidence of the resources that we take for granted in our schools like books, pens, tables and chairs, playground equipment, let alone anything high tech ...

Without a doubt, what I enjoy most is the gratifying professional 'work' aspects of an Equal Health India camp, but it's always a really enjoyable personal experience as well, providing you enjoy hot weather, hot food and cold showers! It's great to be able to interact and work side by side with professionals from other health disciplines, and invariably people who volunteer for this type of trip are caring people who enjoy being 'team players'.

Sue Strachan - Optometrist, Strachan Eyecare Plus