First Days


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Africa » Swaziland » Manzini
August 25th 2015
Published: August 25th 2015
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We have now completed our first couple of days deploying the new cataract surgery program at TLC's Miracle Campus in central Swaziland. The goal has been to deploy a safe, high quality cataract surgery program for Swaziland to address cataract blindness. Most TLC patients are culled from mobile hospital outreaches to remote areas, so most of the patients we see are incredibly poor and subsistence farmers in rural areas of the country. There is a remote screening service in the field that identifies likely candidates for surgery. Those patients are brought to the campus where they are housed and fed for three to five days to have a pre-op assessment, diagnostic workup, surgery and one day of post op recovery. The surgery suite is a two operating table suite, where an operating microscope swings from side to side and two patients are in the room simultaneously, done in sequence. We have two teams of OR staff (scrub tech and circulating nurse) and have the workflow set. Patients are brought down before surgery for dilation, are injected with peribulbar anesthesia prior to entering the room. The room hosts two patients at a time for surgery. Post operatively they recuperate on an outside patio and the next day they have post op visits where eye patches are removed, vision and eye pressure are checked and the surgeon examines them.

Our first day (Monday) was spent problem solving the final pieces for surgery, going through a mock drill, and then at 2 PM we started surgery and completed 10 cases. Today we finished 25 cases and the workflow improved significantly. The surgery itself is taking about 5 minutes per cataract and the set up and turnaround about 10 more minutes, so a sustainable pace of 4 per hour is already being achieved. We can probably increase that to 5-6 per hour once the team is more experienced. Overall the team has performed very well, and is adjusting to the surgery well.

We also had the privilege to remove eye patches from our first group of cases, with most of them doing very well. One lady took off dancing as soon as her patch came off! Simultaneous with all the activity in surgery, busloads of patients are coming in for further screening and we continue to sign up more patients than we operated on today, so we are still falling farther behind. We anticipate workflow efficiency and experience will improve the through put so we can eventually keep up!

The weather is spectacular - spring time weather here. The jacaranda trees are about to burst out ... hope we get to see that. One of the rites of spring here in Swaziland!


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Tot: 2.78s; Tpl: 0.05s; cc: 6; qc: 35; dbt: 0.0306s; 2; m:saturn w:www (104.131.125.221); sld: 1; ; mem: 1.3mb