P. Lloyd Hildebrand

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P. Lloyd Hildebrand

Ophthalmologist joining a medical team providing clinical care and academic exchange programs in Asia, Africa and Latin America to support development of blindness prevention programs including clinical care, educational exchanges and research activities - coordinated through a team of amazing eye care professionals in government, academic, private practice and international non-governmental organization (INGOs) settings across the globe. All in the pursuit of eliminating avoidable blindness and vision loss.



North America » United States » New York » New York » Manhattan May 29th 2019

New York, NY (May 29, 2019) Sitting at my desk about 14 hours after the 14 hour flight back, I'm reflecting through the brain fog the time zone change brings. I think my underlying impression, and one that is so hard to communicate to those that haven't experienced it, is the sheer scale of almost everything in China. Both problems and their solutions have a totally different perspective when one considers a population of 1.3 billion people. Seeing 10,000 patients a day in an outpatient facility, moving 2 million people out of Mianyang after the 2008 earthquake because a breach in the dam threatened the city, reconstruction of the bridges, tunnels, roads and buildings after the earthquake, the burden of cataract blindness with 1.2 million people blind from cataract in Sichuan province alone. The whole issue ... read more

Asia » China » Sichuan » Chengdu May 29th 2019

Chengdu, Sichuan, China (May 25, 2019) Following our team’s final presentation at the meeting we met with the hospital VP and Chair of the Ophthalmology department to discuss how to advance the eye hospital. The consideration was given to do it in an existing facility that is owned or under the SPPH control, but not actually in the main hospital as space is highly sought commodity. There were two suggestions: one a recently built (6 years old) nursing school in the Tianfu region of Chengdu, which is the high tech, high growth area. It was a ten story building on a campus setting with other dorm and cafeteria buildings associated with it. Some of the space was well suited for some inpatient services, but there would need to be a general remodel of the space. Access ... read more
Nursing School Building
Campus where Hospital is Located
Railway Allied Health School Hospital

Asia » China » Sichuan » Chengdu May 26th 2019

Chengdu, Sichuan, China (May 26, 2019) Sunday morning we had a planning meeting in the hotel’s tea house with one of the SPPH hospital's leaders. The purpose of the meeting was to give him feedback on the two buildings we'd seen and come up with an action plan for moving forward. He expressed there was strong support and that the opportunity to advance it was now. We debated the pros and cons of both locations and decided that the northwest location was likely the best to get started quickly and could always be moved later if the patient flow was a challenge. I pitched a high-level business plan as a starting point, refreshing one that we’d presented five years ago and there was consensus that the approach was still solid and we should move ahead with ... read more
Pitching a Plan

Asia » China » Sichuan » Chengdu May 24th 2019

Chengdu, China (May 24, 2019) It is Friday and I've been delinquent in keeping up posts on the blog. I'll fill the details in later. After day 1 of the Sino-American Ophthalmology Conference today, we were invited by the SPPH Hospital's VP and Dean of the Medical School for a legitimate Sichuan hot pot dinner. It was a busy place, loud and boisterous and we had all the usual traditional hot pot choices. Twin cauldrons of boiling bullions - one red because of all the hot peppers boiled into it for flavoring and a whiter one in the middle for those with a milder palate preference. Prior to starting, we mix a bowl of sesame oil, vinegars, garlic, herbs and spices to dip the boiled meats and vegetables in and add more flavors and cool down ... read more
Hot Pot ready to boil
Our Table
Discussing

Asia » China » Sichuan » Chengdu May 23rd 2019

Chengdu, China (May 22, 2019) Each year we come over, there is a major regional ophthalmology conference where now about 200 ophthalmologists from Sichuan attend. It has grown substantially from the first years, and the venues have become increasingly impressive. This year it was held at Sichuan University campus, where they have a five star hotel and an amazing conference center. Was blown away with the size of the screen for presentation - just shy of Texas Stadium's! It must have been 40 ft high. Some leading ophthalmologists and researchers from other parts of China participated in the first day and the two talks preceding mine were a perfect set up for my topic on artificial intelligence in ophthalmology. Our hosts arranged a speaker's lunch at an exquisite restaurant inside the hotel where a charming hostess ... read more
Elegant presentations
Hostess in Traditional Han Outfit

Asia » China » Sichuan » Chengdu May 22nd 2019

Chengdu, China (May 22, 2019) After the quick flight from Kunming, we took the SPPH hospital bus back to the Tian Chen Lou Hotel - a familiar place for those of us who've been coming to China. Its a mid-range hotel that has been remodeled since we initially used to stay here and is quite nice. The beds are much softer than they used to be, the Internet more reliable, and the breakfast has more variety! Wednesday morning was spent with the ophthalmology residents at SPPH presenting clinical cases on the hospital's 12th floor conference room. The residents have come a long way since our initial years here - disciplined in structuring a case presentation, systematically working through a differential diagnosis and justifying the tests they order to get to a final diagnosis. We were having ... read more
Dr. Liu and Berlin - one of the residents
Game Show Hosts Drs. Melson and Tan
Health Economics Lecture by Dr. Melson

Asia » China » Yunnan » Kunming May 21st 2019

Kunming, China (May 21, 2019) We spent the afternoon Tuesday in Kunming, first going to see Lake Dian - one the 8th largest lake in China which is on the southern edge of the city. While it has picturesque views and a nicely developed waterfront park, sadly pollution is a problem. Historically, Kunming had no water shortage, since the city was right next to one of Asia's biggest freshwater lakes. But 90 percent of Kunming's wastewater was pumped untreated into the lake until 1990. In addition, much of the marsh system around the lake was destroyed in a misguided effort to raise rice production by filling the marshes in with trucked-in soil, and agricultural runoff is still a problem, and over half the fish population has been killed off. The lake water is now undrinkable despite ... read more
Sleeping Beauty Island Lake Dian
Park Area
Market

Asia » China » Yunnan » Kunming May 21st 2019

Kunming, Yunnan, China (May 21, 2019) Today we spent the morning at Kunming Hospital. This is a big place! They have 66 departments, 2.2 million outpatients and 55,000 inpatients yearly; and perform over 40,000 surgeries a year. It services Yunnan Province (a population of 40 million) with a high poverty rate as well as training for doctors from Laos, Vietnam and Myanmar. We spent a full morning in academic exchange with the faculty and departmental staff in a case presentation scenario, working through differential diagnoses and management strategies of cases the residents and fellows on both sides presented.... read more
Kunming Hospital
Chairman of Kunming Hospital Dept. of Ophthalmology
Academic Case Presentations

Asia » China » Yunnan » Kunming May 20th 2019

Kunming, Yunnan, China (May 20, 2019) Dynamic Yunnan is a fusion of traditional folk songs and dances set to modern choreography drawn from the rich legends of Yunnan’s ethnic minority populations. There is no central theme other than the cultural celebration, enriched by the colorful traditional costumes. It is a high energy routine that integrates all ages of dancers, themes of nature (sun, moon, rain), young love, a drum dance. It is broken down into a Prologue (Dawn of Life), 4 Acts (Sun, Earth, Homeland, Pilgrimage) and the spectacular solo Spirit of the Peacock Epilogue. The peacock is a Dai worship totem and a symbol of love…called the Sun Bird. Yang Liping emulates the subtleties of the bird’s movements in her dance moves in a vivid and graceful style that is mesmerizing. Spectacular performance!... read more
The Stage
The Dance
Peacock Dance

Asia » China » Yunnan May 20th 2019

Yangon, Yunnan, China (May 20, 2019) There was a frenzy when we arrived at the hospital in Yangon. It is a less equipped hospital and we had only one slit lamp to examine patients. There was a large crowd of patients waiting expectantly for us to arrive. They had been given numbers, had visual acuity and intraocular pressures done. However they were all jumbled together which resulted in a lot of noise and confusion at the start. We were lacking enough translators as well. The first wave of patients all seemed to have had complex problems, many treated elsewhere and alot of them with nothing further we could do. Once we figured out how to manage the flow, we got through the 250 patients by noon - finding a lot of treatable disease - glasses, cataracts, ... read more
Let the Work Begin!
Clinic in Full Swing
Reviewing CT Scan of Patient with Ocular Tumor




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