Trachoma changes path of young girl’s life

Take-home message

Ever since she contracted trachoma as a child, Aisha Simjee, MD, has devoted her life to helping improve the vision of poor people around the world. She recently wrote a book about her experiences.

By Beth Thomas Hertz

Contracting trachoma as a child may be the best thing that ever happened to Aisha Simjee, MD. It certainly has turned into a blessing for poor people with vision problems around the world.

Dr. Simjee, then 7 years old and growing up in Burma, was being raised to one day cook, sew, and clean for a husband chosen by her parents. When she contracted trachoma and was cured through the folk remedy of having a local woman squirt breast milk into the eye, she developed a fascination for eye health that ultimately led her to immigrate to the United States, attend medical school, and become an ophthalmologist in Orange County, CA.

However, she has never forgotten the experiences of her youth and has devoted her life to helping improve the vision of poor people around the world.

She recently wrote a book about her experiences, “Hope in Sight: One Doctor’s Quest to Restore Eyesight and Dignity to the World’s Poor” (White Spruce Press; http://whitesprucepress.com/), in which she recounts her journey. She drew on decades’ worth of personal diaries, as well as accounts from family, friends, and colleagues.

She stresses that she wrote it to motivate others to give back, not to earn money.

“I have been in practice for 35 years, I am married, and I have two daughters who are doctors,” Dr. Simjee said. “I did not write this book to put food on my table. I did it to bring attention to the problems in the world and encourage all young ophthalmologists, and all people, to help others.

“Life is short. Time is precious,” she added. “Do the best you can to give a hand to someone who could be independent.”

According to the World Health Organization, three-quarters of all blindness can be prevented or treated. Worldwide, about 285 million people are visually impaired due to various causes, and 39 million of them are blind. About 90% of the world’s visually impaired people live in developing nations where there is little or no social safety net.

“I have seen how eye treatment can be a matter of survival,” Dr. Simjee said.

She has served on more than 25 medical missions, putting her private practice on hold and usually paying her own expenses. She has even personally paid up to $1,300 in luggage fees for the equipment she brings along. Spanning Asia, Central and South America, Eastern Europe, Africa, and the United States, the trips often involve physical hardships and other discomforts, but the 69-year-old persists.

When she spoke to Ophthalmology Times, she had just returned from a week in Ecuador, where she worked with indigenous Indians. She saw at least 100 patients. None had glasses; they are too isolated to have access to them.

“You have to pinch yourself to believe you are on the same planet,” she said.

Dr. Simjee stressed that she does not travel to capital cities that may have well-equipped operating rooms and facilities. Instead, she goes miles out and works with people who have no other options. She sees heartbreaking conditions, such as kids with wounds from knives and guns, and witnesses patients who have traveled for days to see her. Some have arrived on donkeys or have traveled on long boat rides to get there. On one recent trip, she saw many prison inmates.

“I do not discriminate. My goal is that they can see,” she said. “My indication to treat patients is always that they have nothing to lose.

“Many arrive with light perception or hand-motion vision only,” Dr. Simjee said. “I hesitate to treat both of their eyes at the same time, but they beg me and I sometimes do it. I worry about them getting an infection, of course, but you cannot think like that out there.”

Spanning the globe

Other places that Dr. Simjee has traveled to and described in her book in a series of short chapters include:

• Bosnia in 2000, where 5 years after the official end of the civil war, bombs continued to go off in the streets, leaving an “epidemic” of traumatic cataracts.

• Ethiopia in 2003, where Dr. Simjee and two fellow ophthalmologists performed 100 surgeries for cataracts and other conditions, in between trying to assuage the hunger of crowds of children attracted to her stash of granola bars and dried fruit.

• Afghanistan in 2002 and 2009, serving in clinics and hospitals and being careful to avoid the violence that sometimes strikes aid workers. While there, Dr. Simjee trained local residents in corneal transplants and celebrated the opening of a school built by American soldiers.

• Sir Lanka in 2005, where Dr. Simjee, her daughter, and others helped after the tsunami.

• Haiti in 2010, where 3 months after the earthquake, Dr. Simjee served for 10 days, doing not only ophthalmic work but also helping as an emergency physician, orthopedic specialist, plastic surgeon, and obstetrician (she delivered two babies).

Not asking for anything

Dr. Simjee focuses on short anecdotes and hard facts in her book, not excessive detail or lengthy descriptions about her feelings.

“I want to motivate others to give their time and money,” she said. “I don’t have a foundation and I am not asking them to give me anything directly.”

She acknowledged that it takes a real commitment to leave the comforts of home and travel to help others, but believes it is worth the effort and that everyone has something to contribute.

“I am just a little eye doctor at 4 feet 11 inches and 83 pounds,” Dr. Simjee said. “But I do the best I can to help others.”

She strongly encourages others to follow her path.

“Ophthalmology is such a rewarding specialty, because you can offer most patients effective treatment and have a tremendous impact on their quality of life,” Dr. Simjee said.

Advice for would-be volunteers

Thinking about volunteering on medical missions? Aisha Simjee, MD, offers some tips:

• Find partners. Dr. Simjee often travels in conjunction with Surgical Eye Expeditions International (http://www.seeintl.org/) and has relationships with Tissue Banks International (http://www.tbionline.org/) and other organizations to donate items, such as tissue for corneal grafting.

• Work hard to ingratiate yourself to local ophthalmologists. Their assistance-while you are visiting and in following up with your patients after you have left-is priceless. Sometimes Dr. Simjee will bring gifts to encourage local ophthalmologists to do follow-ups for free, or she will treat some of their patients while she is there and let them collect the fees. “I cannot change their culture, so I must do what I can,” she explained.

• Don’t expect to have perfect working conditions. Dr. Simjee takes as much equipment as possible and she has to be creative at times. For example, she recently had to pay a local ophthalmologist to perform an IOL calculation for her because she didn’t have the facilities to do it herself.

• Don’t gripe. You can expect living and working conditions to be challenging. Do the best you can; be patient and tolerant. Believe in what you are doing and want to do it. Otherwise, don’t go.