A Golden Opportunity for HKI

At a Glance: 

Howard Cohn, Chairman of HKI-Europe, discusses how HKI partnered with a number of INGOs in an effort to treat preventable blindness in Vietnam. 

 

Howard Cohn is an American ophthalmologist with a specialty in glaucoma, and a strong interest in international ophthalmology and blindness prevention. Dr. Cohn has been instrumental in re-establishing a European branch of HKI dedicated to fundraising called Helen Keller International Europe, and has actively worked on HKI programs in Asia. He joined the HKI Board of Trustees in 1991 and currently resides in Paris, France.

Hanoi, 1993.  Feelings from the all-too-recent Vietnam War were still vivid. Vietnam was recovering and reached out to the WHO for help in the health sector. The current national budget for all health care was only a pittance, $2 per person. While there was poor communication and no formal diplomatic relations between the US and Vietnam, fax and phone lines between France and Vietnam were functional, and I was invited to represent HKI at the first meeting of INGOs in Vietnam to decide how best to fight preventable blindness. Others present included CBM, Sightsavers, and the Fred Hollows Foundation. The number one problem then, as now, was cataract. FHF offered to provide operating microscopes to each of the 55 provinces.  HKI adopted 5 provinces, CBM adopted 9, etc. HKI funding came from the Sasakawa Foundation. 

HKI set up the first modern cataract center outside Hanoi and HCMC in Nam Dinh in 1994; an easy 4 hour drive South from Hanoi, where electricity was relatively reliable and there were already skilled surgeons.  The existing technique was done bare-eyed or at best with loupes (no microscope). The eye was opened with a razorblade fragment, the lens extracted with a super dry heated bead of silica that adhered to the cataract and the eye was sutured with sterilized resorbable rat tail tendons that produced a remarkable inflammatory reaction.  No implant was put in, and very few patients had cataract glasses.

The trainers were Vietnamese from Hanoi who had already mastered the modern surgery. Trainees were ophthalmologists from Nam Dinh and neighboring provinces. We, HKI, were the facilitators, providing technical assistance. The program quickly became a great success. Happy patients who could see again without glasses spread the word far and wide. The formula was duplicated in 4 other provinces, Binh Thuan, Can Tho, Ha Tinh, and Binh Dinh.  A sign of success, the Nam Dinh provincial department of health soon built an independent eye center.