Last summer, second-year optometry students from Aston University had the privilege of embarking on an observership programme in Hyderabad, India. Twenty students travelled to India to the internationally recognised LV Prasad Eye Institute (LVPEI). This concept was presented to us by Dr Shehzad Naroo, a senior lecturer of the optometry programme who gave us the opportunity to increase our clinical knowledge in an underdeveloped country. This experience was both life-changing and increased our knowledge of optometry in many different aspects.
LVPEI was established in 1987 with the aim of it growing into a centre of excellence in the field of eye health as well as a partner with the World Health Organization (WHO) in prevention of blindness. It was also created to be a continuing role model for eye health centres in underdeveloped areas of the world. The tour that guests and students receive on their arrival begins with a look at the corneal transplant research wing, then moves through the various units of the hospital to show visitors where they will be working, such as cornea, retina, ocular prosthetics, contacts, glaucoma, paediatrics, and low vision. Throughout the tour it is apparent just how busy LVPEI is from the crowded waiting rooms, and the team of medical professionals working on each ward.
Busy timetable
Aston students travelled to India in groups of up to four individuals, and were given accommodation for the duration of the observership. The programme was well organised and we were all given timetables of how each of our days would run. Our mornings started at 7am, and consisted of lectures that were given to optometry students in their 'pre-registration' year at LVPEI. These lectures were designed to assist the students in their clinical training as well as a time to do their final dissertation presentations. After this lecture we all had breakfast in the canteen, which served all staff and visitors to the hospital. We were then asked to report to the ward that was assigned to us for the day.
We were able to see cases that many of us had never had the chance of observing in the UK, eg papilloedema in children, a surplus of retinal detachments in premature children, severe bacterial and viral corneal conditions, hypermature cataracts, trauma cases and much more. The ophthalmologists and optometrists were very welcoming and answered all our questions. If we had a break during the day, we could go into the library, where many of the pre-registration students would be studying, which had extensive material on eye pathology, optics and other related subjects. This was a great way for us to learn more about the cases we had seen during the day. We were also able to make friends with students in their pre-registration year and ask questions about their experience of working at LVPEI.
In the evenings we were able to attend special guest lectures, such as one by the spokesperson of the Ramayamma International Eye Bank (RIEB), which is the nodal eye bank for all of South East Asia. We learned about the importance of corneal donation, as corneal blindness is one of the most common forms of blindness the only known cure is transplantation, by using healthy corneas donated by individuals upon their death.
One day we visited the International Centre for Advancement of Rural Eye Care (ICARE), where eye professionals are educated to aid populations in the remotest rural areas as well as underprivileged urban areas. We were given a tour of the research centre where a lot of public health work in eye care is conducted. Across from ICARE was the Bausch+Lomb School of Optometry. We took a look at the classrooms, the library, and the beautiful outdoor lecture theatre, and joined some of the students for lunch in the canteen. Another day we ventured out to another extension of LVPEI to visit the secondary service centre in Thoodukurthy, a rural village. We were greeted by the coordinator of the Sri Kuchakulla Ramachandra Reddy Centre, who gave us a tour of the waiting areas, testing rooms, optical store and the operation theatres we even had a chance to try out the equipment. The most memorable part of the day was observing cataract surgery that was done manually, without any sort of suction or phacoemulsification equipment.
Cultural differences
One of the most difficult aspects of this observership was getting accustomed to the Indian way of life, and being able to communicate with patients and the staff at the hospital. The national language of India is Hindi, but for this distinct area the language of choice was Telugu. After a few days, we had quickly picked up the essentials, such as hello/greetings - 'namaskaraam' what? - 'emiti' look up -'paiki choodandi' and look down - 'kindaki choondandi'. The distinct separation between social classes in India was evident in the hospital setting green folders were dedicated to the non-paying community, blue folders for the paying community, and yellow folders for the wealthier community that could afford to pay for their treatment.
The need for eye care was definitely apparent while working at the hospital. Many of the patients travelled from far and wide for this eye care service, many sleeping outside the hospital overnight to ensure that they were seen.
Participating in an observership programme that is especially suited to your line of work is a great way to complement your training and provide insight into your profession in another part of the world. Overall, it is an experience that undergraduate students should be open to, as it may spark interest in more overseas work and charity involvement in the future. ?
