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Blind Faith

Health Wanted


Published September 10, 2003 at 4:00 p.m.

Alight shines from the walls of a fourth-floor office in Fletcher Allen Health Center in Burlington. It's the glow of the Himalayas, captured in framed photographs of the office's occupant, ophthalmologist Geoff Tabin. They show him climbing up Everest, meeting with the Dalai Lama and examining a long queue of wizened, quizzical and hopeful patients. Tabin, 47, is part mountaineer, part "miracle doctor." He's helped cure blindness in hundreds of thousands of some of the poorest people in Asia. "When people can see again," says Tabin, "they exclaim, ‘I'm freed from the hell of darkness! There is a new sky for my eye!"

The Himalayan Cataract Project was born nearly 10 years ago, on a bumpy late-night ride to Lhasa, Tibet. Tabin and a doctor named Sanduk Ruit had been the guests of honor at a raucous banquet celebrating a successful "eye camp" that had brought vision to 200 residents of a remote Tibetan village.

Once a self-described climbing bum, Tabin had traveled to the Himalayas before, on expeditions to Everest and other mountains. Having learned to ski at age 3 and gone rock-climbing as a teenager, he often interrupted his academics for an adrenaline fix at the high altitudes of Asia or Africa. "Inevitably, a gnawing starts in my gut," he writes in Blind Corners, a newly updated tome of his tall tales. "It gets stronger and stronger until the only thing I can do is set out in search of yet another wild adventure."

A graduate of Yale, Oxford and Harvard Medical School, Tabin was also the fourth person to climb the fabled Seven Summits: the tallest peak on each continent. In 1989, he volunteered as a general doctor in Nepal, where eye care was particularly abysmal. The intense ultraviolet sunlight at altitudes of up to more than 20,000 feet, diet and genetic predilection were causing cataracts -- a clouding of the lens -- to blind nearly all of the elderly population.

"There wasn't a single Nepali doctor performing modern cataract sugery," says Tabin. "But then this Dutch team came and did cataract surgery, and it totally blew my mind." He soon decided to pursue international ophthalmology and a fellowship in corneal diseases and surgery with the Fred Hollows Foundation, based in Australia.

Fred Hollows, a pioneer of developing-country eye care, had also trained Ruit, a Nepali doctor of Tibetan descent schooled in microsurgery in the Netherlands. With Dick Litwin, a Berkeley, California, ophthalmologist who helped develop lens implants, Ruit had organized remote eye camps throughout Nepal. When Tabin joined Ruit in the remote mountain village of Jiri in 1993, he was astounded by the doctor's skill. "He's absolutely brilliant. He did about 200 cataract surgeries while I did 30," Tabin says. "And I had to call him over for help about three or four times."

In seven minutes -- less time than it takes to hard-boil an egg -- Ruit performed impeccable cataract surgery, restoring near 20-20 vision to someone who'd barely been able to distinguish between light and dark. Tabin began to learn Ruit's technique, and to transform lives. In the rugged Himalayan terrain, where even stepping out for some supper can be treacherous, "blindness is a death sentence," says Tabin. "People long thought as you grow old, your hair turns white, your eye turns white and you die."

The patients Tabin and Ruit treated at Jiri cried, laughed or prayed when the patches were removed and they were able to see for the first time in decades. "It was this small cadre facing against the establishment, doing the impossible," says Tabin. "We worked 12-hour days but when we finished, we'd have five different kinds of appetizers, with really good bottles of whiskey, and after a great dinner, people would dance and sing. It was just a whole lot of fun."

Tabin then taught microsurgery at the Golcha Eye Hospital in Biratnagar, Nepal, before he was reunited with Ruit at another eye camp in Medrokongga, Tibet. Here, in addition to treating patients, they also trained other Tibetan doctors. Following a banquet in their honor on the eve of their departure, they made a plan to eradicate preventable and curable blindness in the region by establishing a chain of teaching.

Since its inception, the Himalayan Cataract Project has revolutionized eye care in Asia. With a home teaching hospital, the Tilganga Eye Centre in Kathmandu, it provides ophthalmic education to local medical practitioners, trains surgeons and brings in world-renowned experts to share their knowledge. "Our program has evolved to the point where the focus is not me curing 50 people," says Tabin. "It's establishing sustainable, quality, lasting eye care. We're setting up the infrastructure, training everyone from the ground up, equipping and enabling for self-sustaining cures."

Noting that cataract surgery is a hand-eye coordination sport that takes practice to perfect, Tabin derives tremendous pleasure in hearing from Nepalese doctors who proudly inform him that their total number of surgeries in a year has leapt from 690 to nearly 3000.

Meanwhile, a network of additional facilities has allowed the Himalayan Cataract Project to expand into Bhutan, China, India and Pakistan. Patients pay for the surgery according to their means: some $120, some less, others, nothing. In Nepal, more than 101,000 cataract surgeries were performed in 2002, compared to just 1000 intraocular lens operations in 1993. "Nepal is so far ahead of our most optimistic idea," says Tabin.

But that success came at a cost -- to Tabin, who paid for enough of the program out-of-pocket to end up in debt. In 1994 he returned to the States to take what he thought would be a temporary post with the University of Vermont. He ended up marrying a fellow opthalmologist, and staying.

Though he hasn't embarked on a major mountaineering expedition in nearly a decade, Tabin still scales rock walls whenever he can. His steady surgeon hands bear the calluses to prove it. "I still get just as fired up about climbing," he says. "And while I've noticed that I back away from the edge more now, I still get excited about adventures, and adventures in ophthalmology as well."

His most recent adventure took place shortly after Mountainfilm, an annual festival in Telluride, Colorado, at which Tabin delivered the keynote address. After hearing him describe the Himalayan Cataract Project, a producer from National Geographic's "Ultimate Explorer" series approached him about filming a remote eye camp. That allowed Tabin, who still visits Asia a few times a year to train other doctors, to return to his source of inspiration. In June, he and Ruit trekked for five days into the Upper Mustang region of Nepal, a hidden Buddhist kingdom of deep gorges, ancient temples and cloud-fringed peaks. At the same time, hundreds of blind villagers also made the pilgrimage, some on the backs of their children and grandchildren.

Despite the distractions of the National Geographic camera crew and interviews with host Lisa Ling, Tabin and his colleagues remained focused on the task before them. "I really just love seeing the first quizzical expression after the patch comes off," says Tabin. "And then people see their loved ones for the first time… it's a very fun place to practice medicine."

Tabin hopes the resulting show, called "Miracle Doctors" will not only raise awareness of the Himalayan Cataract Project, but also much-needed funds. A $2.4 million expansion is planned for the Tilganga Eye Centre, and resources for skills-transfer eye camps and other long-term endeavors have started to run dry. The project's outlook looks bright, however -- especially when compared to the state of health care back in the United States.

The morning we meet, Tabin returns to his office to find that his technician is threatening to quit because she's learned her pay might be cut by $3 an hour. "And it's ironic," he adds, "that I have a better operating microscope in Nepal than I do here at Fletcher Allen." But then he turns his focus to an elderly patient walking into his clinic, thousands of miles from the Himalayas, and there is that light, all over again. m

Miracle Doctors" airs Sunday, September 28, at 8 p.m. and Saturday, October 4, at 8 p.m. on MSNBC. For more on the Himalayan Cataract Project, visit http://www.


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