Bringing Wellness to the Third World
Some readers may desire to stake their claim as a nonprofit—doing incredible good solely for the sake of doing incredible good. One such wellness revolutionary is Dr. Geoff Tabin, who has set for himself a personal goal to eliminate preventable blindness in his lifetime.
In the world today, 37 million people are blind. An additional 100 million suffer from low vision, where they have difficulty performing daily tasks or living or working most jobs. The saddest thing about this statistic is that 85 percent of this blindness is preventable or treatable.
Half of these 137 million people suffer from curable cataracts—the number one cause of blindness in the world today. A cataract is a clouding of the crystalline lens in the eye that affects every human being if they live long enough. The cure for cataracts is having surgery to remove the clouded lens and replace it with an intraocular lens.
In developed nations, cataract surgery is the most frequently performed surgery, with two million operations performed each year in the United States alone. More than 90 percent of people who have cataract surgery regain very good vision, typically 20/20 or 20/40. Many patients report having better vision after surgery than they had before they developed a cataract. The cost of cataract surgery in the U.S. is about $3,500 per eye and is covered by Medicare or most private health insurance.
Cataract surgery is perhaps the most successful antiaging or wellness treatment known to mankind.
Sadly, this enormously successful wellness treatment, which instantaneously fixes one of the worst symptoms of aging since biblical times, is denied to tens of millions of people worldwide because of its cost. While total blindness due to cataracts has been virtually eliminated in the developed world, in places with intense ultraviolet exposure, poor diet, and lack of clean water, cataracts cripple almost 69 million people and often progress to the point where they block all vision.
Dr. Geoff Tabin was born in Chicago, the son of first generation Eastern European immigrants. He graduated from Harvard Medical School and originally set out to be an orthopedic surgeon, but took a detour to follow his passion for rock climbing.
In 1990 he became the fourth person in the world to climb the highest peak on all seven continents, including the first ascent of the East Face of Mt. Everest. His passion for climbing, often in third-world countries, led him to work as a general doctor in Zaire and Nepal, where he witnessed first-hand the "miracle" of cataract surgery.
Dr. Tabin's mountaineering adventures are told in his (climbing) autobiography, Blind Corners: Adventures on Seven Continents (ICS Books, 1993).
"In the village where I was working it was expected that a person gets old, their hair turns white, and their eye turns white, and then they die," he recalls. "No one had been cured of blindness in the region. Cataracts were a death sentence. There were no external support systems. A blind family member was a great burden on families. After a short operation under local anesthesia people were restored to life. Older people resumed traditional family roles and younger patients returned to work."
Tabin was inspired and returned to America to become an ophthalmologist. After completing his residency at Brown University, Dr. Tabin returned to Nepal to work with Dr. Sanduk Ruit, a Nepali ophthalmologist skilled at finding lower technology (i.e., affordable) solutions that provided the same quality of care delivered in the west but at far less cost.
Tabin adopted Ruit's methods for delivering high quality cataract surgery and they began teaching other Nepali ophthalmologists. Tabin and Ruit trained the first Tibetan surgeon to perform microscopic cataract surgery, and refined their method of skills transfer via high-volume cataract camps. Tabin and Ruit vowed to add their own efforts to those of the other existing eye care programs, with a goal of overcoming treatable and preventable blindness in the Himalayan region in their lifetime.
Tabin realized that solving the problem of blindness in the developing world required a two-pronged approach: create tertiary centers of excellence in ophthalmologic service and establish primary regional clinics staffed by technicians specifically trained in eye care.
Moreover, Dr. Tabin concluded that these solutions could only be achieved by educating and empowering local doctors. Dr. Ruit established the Tilganga Eye Centre in 1994 as the first outpatient cataract surgery facility in the Himalayan region. In 1995 Ruit and Tabin formally began the Himalayan Cataract Project (www.cureblindness.org) as a charitable foundation to support their work.
They developed a system of high-quality, high-volume, and low-cost cataract surgery. An intraocular lens factory in Kathmandu and the utilization of local pharmaceuticals and instruments has allowed them to bring the cost of one cataract surgery down to under twenty dollars! They have performed over 50,000 sight-restoring surgeries. The results have been dramatic toward meeting their goal. In 1994, only 1,500 cataract surgeries were performed in the entire country of Nepal utilizing replacement lens implants to restore quality vision. In 2005, over 150,000 people had quality cataract surgery with lens implants.
Tabin and Ruit are delivering today for $20 per surgery the most popular wellness surgery in the world—an intraocular lens replacement which costs 175 times this amount ($3,500) in the United States.
Tabin and Ruit have trained more than 100 doctors from more than a dozen countries, and many more nurses and technicians. They coordinate eye care programs in Tibet, China, India, Bhutan and Pakistan, and added Ghana and North Korea to the list in 2006. In addition, they provide training for doctors from Bangladesh, Myanmar, Cambodia, and Ethiopia. Dr. Tabin spends three months per year teaching in Asia or Africa, and has become the director of the Himalayan Cataract Project.
Dr. Tabin has several suggestions for how a person can reduce his or her chance of developing eye diseases.
Stop, or never start, smoking. Smoking is correlated with cataract formation and age-related macular degeneration.
Consume a diet rich in antioxidants and omega-3 fatty acids. Fish oils can also reduce the risk of macular degeneration and cataracts. Wearing sunglasses that block UVA and UVB light also reduces the risk of these diseases.
Visit an eye physician for regular checks to detect potentially blinding conditions, such as glaucoma. With early detection vision loss can usually be prevented.
Dr. Tabin is also involved in testing nutritional supplements and eyedrops that may be able to delay or even reverse cataracts.
Drs. Tabin and Ruit will go down in history not as the inventors of the world's most popular wellness surgery, but as pioneers who made this sight-restoring surgery affordable to millions of blind people.
As the wellness revolution enters its next stage, there are similar opportunities to make all type of wellness products and services affordable to the masses, just as Henry Ford did with the automobile.