It’s in Our Nature
Altruism in ophthalmology: it’s never just “you scratch my back, I’ll scratch yours.”
The Maasai herders of the Serengeti plain in eastern Africa have a tradition called “osotua”. It translates as “umbilical cord” and is a central component of their society – essentially, it is true altruism. Life is hard there; if disease, drought or even marauding bandits render a Maasai without livestock, they ask for help and know that their brother Maasai will support them – usually by offering livestock of their own. Crucially, nobody expects the gift to be repaid – there’s no underlying agenda of “you scratch my back, and I’ll scratch yours.”
This month’s issue features the stories of two highly altruistic endeavors – the story of the ultra-low cost solar-powered ophthalmoscope, Arclight, and Kevin Waltz’s efforts to move away from simply performing cataract surgery in Honduras to building infrastructure to support the future. In both cases, ophthalmologists, scientists and engineers have been incredibly generous with their time and money – for people they’ve never met before – and it has life-transforming results. It represents altruism that’s almost as pure as the Maasai.
Clearly, the development and manufacture of an ophthalmoscope with LEDs, small solar panels, rechargeable batteries and a USB charging port has to be paid for at some point – the cause might be charitable, but the company making the device won’t be. In Kevin’s case, even if the equipment shipped to Honduras is donated free-of-charge, transport is not. And the clinics that benefit from them require local staff who have rent to pay and families to feed. Such assistance cannot be achieved through the gift of a goat: it requires money. Thank goodness, then, for not only the doctors and technicians, but also all the companies and international societies that support this work with grants.
There can still be an element of quid pro quo – on-site surgeons clearly gain valuable experience, but I think there’s more to it than that. Kevin talks of negotiating with a local ophthalmic equipment supplier to help support a piece of kit he’s brought into the country in return for his team promising to buy certain consumables from them. But that’s the reality: in this situation, you have to be practical, pragmatic, creative and ready to compromise to get things done. It’s no easy task. So it may not be the same kind of sacrifice as the Maasai: giving away some of the livestock that sustains you and your family, but it can be just as big: your time, effort, resource and headspace.
I don’t know about you, but that humbles me. To those of you involved in such endeavors: thank you.