The Global Ophthopolitics of Philanthropic Ophthalmology
You might want to do the right thing and get stuck in – but there’s a bigger picture to be seen before you do.
Last month’s cover feature – the stories of two teams of eye care professionals (from Germany and the UK) going to Uganda and restoring sight to hundreds of people – got me thinking. They only knew of each other’s projects months after their return to Europe. It seemed to me that there were some efficiencies that (perhaps) could have been achieved by pooling their efforts and resources – if only they had known of each others’ mission in advance, they could have done more with what they had.
I wondered how that could be achieved. My idea: a website. Mapping, multi-device messaging, resource pooling and transport planning tools, educational materials, robust security – and even SMS messaging that could work in the most rural parts of Africa. Yes, I’d come up with Slack for philanthropic ophthalmologists, plus Google Maps. It was all very clever (or so I thought), and with some funding and the advocacy of one or more of the large ophthalmology professional societies, it might actually work. It actually formed the basis of the first draft of this editorial. But then I was introduced to Michael Brennan, ex-President of the AAO. Michael is a fantastic gentleman, an “ophthopolitics” veteran – and someone who has been there, and done that around the world… many times over.
The main message I took from meeting him was this: a gung-ho attitude can get you into a lot of trouble – and spoils it for the rest of us. If a mission goes into a country without having gone through the appropriate channels (as some appear to have done), much is risked. Local ministries of health and professional associations have to be consulted. Local protocols (and laws) need to be followed. They might be restrictive, tedious, unhelpful – but following them keeps you out of a lot of trouble, resentment and possibly jail. Like the groups we featured last month, the right approach is to follow the rules, educate the local professionals, and be generous with equipment you bring, and leave. A website can’t really help with that.
To implement a joined-up electronic method of coordinating and streamlining philanthropic efforts in ophthalmology therefore requires a whole lot of high-level international negotiation beforehand. There’s a place for that: Geneva, at the World Health Organization, where national ophthalmology representatives meet every year or two. If consensus is achieved, legislative cogs may turn, guidelines are made, doors open, and maybe, years later... we might be where we need to be.
So it comes down to this: would such a website be useful in any event? Would the ophthopolitical effort be worth it to make all philanthropic work safer and easier? Or are there more worthy battles to fight?
I spent seven years as a medical writer, writing primary and review manuscripts, congress presentations and marketing materials for numerous – and mostly German – pharmaceutical companies. Prior to my adventures in medical communications, I was a Wellcome Trust PhD student at the University of Edinburgh.
