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Subspecialties Cataract, Health Economics and Policy

A Just Cause

As the granddaughter of Ignacio Barraquer Barraquer (founder of the Barraquer Clinic) and daughter of Joaquin Barraquer Moner, were you expected to become an ophthalmologist?

It was expected of my brother [Rafael Barraquer], but not me. There weren’t many women in medicine when I started, but seeing how passionate my father and grandfather were about their work made me want to be an ophthalmologist too. I decided then that ophthalmology was going to become my life.

What is the best part of being an ophthalmologist?

Being able to give someone back their sight, because very often that means giving them back their life, too. When we travel on our missions, many of the people in need of cataract surgery are of working age. Last year in Mozambique, I operated on a man who was once a professional driver. He hadn’t driven in two years because he couldn’t see. By returning sight to people like him, you give them the ability to work and feed their families again. You give them dignity.

Tell us more about the Elena Barraquer Fundación.

It’s a charity I started almost two years ago that offers eye care to communities without access to it. Ophthalmologists are coming from all over the world to work with us, which is what I always wanted. I certainly wouldn’t want the foundation to die with me, or suffer if I was not able to travel as often as I do right now. I want enthusiastic young doctors to join the foundation and continue my work, when I’m no longer able to do it. 

 What was your last medical mission?

In January we went to Dakar in Senegal, where we’ve been maybe 12 or 15 times before. You have to choose locations where you know the patient is going to be well taken care of afterwards. Luckily, cataract extractions don’t need such close follow-up, but some cases come with associated problems.

What are the barriers to medical care in these countries?

Patients don’t have money – that’s it. Cataract extractions, as we do them in developed countries, have become quite expensive. You don’t only need costly instruments but also the disposable materials to run these instruments, which are even more expensive in the long run. Some of the hospitals we visit don’t even have sterile gloves to use for the operations, so when we travel, we bring everything – up to 500 kg of materials every time!

How many missions do you get to do a year as a foundation?

This year we have treated over 2,217 patients. Every expedition, we perform about 200 or 250 surgeries. When I was in Angola last October, I did 251.  We average about eight missions a year. This year, we have nine planned, all of them with two surgeons because we have come to realize they are more cost effective that way.

The team celebrate another successful trip to Angola (taken February 2019)

Some years ago, we did a study on the economic impact of our one-week missions in Cape Verde. We worked out that restoring sight to those patients brought back $20,000,000 to the country.

Do any moments stand out?

There are so many that I sometimes think I should write a book. The most recent memorable moment was in Angola. The banks there are not allowed to use their local currency to buy things from foreign countries because of government restrictions. And that means they cannot buy the disposable materials needed for cataract extractions, so for six months, there were no operations anywhere in the country. You can imagine the queues of patients waiting for us. It was heart breaking.

Looking at the bigger picture, your work goes beyond saving sight…

Yes. Some years ago, we did a very small, basic study on the economic impact of one of our one-week missions in Cape Verde. We worked out that restoring sight to those patients brought back $20,000,000 to the country. That’s because it’s not just the patients who can resume a normal life, it is their children – particularly girls of school age – who can, too. An educated child has a huge impact on the socioeconomic development of a country.

Have you always been interested international charity work?

Always. When I was a research fellow at the National Institute of Health in Bethesda, Maryland, I went on my first mission, to Port-au-Prince in Haiti. I felt so lucky to have the ability to help all these people. I loved it.

Receiving the 2018 'Sophia Award for Excellence' for humanitarian work from Queen Sofía of Spain

What legacy would you like to leave?

To continue the work of my foundation and to help eradicate preventable blindness by cataracts. We should all be doing something to prevent that – not just ophthalmologists. I think that the ophthalmic industry should collaborate with us.

What is the best way to reach that community?

We hold an important cataract meeting in Spain every February, Faco Eleche. My suggestion is a round table with CEOs from each of the major laboratories to try to reach some kind of agreement. It would make our work much more sustainable if we had their continued support.

How do you fund your trips?

Through donations. We calculated that each trip requires around 25,000 euros worth of disposable materials. Even buying the cheapest intraocular lenses works out at 100 euros per operation.

Do you get to spend much time in the clinic these days?

I spend a lot of time in the clinic. Yesterday afternoon, I did 19 cataracts in two and a half hours. I love my job, so it doesn’t feel like work to me!

What's it like to be working with your brother?

My brother and I are very different, but we get along fine because we don’t step on each other’s toes. He loves to teach and write papers, I am more hands-on. My advice would be focus on one thing because if you try to do too much, you won’t do anything well.

Any chance of your sons joining the family business?

One of them has started medical school, but he doesn’t like it – and that’s okay. My father taught me to always do what I like, because the only way you’re going to do a job well is if you feel passionate about it.

What’s exciting you in the industry right now?

Every year, there is something new – especially in the IOL space – to improve the results of cataract operations, giving patients more independence from glasses. And that’s very exciting. Vitro retinal surgery has changed even more. When I was a resident, retinal operations were boring because it was difficult to reach the retina, they didn’t have the surgical aids to be able to do the wonderful, almost miraculous, things we can do today.

Any advice for those just starting out in the field?

When you are young, go to as many conferences and read as many journals as you can. Things change so quickly that if you don’t keep up with new things, you will fall behind.

Finally, if you weren’t an ophthalmologist, what would you be?

When I see something I feel is unjust, I want to do something about it. So, for that reason alone, I would be a lawyer – to represent lost causes. I would have loved to be a musician because I love to sing and play guitar – I just don’t do it very well.

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About the Author
Phoebe Harkin

Associate Editor of The Ophthalmologist

I’ve always loved telling stories. So much so, I decided to make a job of it. I finished a Masters in Magazine Journalism and spent three years working as a creative copywriter before itchy feet sent me (back)packing. It took seven months and 13 countries, but I’m now happily settled on The Ophthalmologist, where I’m busy getting stuck into all things eyeballs.

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