Teach the teachers: spotlight on Da Nang Eye Hospital

Many who enter Da Nang Eye Hospital can’t see what’s happening around them. But every day, a swell of people turn up, take their ticket and wait patiently to see a doctor. Next time they’re here, they might be able to see - not just hear - the doctors and nurses hurriedly making their rounds.

This sense of urgency and the constant flow of patients at the hospital can overshadow what really happens here. Outside the operating theatre, clipboards clatter and people clamour for attention, but it’s inside the operating theatre that the real action happens. Once the chaos of the waiting room is left behind, each patient is treated to a delicate surgery - a surgery that happens 10,000 times per year in the hospital or one of its nine provincial eye clinics.

Surgery at Da Nang eye hospital today

Da Nang Eye Hospital is one of the three biggest eye hospitals in Vietnam and is the main centre for eye services in the Central Vietnam. It’s an impressive machine: 17 departments, eight operating theatres, 185 beds and 136 staff, including 36 doctors.

But in 1976, this monolithic four-storey building was nothing more than a small ‘eye station’, with four doctors and four nurses. There were no beds and no way to treat the number of patients in the region. It was a similar situation across the country; there were only two eye doctors in all of Vietnam, and together they could only perform 50 surgeries a year.

Fred Hollows training surgeons in Vietnam

When Professor Fred Hollows visited Vietnam in 1992, he knew there was a problem. People were going avoidably blind because there weren’t enough doctors with the skills to treat them.

The workforce of eye surgeons in Vietnam desperately needed the skills and equipment to perform modern cataract surgery that implanted intraocular lenses (IOLs) and restored sight overnight.

The solution? Training.

Teach the teachers. Then the teachers can teach everyone else.

- Fred Hollows

Fred left Vietnam, but he returned soon after with a team of 10 ophthalmologists.  With the support of the Australian Aid program, two training courses were set up. 322 Vietnamese ophthalmologists were taught the modern cataract surgery technique. IOLs were also provided.

Fred insisted on training surgeons who stood to gain the most from training, including younger doctors and those from the provinces - not just senior and academic ophthalmologists who worked in major cities.

According to Dr Jamie La Nauze, who became The Foundation’s Medical Director for Vietnam at the time, “young and middle level doctors were going to develop skills more easily and rapidly but we had to challenge the system to make that immense change quickly”.

Gabi Hollows (second from left) with Dr Binh (second from right) at the opening of Da Nang Eye Hospital, Vietnam

The doctors that were trained then went on to work in different parts of Vietnam and many have passed on their training to the next generation of eye doctors. One of the people Fred taught was Dr Binh, the former Director of the Da Nang Eye Hospital. Dr Binh trained 100 eye surgeons in the central provinces of Vietnam - and each of these doctors has gone on to restore eyesight to countless people - as well as train others to do the same.

This strategy has had remarkable results: in just 25 years, this skilled and growing eye health workforce is now providing services in 14 provinces.

Fred's training program means that the number of modern cataract surgeries performed in Vietnam jumped from only 1,000 a year before the training program to 80,000 a year at the end of the program in 1999.

 Despite such amazing progress, there are still stories like Cam’s or Madame May’s that show us our work isn’t done. Better eye care now exists for much of the Vietnamese population, but in many provinces there’s still a low uptake of cataract surgery by marginalised groups, including those who live in poverty, those with another disability, rural-based populations, and ethnic minorities.

Over the coming years, The Foundation needs to produce teaching materials for 1,300 teachers and 25,000 students to create awareness and education among school children about eye health.

We need to create scholarships for young doctors so they can afford to study.The work is ongoing - not only in Vietnam, but in all the countries where we work. But it’s clear to see that it’s worth the effort. And as long as there are people who can’t easily access eye care, we’ll continue what Fred started: teaching the teachers so that we create a system that can exist without our input.

The Fred Hollows Foundation supports us so much, you have helped train so many of our staff.

- Dr Dat, current Director of Da Nang Eye Hospital