By Dan Twelker, OD

One of the best reasons to go to a VOSH International meeting is to network with optometrists from around the world. While at the 2016 Annual VOSH International Meeting I met Carlos Martinez, Licenced Optometrist, and Emiliano Teran Bobadillo, PhD from the Autonomous University of Sinaloa in Culiacan. We discussed me visiting their program and giving a couple lectures. I applied for the SVOSH Mentorship Program grant through VOSH International and Optometry Giving Sight. The grant provided money for a couple retinoscopes, battery handles, a charger, lens bars, and a practice schematic eye. 

I took a direct flight from Phoenix, Arizona to Culiacan. On Thanksgiving morning I met four of the faculty for breakfast (see photo #1), Head of Dept, Lic Optom Carlos Martinez, Emiliano Teran Bobadillo, PhD, Lic Optom Rosalia Ramirez Jaimes, and Lic Optom Jorge Martinez. I toured the Licenciatura en Optometria building and classrooms (Photos #2 and #3). I gave a 2-hour lecture at the University on Retinoscopy and Refraction. (Photos #4 and #5). I emphasized the need for all optometrists to learn retinoscopy and be competent at a high level. 

The next day I gave a 2-hour on Treatments to Slow the Progressions of Myopia, including bifocals, contact lenses, and Atropine 0.01% solution. We discussed the role of sunlight and outdoor exposure. I gave the optometry instruments to Carlos Martinez, Head of the Optometry Department. In the afternoon we completed an outreach clinic to a local orphanage (Photos #6a and #6b). We screened 17 children and gave eye exams to 5 nuns who ran the orphanage, providing spectacles to those who needed them, and teaching the SVOSH members how to run a vision screening.

One very interesting development is a new social entrepreneur business called Salud Digna.  Francisco Gómez Salazar, who is a Manager at Salud Digna in Culiacán, Sinaloa, gave me a tour of the clinic. They now have clinics in almost every state, including Sonora and Sinaloa where we have worked extensively. Their mission is to “To contribute together with doctors, health professionals, employees, and volunteers so that people will have a better quality of life through the prevention and detection of disease, offering to our community diagnostic studies of the highest quality and lowest price, being sustainable in our operation.”

The clinic offers eye examinations at no charge and high quality single vision glasses at 160 pesos ($8 USD at the current exchange rate), bifocals at 180 pesos ($9), and progressive addition lenses at 400 pesos ($20). The glasses are made on premises and delivered within 45 minutes. They complete a risk profile based on age and family history to decide if an intraocular pressure check and fundus photos are needed. Most local optometrists do not support Salud Digna because they say it will run them out of business. Having said that, most optometrists or opticians wait in their office with little to do because their prices for spectacles are relatively high, only the upper middle class and upper class can afford them. Salud Digna offers high quality spectacles at a price all but the most poor could not afford, especially if they save up for a month or two. This could greatly increase access to vision care in Mexico.

The  Autonomous University of Sinaloa Licensed Optometry Program is now graduating highly educated students at the rate of 15 per year. This will greatly contribute to the visual health and access to vision care for the people of Mexico.

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Updated COVID-19 and VOSH Humanitarian Clinics Advice

VOSH/International recently consulted its US and International Chapters about the feasibility and timing to restart our humanitarian clinics. While the vaccination process continues with different levels of success depending on availability and acceptance, it is evident that vaccine inequity and the availability and reliability of data in several countries are issues we need to consider.

Even if already vaccinated, our chapters are still concerned about the wellbeing of our volunteers and patients.  Some chapters, are organizing clinics locally where they are better able to comply with the existing safety requirements and respective state/country regulations.

The COVID-19 pandemic is being experienced quite differently depending on state, region, country, vaccine availability, vaccine acceptance, and the spread of SARS-COV-2 variants. Most VOSH chapters are not holding clinics or traveling internationally in 2021.

Thus, VOSH/International is slightly moderating its overall guidance against clinics and travel issued in late March 2020 and renewed in January 2021. This will be reviewed and communicated on a quarterly basis.

If a VOSH Chapter choses to hold a clinic or travel internationally, we highly recommend that the chapter performs due diligence to comply fully with the requirements established by the visited country, ensures all VOSH volunteers are aware of and follow strict safety guidelines and all existing protocols and regulations of the country, and keeps the principle of “do no harm” embedded in all its decision making. As always, the wellbeing and safety for VOSH volunteers and our patients is of utmost importance and central to any decision-making process. We have published our updated clinic guidelines with best practices to be observed in this new context. VOSH chapters in specific countries are using protocols that need to be considered as well. You can download VOSH/International clinic guidelines here.

*VOSH/International is formed by autonomous US and international chapters that are fully and only responsible for their activities, fundraising and decision-making.  VOSH/International can only provide recommendations based on our best knowledge and information at the time.

Also please keep checking the following sites with official and most recent updates:

World Health Organisation: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: https://www.cdc.gov/coronavirus/2019-ncov/travelers/when-to-delay-travel.html

US Government Travel Advise: https://travel.state.gov/content/travel/en/traveladvisories/COVID-19-Country-Specific-Information.html

Thank you for your hard work and dedication to improving vision and eye health throughout the world.

John Daniel Twelker, OD, PhD, FAAO, FVI

President, VOSH/International

July 2021