Dr. Koumijan Reflects on Examining Patients in Nicaragua

2018 marks the 5th year that I have traveled to Granada, Nicaragua with a team of doctors and volunteers to provide health care at the Japanese Hospital in Granada. People there are generally friendly and bring smiles to our faces. Granada is a safe, tourist city with many great restaurants and beautiful sites such as Mombacho Volcano, a lake with many islands (including one with monkeys!), and Catarina Masaya, a small city that overlooks the Apoyo Lagoon. The local pottery is beautiful. The coffee and rum are especially delicious and make great gifts for friends and relatives back home! Another beverage I enjoy in Nicaragua is the beer. “Tonya” is the best, especially after a hot and tiring day.

This year was special in that Nicole Chase (pictured below), Optometric Technician and Assistant in my office, accompanied me as a volunteer. Our eyecare team was made up of four doctors and two volunteers. We set up our examining area in one large room at the hospital. With doctors, patients, families, and the eyeglass dispensing process, the room gets busy and noisy! Still, we managed to examine 600 people in four days. During this time, we provided many individuals with the eyeglasses they desperately needed to see at distance and to read up close. We also dispensed sunglasses to all patients to protect their eyes from the strong sun, which stimulates cataract development and pterygium, a growth on the front of the eyes, which — if not surgically removed — can also cause blindness.

The addition to helping people with eyeglasses, we screened for eye health problems such as glaucoma (high pressures in the eye) and cataracts (a clouding of the lens in the eye). Although there are eye surgeons who also come for the week and perform cataract surgery, their schedules fill up very quickly. As a temporary solution, we provided eye drops to glaucoma patients to lower the pressure. Some of the patients know they have glaucoma, but cannot afford to keep purchasing the eye drops. Although Americans complain about our healthcare system in the U.S., many of us are fortunate enough to have access to care and medicine. Although the U.S. has a ways to go to perfect its healthcare system, we can be grateful to see clearly.