ORBIS’s pediatric eye care project in
Baotou, Inner Mongolia
2008 Q3 & Q4 Progress Report
Period covered: June 16th – December 31st, 2008
1.
1. Capacity building
1.1 Third hospital-based program (HBP)
The project’s third HBP was held at Bao Tou Eye Hospital (BTEH) between July 21st
and July 25th last year. Its key focuses were strabismus 斜視 and amblyopia 弱視. In
all, some 45 eye doctors and 20 other medical professionals from BTEH and its
project sites benefited from this training. ORBIS volunteer faculty (VF) member, Dr
Paul Otis, from the US not only trained young doctors via lectures, but also
demonstrated both typical and difficult surgeries that provided hands-on training for
trainees.
The key objectives of this HBP’s screenings, surgeries and lectures were to:
 Describe basic features of dyslexia 描述誦讀困難的基本特徵
 Describe and utilize non-surgical treatments of strabismus and amblyopia 描述和
運用斜視和弱視的非手術治療
 Demonstrate the most advanced techniques for assessing visual development
among complicated or non-co-operative pediatric patients 掌握複雜或不合作兒童
眼科患者的最高級視力發育評估技巧
In all, some 60 patients were screened and 10 surgeries were performed by Dr Otis
with the assistance of local doctors Dr Ma Liping 馬麗萍, Dr Chen Xiaoling 陳曉玲 and
Dr Hou Liwen 侯利文. During these operations, Dr Otis shared on-the-job surgical
explanations and advice that gave his local counterparts valuable practical insights
into the many topics covered in his daily lectures.
Feedback from the trainees was
very positive. Normally the
patients selected by ORBIS VF
members for training are typical
cases, but this HBP selected
several more complex cases.
The trainees were very
impressed by the management
plan, the various ways of
dealing with difficult conditions
and each treatment’s positive
results. Steps used in
diagnosing and managing
cases have also proved to be
very useful in trainees’ daily
work.
1.2 Training of medical professionals

Three-month fellowship in India
Between October and December 2008, Dr Chen
XiaoLing and Dr Hou Liwen completed respective
three-month fellowships at LV Prasad Eye Institute
(LVPE) and Goutami Eye Institute in India in the field of
pediatric ophthalmology 小兒眼科 and cataracts 白內障.
Having learnt the most updated skills for diagnosing
and treating pediatric congenital disease 先天性小兒眼
疾 and retinopathy of prematurity 早產嬰兒視網膜病變,
Dr Chen was able to fully participate in screenings and
case discussions. In performing some 200 small
incision cataract surgeries in Goutami Eye Institute, Dr
Hou exceeded the number of procedures he had
undertaken in his career up to that point. The two
doctors both returned to Baotou extremely impressed
by the highly efficient, high volume and quality eye care
services they witnessed in India. Each doctor
subsequently shared his experience, knowledge and
skills at a project mobilization meeting in January 09.
As the respective heads of pediatric and anterior
ophthalmology 眼前節, the two doctors’ enhanced
competency will be critical in ensuring BTEH can
provide high quality patient care and transfer
knowledge and skills to young doctors.
 Hospital-based training
Between April and December 2008, five doctors from
the rural eye care network successfully completed hospital-based training in basic
general ophthalmology and pediatric eye care knowledge and skills at BTEH. After
training, each doctor was able to manage certain conditions, identify patients needing
referral and provide patients with important eye care information.
Period
Name
Responsible unit
Apr-July
Dr Guo Xiaobin
Siziwang Qi County Hospital
郭曉彬
四字王旗縣醫院
Dr Du Xueqin
杜雪琴
Dr Wang Wenjing
王文靜
Dr Liang Junfeng
梁俊峰
Dr Liu Meizhao
劉美召
Dongsheng People’s Hospital
鄂爾多斯東勝區人民醫院
Shaerqin Township Clinic
沙爾沁鄉鎮中心衛生院
Siziwang Qi County Hospital
四字王旗縣醫院
Maodai Township Clinic
毛岱鄉鄉鎮中心衛生院
July-Dec
July-Dec
July-Dec
July-Dec
 Launch of Inner Mongolia’s first ever wet lab
In addition to assisting their mentors in diagnosing patients at the clinic and helping
with surgeries in the operation theatre, trainees also received lectures and practiced in
BTEH’s new wet lab 模擬手術室 which opened in September 2008.
In February 2008, BTEH appointed Deputy
Director, Dr Bian Hongxia 邊紅霞, to oversee
training. Her specific activities included
designing and arranging theoretical and
practical training sessions at the wet lab. All
new/junior doctors and even their
counterparts from other local hospitals are
free to use the wet lab and practice cataract
surgery on pig eyes for free. The first facility
of its kind in Inner Mongolia, the wet lab
offers young doctors a wonderful opportunity
to sharpen their surgical skills and thus helps
enhance the overall quality of eye care services.
 National retinal training workshop
Between November 27th and December 4th, 2008, BTEH’s Dr Bian Hongxia and Dr
Wu Yongsheng 鄔永生 attended a national retinal training workshop hosted by the
Chinese Ophthalmic Society, Retina Group in Shanghai. Diabetic retinopathy (DR) 糖
尿病視網膜病變 and age-related macular degeneration (AMD) 老年黃斑病變 were
identified as being key topics for early intervention at these sessions.
New advancements in DR and AMD
medical management and surgical skills in
dealing with these two conditions were
also shared during this workshop.
Ultimately, some 100 doctors nationwide
benefited from presentations by the
Chairman of Chinese Ophthalmic Society.
Other influential retinal authorities from
Beijing, Shanghai, Guangzhou, Hangzhou
and Chengdu also gave presentations,
chaired case discussions and gave
surgical demonstrations during the week.
 “Training the trainer” workshop
52 participants from BTEH and its neighboring rural eye care network attended this
December 8th to 12th, 2008 workshop. On the first two days, “Training the trainer” was
the main topic. The focus was how to best design and deliver pediatric eye care
training to community doctors after assessing patient needs. Teaching tests and
comments were also rehearsed. The next two days covered practical training for the
community doctors. The content was simple, straightforward and easily applicable to
each doctor’s daily work.
1.3 Recruitment of new staff
To date, BTEH has almost doubled its
service numbers in terms of outpatient
visits, medical treatments and surgeries
since investing in community-based
activities such as eye health education
and free screenings. In order to cope with
the resultant unprecedented increase in
large-scale community activities and
patients, BTEH hired an additional 12
undergraduate doctors and 10 nurses.
1.4 Implementation of phoroptors 綜合驗光儀
Seven phoroptors were purchased in 2008 and been
operational since June. BTEH and its co-partners were very
proud to have these phoroptors as such equipment is
generally not found in other hospitals. BTEH medical staff are
now using the machines to provide high quality optometry
services for local children. Three more phoroptors will come
on line in 2009.
1.5 Inspiration from Stanford University
Between November 13th and 18th, BTEH welcomed an intern from Stanford University
in the US who assisted Director Ma in diagnosing patients at the outpatient clinic. The
intern’s other responsibilities included observing surgeries in the operation theatre,
participating in community outreach activities and consulting on eye health education.
The intern also taught young doctors in the wet lab and presented research studies.
His visit proved an excellent example of how eye care-related knowledge and skills
and even culture, education and health care system practices can be shared between
China and the US.
2. Community eye care activities
2.1 Co-operation with local public health bureau
BTEH is now the only facility in Baotou
to offer poorer patients an easily
affordable scaled pricing framework.
For cataract patients identified in the
community the maximum charge is
RMB800. BTEH is also collaborating
with the local government in
performing subsidized surgeries for
poorer families. To date, some 150
free and 114 low-priced surgeries have
been performed on patients who would
otherwise have had no hope of
regaining their sight.
Touchingly, BTEH staff rallied around and generously donated the funds that enabled
an impoverished child with congenital cataracts to receive surgery on both eyes
(please refer to the patient story in section 5). BTEH is now very probably the Inner
Mongolian leader in safe, speedy, affordable small incision surgery for cataract
sufferers.
The fact that BTEH is coping so well with its encouraging patient increase is further
motivating staff to get involved in community outreach activities and provide muchneeded technical support in rural areas. Leveraging the platform ORBIS and its
donors have provided, BTEH is doing everything possible to mobilize and integrate all
eye care-related resources from local government and health authorities and
neighboring disabled federations and social resources. The ultimate aim is to ensure
eye care services are easily affordable and accessible by even the poorest person.
2.2 Collaborative community screenings
BTEH continually conducts community-based eye disease screenings and is
expanding these activities into more and more communities and schools. At the same
time, eye care information is being distributed to the public and parents.
Before the project became active, the local community lacked confidence in BTEH and
rarely visited the hospital or its eye care network for follow-ups or treatment. Nearly
two years after project implementation, BTEH has cemented its reputation for
providing affordable top quality optometry and pediatric and other eye care services.
While still more people are now actively seeking treatment at BTEH, many visuallyimpaired people remain reluctant to use the services because of financial difficulties.
By offering low-income adults and children lower prices for services such as refraction,
optometry, strabismus, and surgical management, BTEH has transformed the lives of
many poorer patients.
BTEH is also continuing to organize largescale community eye care activities. Specific
examples include community eye care
lectures, live “Q & A” sessions on eye care
knowledge, eye care phone-in hotlines to
local radio stations and eye care promotion in
all local newspapers in the run up to October
2008 World Sight Day.
During Q3 and Q4 of 2008, BTEH conducted
pediatric eye screenings in 32 kindergartens and 18 primary schools in Baotou. As a
result, many eye conditions were identified early and treated before long-term damage
was caused. As awareness of the importance of protecting one’s sight has also
significantly increased, we are confident blindness occurrence rates will continue to
fall steadily.
3. Medical achievements
During the second half of 2008, the project’s key achievements included:
Number of doctors trained
Number of patients examined
Number of patients who received medical treatment
Number of eye surgeries performed
106
21,098 adults;
23,724 children
12,680 adults;
8,616 children
7,024 adults;
726 children
Number of people educated about protecting their sight (via
60,000
eye testing activities, eye care lectures, out-patient
consultations, etc)
Number of people informed of the importance of protecting
600,000
their sight (via media advertising/ news reports and the
distribution of “information, education & communications”
materials, etc)
Sharing mission
In August 2008, a rural worker called Li Ke-xing
from a village in Guyang County brought his 8month-old baby Li Dong-sheng 李東升 to BTEH for
an eye check up. Sadly, little Sheng was found to
suffer from congenital bilateral cataracts 雙眼先天性
白內障, nystagmus 眼球震顫 and esotropia 內斜視.
BTEH’s doctors recommended immediate surgical
implantation of an intraocular lens to save the
baby’s sight. Having recently sold almost everything
he owned to pay for his wife’s battle against cancer,
Li was devastated to discover his son’s life
transforming operation would cost RMB10,000.
Fortunately, BTEH Director, Dr Ma, strongly
believed that “Little Sheng was just too young to be
abandoned to his fate”. Having been ORBIS’s local
partner and shared our sight-saving vision for
several years, Director Ma generously decided to
waive all the necessary fees. Li was deeply touched
when told of Director Ma’s kindness. A week later,
little Sheng became the youngest-ever patient to
undergo an operation at BTEH. To minimize risks
caused by the baby’s age and size, BTEH devoted
its best medical staff and facilities in the battle to
save Sheng’s eyesight.
Little over a month later, Little Sheng had made a
full recovery and was able to begin a new life full of
hope, blessings, and joy.