Future Focus: Jacky Jiang

Jacky Jiang, medical student at UNSW, has recently completed an eye-opening four-week elective in Kathmandu, Nepal.

Conducting his four-week elective at the B.P. Koirala Lions Centre for Ophthalmic Studies in Kathmandu, Jacky was able to observe a wide variety of eye surgeries, examine patients and learn about unique eye pathologies prevalent in Nepal.

Inequity in access to healthcare

Having read about world-renowned Nepalese ophthalmologist Dr Sanduk Ruit, and his work with our very own Fred Hollows, I felt incredibly inspired to visit Nepal and learn about the inequities in access to healthcare that this duo had made their mission to tackle.

While BPKLCOS was a relatively well-resourced eye department, the struggles in accessing care were still glaringly obvious. Some patients needed to travel days from remote villages into Kathmandu, leading to delayed presentations of avoidable causes of blindness. Poor vision not only reduces quality of life due to the inability to function independently, but it can also majorly impact one’s mental health and wellbeing. Therefore, restoring vision is so incredible because it allows the patients to essentially live their lives again.

I remember one patient in her 60s. She had very dense cataracts in both eyes, resulting in vision of 6/60, which is considered legally blind in Australia. She underwent cataract surgery and returned the next day with a massive improvement to her visual acuity of 6/9! But even more remarkable was the smile on her face when we removed her eyepatch - a moment I will never forget for the rest of my life.

Cultural differences

Another thing that struck me was the layout and nature of the clinics. There were no private rooms for the patients, or even cubicles to divide the space. The slit lamps were all positioned side by side in the open, meaning patients simply couldn’t be offered the same type of privacy and confidentiality that there would be in a more developed setting. The same held true in the operating theatre, where there were five operating tables next to each other in the same theatre. Still, it was quite awe-inspiring to watch the talented consultant ophthalmologists whizz through cataracts with such speed and precision. The director of the department, Dr. Sagun Narayan Joshi was so fast in fact (averaging five minutes per cataract) that the next patient would be prepped and given local anaesthetic on the adjacent operating table while he was still operating on the first patient.

Enjoying Nepal

We spent our time in Nepal at a homestay with a lovely Nepali family who would cook us traditional Nepali cuisine, including a lentil curry called dal bhat, and dumplings known as momos. During our downtime from our placement, we would get involved in the community by playing basketball or futsal with the locals and exploring the numerous Buddhist and Hindu temples in Kathmandu Valley.

We managed to squeeze in a weekend trip to Chitwan National Park, where we spotted elephants, crocodiles, and rhinos on the jungle safari. Not to mention, easily the highlight of our trip was trekking up into the Himalayas and watching the sun rise over the Annapurna mountain range.

Conclusion

All in all, this elective was a rich and fruitful learning experience, and I’m so grateful to have had the opportunity to learn from some of the brightest minds in the field. The elective has undoubtedly reinforced my commitment to pursuing ophthalmology, and I will carry the lessons I’ve learnt here with me throughout my professional career. Thank you to the many residents, consultants and staff who welcomed me with open arms, and took the time to translate things into English for my learning’s sake. Finally, thank you to BOQ Specialist for the generous FutureFocus grant which allowed me to embark on this adventure. I hope to come back to Nepal one day with the skills and ability to make a bigger difference!

Developed exclusively for medical and dental students, each year the BOQ Specialist FutureFocus grants provide students with the opportunity to undertake an elective so that their commitment to helping others can be realised. Applications for our FutureFocus grant are currently open, apply here.

You can also access funds to help undertake an overseas placement, with our Student Banking Package.