Rocco Robilotto and a young patient.
The 2008 clinic site was
in Nandaime, Nicaragua. The optical dispensary used a
computerized inventory system (REIMS) to pick the best possible prescription match from
the library of donated eyewear. This system worked well and worked very
fast. For the first year, NEVOSH included a veterinary clinic.
Our hosts for this year were Muriel Laverty and Omar. Without
their coordination and assistance, we would not have been able to put
together a successful clinic. We greatly appreciate their efforts
in making the whole experience very smooth and rewarding for the people
of Nandaime. In the photo at right, Omar is being interviewed
by a Nicaraguan television station.
The mission report is an official record of the Clinic put together
by NEVOSH. It normally includes stories from participants
of special encounters they had during the trip.
The clinic site this year was a school in Nandaime, Grenada
Department, Nicaragua. It was more than adequate for our
needs. We appreciate the work of our facilitators, Muriel
and Omar in scouting the location.
A visit to a VOSH clinic for a patient includes much time spent
waiting in line. They wait in the morning outside the
gates of the school. They must again queue separately
for Registration, Screening, Exam, and the optical dispensary.
If indicated, they will again need to wait in line for Dental,
Medical and pharmacy services.
Registration is the first step in the NEVOSH clinic process
for the patient. They will be given a sheet of paper to
carry, which has their name, age, city, and any medical or specific
eye complaints .
Visual Acuity, or screening, is the step in the process that
has patients looking at eye charts through one eye at a time
to determine generally the state of health of their eyes.
This important step gives the optometrist a numerical indicator
of eye health, such as 20/20, 20/40, or in some cases, 20/400
or even "hand motion" which indicates that the patient
is able to perceive only a hand wave in front of their eyes.
Here the patient undergoes a much more rigorous examination
of ocular health. With the use of trial lenses, the optometrists
are able to zero in on the correct prescriptions for the patient
for both near and far vision correction. By swapping and
rotation of non-spherical lenses in a round trial frame, correction
for astigmatism is determined, both in the power of the astigmatism
and the correct angle, or "axis". At the completion of
this examination, the patient carries his or her paper to the
optical dispensary. This year, the optometric students
from SUNY were unable to attend and perform examinations.
This shifted a heavy load of burden onto the travelling optometrists.
The cadre of veteran VOSH ODs stepped up to the challenge and
exhausted themselves to see every patient possible that came to the clinic
in Nandaime. The work that they performed was more challenging
than past years, simply due to the volume that each examiner
needed to see to get through the line. Kudos to each and
every OD for this monumental effort.
The optical dispensary is tasked with finding the best match
to the prescription given by the optometrist. From a
large library of donated eyeglasses, the dispensary staff
picks the best match possible. This year the dispensary
was aided greatly by the computerization of the library inventory
under the REIMS system. REIMS stands for Richmond Eyeglass
Inventory Management System, and was developed specifically
for this type of remote clinic. Using this system, the
prescription is entered into a laptop on site and the system
returns the best matches from the inventory. It is pretty
slick, and can be set to prioritize the right eye, or the left
eye. If bifocals are not available in the best prescription
match, it can automatically split the prescription into two
pair of glasses, one for distance and the other for near vision.
In preparation for this trip, an enormous amount of time
was spent by VOSH volunteers stateside in entering the prescriptions
of eyewear in the library into the system. Among those
taking on this important and seemingly endless data entry task
were Larry Ginsberg OD, Jennifer Burney, Stephen Burney,
Deb Imondi, and Sarah England. Major Kudos
are in order for those who entered the prescriptions before
the mission, and especially to Stephen Burney, who was the
on site expert in all thing REIMS. For the 2008 trip,
all of the plus single vision and bifocals were in the
computerized inventory. For any minus prescriptions,
which are less common, we had to resort to the old method of
digging through the trays of eyewear, organized by power. At the end of
the clinic, we were able to run a report, showing how many glasses
were dispensed, and in what power, to ease the replenishment
Once again this year, the intrepid eye surgeons, Dr. Steve Grimes
MD, and Dr. Charles Collins MD, made the trip and restored the
sight in one eye for the most needy patients. Over 50
Pre-Op evaluations were carried out at the clinic site by Carl
Sakovits, OD, Joe England MD, and Sarah England. Some
of the patients evaluated did not to show up for the procedure,
and one feisty hombre got up off the gurney and walked out of
the hospital without receiving the surgery.
Every year that
NEVOSH has had an Ophthalmologist performing surgeries, many
lives are greatly changed by the renovation of sight to the
legally blind. This year, 50 patients received cataract
surgeries at the hospital in Masaya. Dr. Grimes set his
personal record for the number of cataract procedures completed
in one day. We do not have enough kind words in the dictionary
to express the gratitude of NEVOSH and the patients involved
to these intrepid surgeons, their well tuned assistants, and
the operating room translators.
Carl Sakovits, OD also saw the patients after the procedure,
fitting protective sunglasses and witnessing first hand the
moment that they first gain vision as the bandage is temporarily
removed to determine the correct prescription for eyewear.
The medical clinic this year saw patients with a wide variety
of health issues. Hearts were listened to, blood pressures
were checked, and prescriptions were written for the Pharmacy
to fill. All of the staff in the Medical Clinic were returning
NEVOSH veterans, including Rocco Andreozzi DO, Joe England MD,
Bruce Fischer MD, Geoff Burns MD, Lee Arnold PA, Becky Sox NP,
Sue Seidler NP and Lynn Normand NP.
The Pharmacy crew this year dispensed medications based on prescriptions
written by the medical team. In a change from previous
years, the pharmacy crew could not bring donated medications
which were within 6 months of their expiration dates.
This resulted in a dearth of available medications to dispense,
but the pharmacy crew did all they could to make the best of
this situation, dispensing what they had in the most appropriate
and diligent manner.
The mobility clinic always changes lives in a huge way.
For the most needy patients, mobility came through with shiny
red Chinese-made wheelchairs. The wheelchairs were provided
through the Wheelchair Foundation. Patients were evaluated
based on need and wheelchairs were assembled and adjusted to
fit the patients. The stock of wheelchairs was released
from customs only days before the clinic was scheduled to begin.
For this small miracle, NEVOSH wishes to thank MINSA, Nicaraguan
customs, Muriel and Omar and all those who strove to ensure
that the wheelchairs would be available to dispense in time
for the clinic.
The dental crew, headed by John Kerwin, DDS, was staffed entirely
by returning veterans. After a preliminary exam, teeth
were extracted, restorations performed and the dental health
of 456 Nicaraguans was improved. Dr. Kerwin has organized
a golf tournament annually to help fund NEVOSH. Without
his effort, the clinic would not have the dental chairs that
have made the procedures much more comfortable for the patients,
and eased the access for the Dental Crew.
Once again this year, NEVOSH was further enhanced with the presence
of a licensed dietician, available to discuss diet strategies
with patients. Becky Tiexera discussed eating habits and
ways to improve diet. Common concerns included eating
right with diabetes, vitamin supplements, and proper nutrition
for expectant mothers.
Carolyn Grimes hosted a veterinary clinic in Grenada this year.
The clinic is one of many aid institutions founded by recently
recognized citizen diplomat Donna Tabor. Carolyn
was able to scrub up and perform spay and neutering procedures,
and treat walk in patients. During her four day clinic,
Carolyn treated 43 four legged patients and a dog named tripod.
In an effort to bring assistance to those who need it the most,
NEVOSH set up three small remote clinics in areas where the
need is greater than in Nandaime. The recipients of care
in these areas were very grateful for the care they received
from the travelling doctors with NEVOSH.
Without the work of a dedicated group of translators, the 2008
NEVOSH clinic would not have been possible. We extend
our sincere thanks to the translators who worked diligently
to ensure that the issues expressed by the patients in the clinic
were understood by the NEVOSH doctors and clinic staff.
In case you did not know it, Nicaragua is one of the most beautiful
countries on earth. Nicaragua is blessed with volcanoes
and lakes, rich soils, verdant flora and many types of unique
fauna (like the freshwater shark). The spectacular scenery
of this country is truly something to behold. This section
of our website is devoted to photos depicting Nicaragua's beauty
submitted by travelling VOSH members.
Los Gentes - The People
We need a place on the site for photos of the Nicaraguan people.
The doctors enjoy meeting them and getting to know each of them
a little bit. We end up with some great photos of the
children and other clinic patients in attendance, and that's
what this section of NEVOSH.com is for.
|2008 NEVOSH Mission to Nandaime, Nicaragua
Patient totals as reported by Kevin Somerville
• Optical totals include both prescription glasses (783)
and readers/sunglasses (553)
• Medical totals include those from 3 remote clinic sites
• Dental totals include both restorations and extractions
• Mobility totals include wheelchairs (93), walkers (21)
and treatments (17)
• Veterinary totals include sterilizations (23), tumor removal
(1) and walk-ins(20)
Submissions of photos and stories from those who were
on site are being solicited. For more information on submission,
2012 Panama & Tennessee
2010 Nueva Esperanza
2009 Nueva Esperanza
2008 Nandaime, Nicaragua
2007 Monimbo, Nicaragua
2006 Nandasmo, Nicaragua
2005 Catarina, Nicaragua
2005 Mus, Turkey
2004 Nindiri, Nicaragua
2003 Jinotepe, Nicaragua
2002 Ticuantepe, Nicaragua
2001 Monimbo, Nicaragua
2000 La Concepción, Nicaragua
1999 Masatepe, Nicaragua
1998 Niquinohomo, Nicaragua
1997 Lake Yohoa, Honduras
1996 Jutiapa, Honduras
1995 Omoa, Honduras
1994 Vera Paz, Guatemala
1993 Coatepeque, Guatemala