by Susan J. Hughes
Madison, Wis. has been Chandra's home since July 1, 1974, and through work at UW and his international network, he has developed programs through CBF to provide free cataract surgeries to patients in developing countries. Chandra?s international surgical arm extends into India, the Philippines, Vietnam, and Kenya, with plans to put surgical centers in Latin America and Africa in the future.
"Truly, what I want the people of Madison to realize is that CBF, headquartered here in Madison, has a global reach and will impact health care in developing nations for years to come," Chandra said.
Ninety percent of blindness is in developing countries. This is where Chandra's worldwide influence is primarily felt. He believes that eliminating treatable blindness is a reasonable health-care goal because the Rotary Foundation eliminated polio by providing vaccines worldwide, and rickets has also been eliminated by providing Vitamin D-fortified milk to children in developing nations.
Many poor people in developing nations do not have the nutritional support to help defeat blindness before it begins. The main cause of blindness in children is xerophthalmia, which is a deficiency in Vitamin A. Vitamin A supplements are desperately needed to prevent permanent blindness in children in poor nations that lack sufficient food and water to prevent disease.
To combat long-term blindness and provide the necessary infrastructure to continue providing these surgeries, Chandra has helped establish an intraocular lens factory, Aurolab, in Madurai, India, which produces lenses at a fraction ($4 in India) of the cost of producing them in the U.S. ($150-200). Eighty percent of these lenses are distributed to nonprofit organizations in 104 countries around the world at no cost. He has also started a suture factory in the same town. Sutures and lenses, in addition to instruments, medicines, and human capital, are the main components needed for successful cataract surgeries.
Part of Chandra's vision for ending treatable blindness is to provide human resources and infrastructure so that these services would be sustainable for years to come in vulnerable areas of the world. "Cataracts are the main problem in developing countries due to Vitamin A deficiencies," Chandra explained. "Children can develop the disease because of dehydration, and malnutrition. Ideally, you want to catch the disease by the time the child is 10 years old. If you catch it in the early stages, you can administer a Vitamin A tablet or liquid. In the later stages, injections are necessary. However, once the child develops full-blown blindness, it is unfortunately no longer treatable. More than 60 percent of blindness cases are avoidable."
Chandra graduated with degrees in biology and chemistry from Lucknow University in India. He continued his studies in the same university until he received his medical degree. Afterward, he trained at the Harvard Medical School until he became a retina specialist, and then decided to come to Madison, Wis. He said he chose to study opthalmology specifically because "you can see diseases of the eye; in no other field of medicine can you see the disease itself."
CBF has treated 500,000 patients and has performed 100,000 cataract surgeries. Chandra said there is no feeling like watching someone see for the first time.
"It is a remarkable feeling, how much satisfaction you have," Chandra said. "For example, I had a patient -- an 80-year old woman, from Nairobi, Kenya -- who was bilaterally blind from cataracts. Before surgery, her head was down and she appeared to be in despair and depressed. I did not speak Swahili, but the next morning, she smiled at me. At that moment, I knew she could see. That was a very powerful moment for me, an extremely satisfying and rewarding feeling."
Currently, there are 45 million cases of blindness in the world. That number is expected to climb to 70 million by 2020. The elderly population (60+), the majority of whom develop cataracts, is growing worldwide. This group grows as the general population increases.
While HIV ranks as the number one world health problem, Chandra continued, most of the people infected by it will die, sad as it is, but they don't become socioeconomic burdens to society for long, unlike blind persons. Blind people, particularly in poor countries, cannot work or be productive, yet they remain alive and have become a major problem for these nations on several levels.
The idea for CBF was spawned after Chandra had been in practice for approximately five years. He wanted to give something back; so he traveled to India where he had a well-developed network of contacts, and he showed them the latest in retinal surgery techniques. While in India, he had 50 people waiting for cataract surgery, a curable disease, outside his operating room. He then realized that he could influence people's lives better by trying to eliminate treatable blindness instead of focusing on retina irregularities.
A cataract surgery in a less developed country such as India, only costs $20 thanks to the generosity of volunteer doctors like Chandra. When he travels to India two or three times a year, he pays his own transportation and does not draw a salary from the CBF, even though CBF receives $150,000-200,000 in donations from foundations and individuals every year. The current goal for CBF is to provide 1,000,000 surgeries by 2020 at a cost of $2 million to the foundation.
CBF's work in hospitals, charitable organizations, and medical schools is ongoing in India. CBF's goals are to bring medical help to remote areas of India and provide free surgeries to those residents. There are 9 or 10 eye centers in India, and the foundation plans to extend its reach to Africa and Latin America where there are very few opthalmologists. In India, the ratio is 1 opthalmologist per 100,000 people, while in Africa it's 1 per 1,000,000 people. Thus, Chandra feels there's plenty of inroads to be made concerning these areas' eye care.
CBF just celebrated its 20th anniversary in Madison on October 15. Governor Doyle signed into law a petition drawn up by Chandra to declare the second week of October "World Sight Week." As part of this celebration, CBF held a free eye camp where eye doctors screened 72 patients and provided free medicine and eyeglasses.
"Seventy percent of the world's problems lie in developing countries," Chandra said in his closing statement. "I believe that we should share our resources with those that can benefit from them. Overnight you can give sight to someone for little more than a cost of a dinner here in Madison."
Indeed, giving the gift of sight is priceless.
