Technology transfer challenges: status of phacoemulsification cataract surgery in Haiti, 2018

Session Details

Session Title: Orbis Treatment and Prevention of Blindness in the Developing World

Session Date/Time: Monday 24/09/2018 | 12:15-12:45

Paper Time: 12:21

Venue: Stolz 1

First Author: : Y.Zelenski CANADA

Co Author(s): :    D. Eisenmann   C. Dumas                 

Abstract Details

Purpose:

Given the limited national research on technology transfer, the purpose of this paper is to understand the nature of barriers Haitian ophthalmologists face in adaption of modern surgical technology-phacoemulsification of cataract and to review solutions to remove these barriers with emphasis on education, supply, and human resources.

Setting:

The ophthalmology department of University Hospital of Port-au-Prince Haiti along with network of affiliated private and public ophthalmic centers across the country.

Methods:

The key methodology includes country survey of ophthalmologists (N=69) who are either involved in cataract surgery in Haiti or observe/implement activities related to the phacoemulsification of cataract, to capture their experiences, observations and insights. A one-page paper questionnaire was developed to ascertain barriers to adaptation of phacoemulsification and to develop more effective strategies that support transfer of new technologies in Haiti. Discrete data points were extracted from the survey and summarized in the Excel spreadsheet. The deductive approach was used to group free text comments into like themes to identify any additional barriers and solutions.

Results:

Year to date, there are 69 ophthalmologists residing and practicing in Haiti. This survey encompassed of 43 respondents at a 64% response rate. Sixteen doctors (24%) have obtained training in phacoemulsification in Haiti and internationally with duration of training ranging from 10 days to 3 years. Only six doctors have operational phaco machines; of those, only two adapted phacoemulsification as method of choice, performing in average 300 cases, 90% of all cataract surgery, annually. The most commonly held viewpoints on main barriers were: limited economic capacity of population, lack of affordable consumable supply, equipment maintenance and limited knowledge and skills.

Conclusions:

The analysis demonstrates multidimensional challenges that require complex solution including in-country specialized surgical training, low-cost consumable supply, co-financing of equipment and treatment fees. Potential domestic solutions could be an adaptation of cost-effective small incision cataract surgery to contain equipment and maintenance cost as well as co-financing of surgery through insurances to keep surgical price affordable for low income patients. Respondents-national ophthalmologists collectively represented an impressive breadth and depth of relevant knowledge and experience about current challenges of phacoemulsification in the country. The paper sought to harmonize an effort and resources to advance transfer of surgical technologies of cataract in Haiti.

Financial Disclosure:

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