Monday, December 12, 2016

Sight for Sore Eyes

Have you ever put on somebody else’s eyeglasses and wondered how in the world they can see through them? 

It’s hard to see through glasses that aren’t yours, but that’s what we ask our patients at the Nueva Vida Clinic to do all the time when we try to match them with used glasses that have been donated. But thanks to a pilot project we’re doing with the Bucknell University Engineers, we can now make eyeglasses to order at the Nueva Vida Clinic!

Since we started our Vision Program six years ago with training from a Cuban ophthalmologist, Pat and I together with a host of volunteers have weekly been doing vision testing and trying to match patients to used glasses that we get donated from the New Jersey Lions Club Eyeglasses Recycling Center. While this system works very well for reading glasses, it’s harder for distance glasses: we have to find patients a match in their right eye then the left, as well as a match for astigmatism corrections. Most of the time we can get close to what patients need, but it’s usually not exactly what they need, and that can make a big difference. Even when we get close, the frames are often out of style which has a big effect on patients’ ability to adjust to wearing glasses.

So in an effort to get patients' glasses made to their own prescription in better-looking frames, we are working with engineers to try out a pilot program in hopes that we can create a low-cost sustainable vision program that can be adapted to other places as well. The program is called Project for Sustainable Eye Care or PROSEC.

In June, Bucknell engineering graduate student Paden Troxell came down to Nicaragua with small machinery, a stock of a selection of frames and blank lenses in a range of pre-ground prescriptions. Paden taught Pat and Sarah and I how to make the glasses and use the small lens cutter and lens beveller, and since then we’ve been giving our patients at the clinic the option of purchasing PROSEC glasses for just under $7 instead of trying to match them to a donated pair of distance glasses.   We settled on the price of $7 to cover the cost of the frames, lenses and someone to cut the lenses and fit them to the frames, since Pat and I hope not to be doing that forever!

So far we have sold and made over 100 PROSEC glasses, and have found that since we have begun to offer the low-cost glasses, more patients are coming in to the Clinic for eye exams. In November, we worked together with our Ciudad Sandino Rotary Club to do three days of Vision Checks in rural communities and in a local church. We checked everyone's blood pressure, did vision checks, handed out reading glasses at no charge, did refraction tests for distance glasses, and sold PROSEC glasses. In that time we saw 195 patients, handed out 115 reading glasses and sold 42 PROSEC glasses, the vast majority of which Pat made in the following weeks (with a tiny bit of help from me).

These vision days were a huge success, and we hope to continue them more regularly next year with the help of Rotary and community volunteers. Just making the glasses more accessible to people – making it easy to get eye checks, affordable price, and good choice of frames – means that many more people will be able to see!

Of course we’re learning as we go – we will be adding a new machine in January in hopes of making the lens cutting more efficient, we will be revising our frame stock to remove difficult frames and add more popular styles, and while we can’t currently correct for astigmatism, we hope be able to do so in the future. - Becca 

Monday, December 5, 2016

Las Lobas Camp

Last weekend we held the first Las Lobas Camp. Jessenia and I decided that we should do our own weekend camp with all of the Lobas up at El Porvenir. Our thinking was that we could afford El Porvenir (only food cost and diesel to get up the mountain) and that it would be a good experience for the urban Lobas to be in the forest with no running water or electricity (or cell phones!) for a few days.

As with everything we do with this group, we didn’t really know how to run a camp, but thought we could figure it out. We invited Diana to come along to help, all of us brought our kids and Paul came too. All but two of the Lobas were able to come, so there were 10 of them! It was amazing to have that support from the parents, in fact, many of the families came to the Clinic to say goodbye to the girls and take pictures of them with their phones as they got in the ambulances! For several of them it was the first time they slept away from home.

The first night we set guidelines for the camp together with the girls and posted them on the wall…we were immediately afforded an opportunity to go back over them when several of the girls had trouble sleeping on pads on the hacienda porch floor and kept others up with their talking and shining flashlights.

On Saturday morning we did team-building and trust-building activities, and they spent two hours picking coffee in pairs. We held a contest to see which team could pick the most coffee, Gabriel from the co-op measured it at the end of the exercise and declared a winner. Although nobody actually liked picking coffee, they all participated and were all sorely disappointed at the end to learn they’d only earned $0.52 each.

In the afternoon Diana organized everyone to make a piñata and party favors for a village party while Jessenia and I carried out individual interviews with each of the girls.

These interviews were my favorite part of the camp by far. We had asked each of the girls to write down their goals for the next year, and so when we sat down we talked with them about what we had observed in them in the past year, anticipated possible obstacles to meeting their goals, and talked over possible ways around those obstacles. In part, this was a chance for Jessenia and I together to reinforce good behavior and offer constructive criticism –it was gratifying to see some of the girls’ faces light up with pleasure at hearing positive things about themselves. But we also got to learn more about many of the girls – we were thrilled to find out that one of the girls who hasn’t gone to school for years has been secretly studying and just passed 3rd/4th grade! She’s now headed to 5th/6th and we told her if she wants to keep a secret that’s fine, but that she should invite us to her graduation next year! Jessenia offered insight and support to one of the girls who has a lot of responsibilities at home following a death in her family – she often has to cook for 10 people. We talked with one of the girls who is a natural leader about the pressures that leaders can feel – she has been uncharacteristically crying and getting angry at others – and talked about how she can take care of herself better. Each girl got a hug from both of us and I don’t think I’m mistaken in my observation that we gained a new level of confidence with most of the girls over the camp.

Diana and Jessenia organized the village party late in the afternoon with participation from all the Lobas – it was the most organized piñata I think I’ve ever been to! The Lobas really enjoyed doing something for the kids in the community – they had been affected by seeing the kids working. Everyone up at El Porvenir hauls their own water – 20 gallons per family – from the hacienda. Several of the Lobas saw a little boy struggling to carry his family’s water up the steps to his horse, so they carried the jugs themselves and gave the boy a tangerine to eat while they figured out how to get the jugs onto the horse. They were then shocked to see him – barefoot but for his spurs –  lead his horse over to a low wall where he could climb into the saddle and pull the last jug onto the saddle horn with a rope before head off for home.

Saturday night we walked out to the viewpoint and had a bonfire with marshmallow roasting, and Sunday morning we had our closing circle activities there.

Not every moment of the camp went swimmingly, of course. There times of hurt feelings and a few small disciplinary issues, par for the course. But in the end, no one can take memories of this camp away from the Lobas. They have all slept away from home, picked coffee, hauled water for hand washing and drinking.

I don’t know if any of the advice Jessenia and I doled out will take hold, but there was one solid moment of hope where I began to feel it might. During a free time at the end of the camp all the girls all crowded together on the mats talking to each other. “You don’t want to get together with a boy too soon,” said one to another. “First you have to finish school, there’s plenty of time for that later.” All the advice that means so little from Jessenia or me takes on much more weight one Loba to another. - Becca