Bringing hope on wings
A grey haired woman lies on a stretcher bed covered with a sterilised green sheet. Her journey to Dundee Hospital started before sunrise when she left her homestead and undertook the trip which entails two long distance taxi journeys.
The elderly woman’s clear voice echoes well beyond the walls of the hospital corridor as she thanks the doctors who landed in Dundee from Pietermaritzburg that afternoon and were preparing to remove the cataract from one of her eyes restoring her almost non-existent eyesight.
‘Thank you so much my children I have been waiting for too long to be able to see well again,’ she says in isiZulu.
Cubungana Buthelezi continues to thank the surgeon, Dr Roelof Cronje before he even starts the operation. Like several other patients Buthelezi has literally crossed rivers to access health care in some of the disadvantaged areas visited by the AMS volunteer specialists.
The 61 year old grandmother of ten has been visually impaired for months now and has been forced to adjust to a life of not being able to see her own grandchildren. She anxiously asks a nurse whether the operation will be simple and painless.
‘Is it not going to be painful when he fixes my eye?’ she asks one of the nurses.
Buthelezi used to enjoy weaving mats, tending to her garden and looking after her grandchildren among other things but the cataract robbed her of all those pleasures.
She explains that it took some time before she reached a stage where she could no longer see and describes how her daughter became her eyes.
‘She does everything for me. She is the one who brought me here today because I can no longer find my own way. I can’t do anything for myself and rely solely on her for everything now,’ she confesses.
It has been a great struggle for the unemployed mother of seven who has had to stop all her other activities to look after her unwell mother who also suffers from hypertension and struggles to walk.
‘I go everywhere with her. I have to wake up early to prepare her when we have to go to the hospital or to collect her pension money. I bath and dress her everyday because she is no longer able to,’ she says.
She is hopeful that her mother will get well and return home to see her grandchildren because she had been complaining that she misses seeing them.
‘All she talks about is seeing her grandchildren. The whole family would be pleased if the operation is successful and she comes back able to see. We are all very hopeful,’ she says.
Cronje, dressed in a green theatre suit, pleads with Buthelezi to relax and stay calm as he administers an injection above the eye he is planning to operate on.
Ignoring the doctor’s plea she continues to thank him. Buthelezi tells one of the nurses that she heard a long time ago that her condition could be cured but was too fearful to have the operation.
‘There are many who regained their sight after coming here but some people said my eyes might be permanently damaged if I have the operation. So I was scared and delayed coming,’ she says.
After the injection Buthelezi is wheeled into the theatre for the actual operation.
Minutes later the hospital’s industrious Matron Jean Fricke wheels in a hopeful Florence Dlongo who has come to Dundee for the same operation. She cheerfully announces that she is not fearful since this is her second time around.
‘I had the operation done on my left eye last month and can now see clearly with it. I just need them to fix the other one as well,’ she says matter-of-factly.
Dlongo has not been able to read her bible – even after her one eye was repaired she still struggled to read the fine print.
‘They invited me to preach at church even when I couldn’t see. I had to recall the verses I knew by heart but I will now be able to read from the bible and directly quote it’, she says.
In the theatre nurses calmly prepare the equipment the doctor will use during the operation, while he busies himself with examining Buthelezi.
A microscope is placed over Buthelezi’s eye to magnify the area being operated on. The area around the eye is then wiped with a disinfectant. Cronje grips the scalpel and makes a small incision of no more than 3.5mm on the side of the cornea.
Next, his latex gloved hands gingerly insert a phacoemulsifier (the phaco is a tiny instrument also referred to as a probe) into the eye. The phaco releases ultrasound waves that soften and break up the cloudy lens. The lens is then suctioned and removed. Next it is replaced with an intraocular lens. To finish off the process the eye is hydrated and injected with antibiotics and steroids before being covered with an eye pad and shield which will be removed after 24 hours.
The procedure is over within 15 minutes and the nurses swiftly prepare the theatre for Dlongo’s operation who is eagerly awaiting her turn. For the rest of the afternoon Cronje operates on 6 of the 12 patients scheduled for surgery. His colleague Dr Cathrine Dewar who is also a surgeon will resume surgery the next morning while Cronje does routine visits to the patients he has operated on.
Hours later Dr Cronje emerges from the theatre door looking exhausted, but satisfied. He collapses on one of the chairs in the doctors’ changing room.
He plugs his i-Pod into both ears and melts into the chair until someone interrupts his quiet moment and enquires what music he is listening to.
The young doctor reveals that he is listening to a lecture from his Ophthalmology course for which he is preparing to write exams.
Cronje has been part of the AMS flying doctor service since 2007. The trips and visits to rural hospitals serve as breather for him as he gets to see the countryside in between working as an Ophthalmologist at Grey’s Hospital.
‘Flying to the rural areas is always enjoyable and AMS is organised – we always find everything in place which makes our job as doctors a lot easier,’ he says.
He is not shy to admit that operating on a person’s eye was daunting when he started out as a surgeon, but he believes the experience he has collected working with AMS has made him a better surgeon and allows him to remain calm during the highly technical procedure.
The success of the operation is largely measured by the results the following day when the bandages are removed and the eye is inspected.
‘Removing the bandages and discovering that you have recovered the eye sight of a person who could hardly see a thing is fulfilling for me,’ he says.
After a 24 hour long wait Buthelezi’s bandages are taken off and reveal that the operation was a success.
Her eyes show no signs of an infection having developed overnight and she excitedly announces that she is able to see. She immediately asks that they fix the other eye, but they inform her that she will have to wait for her next appointment in two weeks to know when her other eye will be fixed.
‘I now can see and cannot wait to go home to be with my grandchildren. I miss my home and being able to do things for myself. But my other eye is also giving me problems, I will be coming back to have it fixed as well,’ she says.
The two doctors still have a long line of patients to see before returning to Edendale and Grey’s hospitals in Pietermaritzburg.
After a long day’s work the well equipped nine seater Pilatus PC-12 fixed wing aircraft effortlessly lands on a designated area to pick up Cronje and his colleagues on its way back from collecting other specialists who have been running clinics in orthopaedics, optometry as well as psychology in other rural parts of KwaZulu-Natal.
Side bar
The SA Red Cross Air Mercy Service is non profit organisation with bases in the Western Cape, Northern Cape, Mpumalanga, KwaZulu-Natal and Free State. For over 43 years AMS has been providing air ambulance services to various communities, with a special focus on rural areas.
During this time the AMS flying doctor service has been transporting medical specialists to remote areas of KwaZulu-Natal and the Northern Cape. The AMS works in close partnership with the Provincial Departments of Health in all the Provinces where they have services.
Every day the nine seater Pilatus PC-12 fixed wing aircraft sets off at 7am and flies to outlying areas of KwaZulu-Natal. In the aircraft a troop of specialists sit chatting, others reading while some unwind and explore the scenery through the windows.
Fixed wing pilot, Mark Hansen focuses on the plane’s control panel with the sole aim of flying the doctors safely to their destination. He has been flying them since 2008.
Hensen finds flying doctors who offer a special service meaningful but adds that it helps that the programme is well run and organised.
‘It’s amazing to know that you are flying people who offer scarce and much needed services to some of the poorest communities,’ he says.
Ronel Badenhorst AMS volunteer flying doctors service co-ordinator is on the phone organising transport offered by the department of health to pick up doctors. She is one of the reasons behind the smooth running of the programme.
‘I make all the necessary arrangements for every trip so that the doctors and pilot can focus on the work they are supposed to do,’ says Bedenhorst.
A few seats away a young lady with hair extensions and her friend are chatting. Phindile Madlala and Vuyo Maqabane are both Optometrists and have been working at AMS for over a year.
They both agonise over the 50 or more patients that will be waiting patiently when they reach the Optometry clinic at Ixopo, a small town in the outskirts of KwaZulu-Natal.
‘Our patients are going to be relieved see us. They’ve probably been at the clinic since the early hours of the morning since it is normally two taxi journeys away from them while others have walked,’ says Madlala.
Scarce medical care offered by the programme include Optometry, Obstetrics and Gynaecology, Orthopaedics, Ophthalmology and Psychology among others. The specialists carry out routine visits to hospitals in Pongola, Kokstad, Matatiele, Nongoma, and Hlabisa and other remote settings. At present, a total of 49 hospitals are serviced through this programme.
The flying doctor service provided support to 4339 hospital staff reaching 24 456 patients in KwaZulu-Natal between March 2008 and February 2009. The Optometry clinic consulted 5058 patients and dispensed spectacles to 1 427 patients. Over 596 patients had cataracts removed and1 181 accessed orthopaedics services.
Apart from the flying doctor service, AMS offers a host of services such as the air ambulance and the emergency rescue service in metropolitan areas of the Western Cape and other provinces.
Using its modern fleet, which includes among others the Agusta 119Ke with the capacity of carrying 2 pilots, 3 crew members and a stretcher, AMS facilitates mountain and surf rescue services as well as inter-hospital transfers for critically ill patients. Both services are provided in collaboration with the Metro Emergency Services.
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