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 Reports of Trips to the Thai/Myanmar Border

The Mae Tao clinic is in Mae Sot, Thailand, on the border with Myanmar(Burma) and aims to provide much needed medical care to the marginalized Burmese refugees living at a number of camps along the border. Dr Frank  Green

(Consultant Ophthalmologist, Aberdeen Royal Infirmary) and Dr Philip Ambler (GP and clinical assistant in Ophthalmology, Oxford) first provided eye care in 1990 with regular short visits. Upon retirement in 2011, Dr Green was  able to spend 35 weeks per year at the Mae Tao clinic. Sadly, Dr Green died in 2019. The work was continued by Dr Ambler and the Karenaid charity set up to support it and a second clinic has been opened at San Jae Dee. Now Karenaid has handed over the funding of both clinics to Fiona's Eye Fund. 

Report November 2023 Report by Dr Lai~Yeung Lai

Team members Drs Lai-Yeung Ngai, Simon Hewick, Kate Claridge, Phillip Ambler
San Jai Dee Clinic.We were joined by Tom Scott (a close friend of Dr Frank Green and Phillip), who had been on numerous trips previously with Karenaid, and Dr Myles Potter, an ophthalmology trainee from the Peninsula deanery. We arrived to see a full clinic and were greeted by familiar faces: Goong, Star, S’Lai (Scrub team), Dr Tok and Yoriko. In total 86 cataract operations were completed.
86  Mae Tao Clinic. We managed to complete 11 SICS operations and see 56 patients on Day 1.

Day 2 - 3 We performed 19 SICS, seeing 60 patients on day 2, and 14 SICS, 1 combined SICS/trabeculectomy operation and 1 anterior vitrectomy, seeing another 24 patients on day 3. Again, it was reassuring to see some patients had returned for their second eye operation. In total, we performed 70 SICS, 1 Trab/SICS, 1 revision/anterior vitrectomy and 1 secondary IOL, with a complication (PCR +VL) rate of 4/70 (5.7%). The total number listed was 80.                                                                                                                                                 Read more

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Report April 2023 Report by Dr Lai Yeung Ngai
Team members, Phillip Ambler, Simon Hewick, Lai Ngai, Kate Claridge, Goong Netek Ailsa Hewick, Hazel Adler, Star,
S’Lai, 3 local helpers/translators.

San Jae Dee clinic, Thailand on the border with Myanmar. Following the feedback from the previous trips, prescreening was recognised as playing an important part in the service, and this was performed very effectively by Goong and his team. 92% of the patients screened on the first day were listed for cataracts. We were able to open up two operating tables. In 5 days we achieved 83 cataract operations plus 76 SICS, 2 eviscerations, 2 Yag Caps, 3 Yag PIs
Mae Tao  clinic . The theatres were again run as in San Jae Dee with prefilled sterile syringes of antibiotics, steroid, phenylephrine etc made up by the scrub team every morning. The prescreening was very good. In 5 days we achieved 88 cataract operations plus 2 pterygia, trabeculectomy and 1 ACIOL4 pterygia operations.

                                                                                                                                                                            

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Report April 2022 Report by Dr Lai-Yeung Ngai
Mae Tao Clinic. Total operations completed in MTC was 109 out of 126 listed. Some patients were asked to return next visit, and some patients did not show up (either due to transport or other personal issues). The road from the MTC into MaeSot was manned by Thai Police for 2-3 days which may have prevented entry/re entry for some of the patients. It was sad to leave, with the remaining post-ops happy to pose for pictures and bid us farewell. 
San Jae Dee (SJD) clinic . The plight of these patients was highlighted by one patient who had suffered a fractured wrist, but she had decided to travel the 5 days in order to see us, and despite this wanted to have her cataract surgery before heading back to Burma to have her wrist treated and plastered. She must have been in pain throughout. We carefully prioritised her case and treated her cataract upon diagnosis. She was then transferred back to Burma to fix her wrist. A total of 124 patients were seen and treated, 33 cataract operations completed.The post ops were a delight to see, and we could tell of their happiness of sight being restored.
 

Dr Lai operating

Report 2019 Report by Dr Ngai-Yeung Lai
Dr Lai-Yeung Ngai, Dr Simon Hewick

Three Pagoda Pass, like Mae Sot is a border crossing between Thailand and Burma, and is therefore accessible to the Myanmar border communities. The team at SJD had advertised our trip and helped organise translators and transport of patients across the border. We saw 300 patients in the first week; 43 required surgery (33 of which were cataract/small incision cataract surgery (SICS) operationsIn the second week two patients were brought in by a volunteer medic who had come upon these patients whilst at her local temple. The elderly, frail gentleman was blind and had no relatives. He was living at the temple and would have had no means to access health care. Another elderly lady was dependent on her widowed daughter for all her care, and her blindness had rendered her housebound. They both had dense, white cataracts. We performed cataract surgery on both; and the benefits were immediate on removal of the dressings the next day; the gentleman was able to read, and we could prescribe reading glasses to help improve their quality of life and independence.

 Patients waiting

Report May 2017  Report by Dr Ngai Yeung Lai
Mae Tao clinic, Thailand on the border with Myanmar (Burma) Dr Lai-Yeung Ngai and Dr Simon Hewick
The new Mae Tao clinic is in Mae Sot, Thailand, on the border with Myanmar(Burma) and aims to provide much needed medical care to the marginalized Burmese refugees living at a number of camps along the border.

In week 1  we listed 66 patients for cataract surgery.  It was a steep learning curve, again, with adjustments required with the instruments available and the differing anatomy of the eye.  I performed 11 cataract operations and 1 chalazion, Dr Hewick performed 14 cataract extractions.
In week 2 the rainy season started with a ‘bang’ of thunder:  I acted as scrub nurse to Dr Hewick, and Dr Hewick did the same for me. It worked well, as it meant that two operating tables could be maintained. 
We saw 116 patients, 102 new, and 14 return patients. I  complete9 cataracts and 2 chalazion operations and Dr Hewick performed 17 cataract extractions, 3 chalazion excisions, 2 ptergia and autografts and 1 orbital exploration.  I would like to thank the trustees of the Fiona Dolan fund for their sponsoring of the trip and giving us the opportunity to help care for and try to improve the lives of those in need.              

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Report  August 2016 Report by Dr Ngai Yeung Lai

Dr Lai-Yeung Ngai and Dr Simon Hewick
Week 1: Mae Tao Clinic, Thailand. We were referred approximately 70 patients and listed 50 patients for surgery to commence the following day. Because of the great distances and expense the patients have to bear, all assessments (refraction, biometry) was performed on the day, again requiring effective teamwork….. Between Monday and Thursday, we saw 117 new patients, and approximately 30 return patients. Performed 53 cataract extractions, 11 pterygium removals, 1 trabeculectomy, 4 chalazion drainages, 1 ptosis repair, 2 eviscerations and 1 wound exploration.
Week 2: The week began with truly challenging conditions with heavy rain most days, making travel and access to the clinic difficult for us and the patients. Therefore we only saw 36 patients, and performed 20 cataracts and 2 pterygiums in 3 days. Overall, I performed 23 SICS, 3 pterygium excisions and autografts, and 3 chalazion drainage operations. I witnessed and experienced firsthand the practicalities of performing ‘high volume’ surgery, in basic but optimized conditions, and saw how it was possible to set-up a cataract operating unit in very basic, rural conditions and still maintaining high standards of care.  

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Report Sept/Oct 2012 Report by Kurt Spiteri

Thai/Burma Border  Sept/Oct 2012
I was impressed by how organized the whole setup was, and how efficiently the clinic ran.   I learnt various surgical techniques from Mr. Green including small incision cataract surgery (SICS).   In the first week we examined and treated approximately 140 patients (not including post-ops), and performed surgery on 64.   On Sunday we travelled hundreds of miles to one of the eye camps in the southern part of the border, called Nupo camp.  There we set up our equipment and ran clinic and theatre at the same time.  In the three days we spent at the camp, we examined 110 patients, performed 20 biometries and operated on 27 patients.  All surgeries in the clinic and camp were done under local anaesthetic, including enucleations and eviscerations.  This was especially challenging when it involved young children!  Overall, I was able to perform 35 SICS.  I also carried out excision of advanced pterygia with conjunctival autografts, enucleations, trabeculectomies and lid procedures.  I would like to take this opportunity to thank the trustees of the Fiona Dolan Fund for sponsoring part of the cost towards this successful and life-changing experience. 

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