A century on, Hadassah’s ophthalmology department sees a global impact
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A century on, Hadassah’s ophthalmology department sees a global impact

From Africa to Ecuador, Israeli research and training contributes to a vision of healthy eyes for developing nations

Dr. Gustavo A. Gutierrez of Mexico, a Hadassah ophthalmology resident. (Courtesy)
Dr. Gustavo A. Gutierrez of Mexico, a Hadassah ophthalmology resident. (Courtesy)

For the Sanchez family, the 100th anniversary of the renowned Ophthalmology Department at Israel’s Hadassah Medical Center holds special meaning. Though they’re from Ecuador, they’ve had two generations of doctors participate in Hadassah’s ophthalmology residency program.

Dr. Miguel Sanchez was just one of a handful foreign ophthalmology residents at Hadassah back in 1981, but today his son, nephew and nephew’s wife are all part of the thriving Latin American community training in Israel.

“I guess we have ophthalmology in the family,” says Sanchez’ nephew, 31-year-old Dr. Diego Almeda.

Almeda’s parents are lawyers, but his grandfather founded Vistotal, an eye institute in the capital of Ecuador where his Hadassah-trained uncles practice.

“I grew up playing in the eye operating room, it was my gymboree,” says Almeda. “So I guess it’s not a surprise that I am specializing in retinas. I still love the operating room and enjoy all types of retinal surgeries.”

Establishing a vision

Over the last 57 years, Hadassah’s Ophthalmology Department has trained almost 150 ophthalmologists from 40 different countries across the Americas, Africa, Europe and Asia. In line with the humanitarian vision of Hadassah Women’s Zionist Organization of America founder Henrietta Szold, the residency program places an emphasis on educating doctors from developing nations.

When Szold first set foot in pre-state Israel in 1909, the notion that the Jewish homeland would extend aid to other nations in the field of ophthalmology was a remote one.

“Hadassah founder Henrietta Szold was appalled by seeing children with flies in their eyes when she and her mother came to pre-state Israel in 1909. Those children had trachoma. Today, there is no trachoma in Israel although it’s endemic in many countries in the world,” said Ellen Hershkin, national president of Hadassah.

Hadassah the Women’s Zionist Organization of America President Ellen Hershkin. (Courtesy)

Trachoma is a severe but treatable disease common in poor and unhygienic conditions that often causes blindness.

“Wiping out trachoma was the beginning of the many miracles that have taken place here by the doctors and nurses who were supported by the generosity of Hadassah members abroad. For 100 years, Hadassah Medical Organization has been devoted to wiping out eye disease and blindness. We couldn’t be prouder of this achievement,” she said.

The disease was a major catalyst for the 1912 founding of Hadassah, and indeed, in 1913 — only one year after the organization got its start — the women’s organization had already dispatched two American nurses to help fight child blindness, along with other pressing issues. Soon, with the regular application of eye drops shortly after childbirth, trachoma was effectively eradicated in Israel.

Hadassah’s ophthalmology department was officially launched it 1918 as one of the original five departments that were part of the first Rothschild Hadassah Hospital on Jerusalem’s Hanevi’im Street. The department grew as quickly as the fast-growing country blossoming up around it. By 1959, only 11 years after Israel achieved independence, the department recognized the dire need for professional ophthalmologists in African countries.

Illustrative: Jerusalem’s Hanevi’im Street (photo credit: Abir Sultan/Flash90)

Though the newly established State of Israel had little money to spare, Hadassah’s ophthalmology department decided to share what they did have – manpower. To that end, it became a prerequisite for each Hadassah ophthalmology resident to commit to spending a minimum of two years serving communities in Africa if they were to attend the program.

To date, 48 residents from Hadassah University Hospital have spent between two to four years in Africa on working missions. They have examined more than 1 million patients and performed more than 200,000 vision-saving operations.

Hadassah Mt. Scopus Hospital, 1939. (Hadassah)

A blessing down in Africa

One of these doctors was Dr. Edward Averbukh, a Hadassah Ophthalmologist who in 1993 moved with his family to Malawi, where they would spend the next two years.

“I performed more than 2,000 eye surgeries throughout the country,” says Averbukh. “There was one other ophthalmologist in Malawi at the time, trained by Hadassah, but he was busy teaching other medical professionals to treat eye traumas. The surgeries were my job.”

Averbukh lived in the Malawian capital of Lilongwe with his wife Shoshi, a museum curator, and their two young daughters – then aged 3 and 5.

“My daughters still remember that time as the most beautiful years of their childhood. They remember the trips we took to the African countryside and the exotic animals we saw,” says Averbukh. “We lived in a community of volunteers from other countries, all dedicated to doing good in the world. My wife and I are still in touch with many of them, more than 20 years later.”

Averbukh’s commitment to his patients wasn’t forgotten.

“When I visited Malawi 10 years after leaving, the locals told me that no other doctor would come to the hospital at night to treat eye trauma,” says Averbukh. “No visiting doctor cared enough, and the patients had to wait until morning to be treated.”

“The locals say, ‘White people leave’ and they are right. I know I made a difference there, but the real impact is training African doctors to treat their people. Long-term progress will be made in Africa when more African doctors train at Hadassah.

“I am excited that we are now training doctors from Rwanda and Cameroon, and I hope more African doctors join us soon,” Averbukh says.

Giving tools as well as treatment

In addition to training doctors in their home countries, Hadassah established the Diploma Course in Ophthalmology in 1961, at the behest of then-department chair Prof. Isaac Caesar Michaelson. The course provided a more efficient way for foreign doctors to train at Hadassah University Hospital in Jerusalem.

Alejandro Lichtinger, left, with Tura Galbinur, a fellow from Azerbaijan. (Aviad Tevel)

The residency program is conducted in English over three years – just like in the United States – with many of the international residents choosing to stay an additional year to specialize as an ophthalmology fellow.

Dozens of Hadassah’s international ophthalmology residents hail from South American countries such as Ecuador, Costa Rica, Panama, Haiti and the Dominican Republic.

Mexico holds the record for the most ophthalmologists trained at Hadassah, with 37 residents who have studied in Jerusalem since the 1970s. The majority of these residents are not Jewish and have no connection to Israel, but come because of Hadassah’s reputation and ability to provide residents with the most innovative and advanced training available.

International residents study together with Israeli residents to create a unique and diverse student body. While the courses are conducted in English, the international residents study Hebrew so they can interact with patients and Israeli medical staff.

“The international diploma course in ophthalmology reflects the tradition of Hadassah. At the Hadassah Medical Organization we aim to distribute knowledge and skills and to outreach to patients at need wherever they are. The graduates of our diploma course in ophthalmology are a source of pride to all of us. They are also ambassadors of Israel in countries where little is known about our daily life,” said Prof. Itay Chowers.

Curing blindness from preventable causes in Mexico

“My father is an ophthalmologist,” says Dr. Gustavo A. Gutierrez Vargas of Colima, Mexico. “In fact, one of my earliest memories is of going with my father to the operating room as he performed a cataract surgery when I was three.”

As Vargas went home to perform “eye surgeries” on his toys, his family didn’t have a hard time predicting his future profession. Where he would do his residency, on the other hand, came as something of a surprise.

Dr. Gustavo A. Gutierrez of Mexico performing cataract surgery. (Courtesy)

“I first heard about Israel in the medical field from a resident at my medical school, who mentioned it as one of the top places in the world to do an ophthalmology residency,” says Vargas. “At the time, it was a surprise to me to have Israel in the same group as the US, Canada and the UK. Afterwards, I kept running into former Hadassah trainees as a medical student, all of them being accomplished and successful doctors who were performing on a very high level in several fields. They were all the sort of doctors that you looked up to as a medical student.”

Vargas was thrilled with the opportunity to study abroad, but was daunted by the fact that Israel was a world away.

“Despite the fact that I’m an only child and we’re quite a close family, my parents were always entirely supportive of my decision,” Vargas says. “We all knew it wouldn’t be easy, but it was something I couldn’t miss and I had to do. Although my father knew about Israel from the medical field, my parents were surprised by the pictures I sent them from Jerusalem, Tel Aviv and Hadassah. It was a modern and vibrant country, with top notch hospitals.”

“The main question was what I would regret more in 20 years — leaving behind my family, friends and culture for a bit, or not taking the chance to go abroad and potentially become one of role models I had as a medical student,” Vargas says. “It took me only a second to realize this was a once in a lifetime opportunity, so I took the step and I’m here.”

Vargas was recently accepted to be the Fellow of the Glaucoma Department under the mentorship of Dr. Gabriel Greifner, the leading non-penetrating deep sclerectomy surgeon in Israel. It’s an opportunity that hits close to home for Vargas.

“There are 5,459 ophthalmologists in Mexico,” he says. “Seems like a lot, but we have a population of over 120 million people. More so, there are currently less than 100 glaucoma specialists in all of Mexico. Due to the lack of specialists, people in Mexico still go blind due to preventable causes such as cataracts and glaucoma.”

While Vargas appreciates his time in Israel, it’s not his long-term goal to stay, but rather to deploy his newly-learned skills back in Mexico.

“I’m going to finish my fellowship in the first quarter of 2019,” he says, “and then I’ll go home.”

A family affair

Almeda’s love for ophthalmology dovetailed with his personal life. He met his future wife, who followed him to Israel to take part in the Hadassah residency.

Dr. Belen Quizhpe, 30, grew up in a small city a 12-hour drive from the Ecuadorian capital of Quito. She is as sensitive as anyone to the difficult realities when it comes to receiving quality eye care in the developing country.

“Even as a medical intern, I had to think twice before sending patients for eye tests because it is an out of pocket expense,” she says.

Dr. Gustavo A. Gutierrez of Mexico receiving his diploma from Prof. Jacob Pe’er, the head of the ophthalmology department at Hadassah Medical Center, April 2017. (Courtesy)

Quizhpe originally planned to train as a transplant surgeon, but after meeting Almeda during their medical training, she followed him to Hadassah for an ophthalmology residency to specialize in cornea transplants.

“We only met in our last month together as interns,” she said. “But we fell in love right away. Diego knew he wanted to follow in his family’s footsteps and train at Hadassah. Six months after he left Ecuador, I followed him to Israel.”

After a year together in Israel, Dr. Belen and Dr. Diego returned to Ecuador for their wedding.

Dr. Miguel Sanchez’ son is also no stranger to medical partners who also happen to be romantic partners.

“My parents both trained at Hadassah,” says Dr. Juan Sanchez, 31. “I grew up seeing their devotion to eye care and decided to continue in their footsteps.”

Like his parents, uncle, cousin, and cousin’s wife, Sanchez also knew that Hadassah’s residency program was a golden opportunity.

“During my time here I had access to great facilities and technology and the best people – all experts in the field. Hadassah ophthalmologists are the best in what they do and I am lucky to have trained here,” Sanchez says.

This article was written with the sponsorship of Hadassah, the Women’s Zionist Organization of America.

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