The Hospital in the Sky – an OMEGA film with Cindy Crawford

This movie is playing
with English subtitles. On the North coast of Peru
lies the city of Trujillo. At the local airport the baggage handlers
await a unique visitor. An aircraft
unlike any other in the world. An aircraft
that can perform miracles. It is a totally self-sufficient,
fully operational flying eye hospital. The international NGO
behind all this is Orbis. Now you may not have heard of them,
and I know it sounds corny, but they really do like
to fly below the radar. It’s just the sort of people they are. They’d rather get on with the task
at hand than talk too much about it. And that’s where I can hopefully help. I’ve been invited to experience this
– their 12th mission to Peru. It’s my first mission
and I’m excited and a little bit nervous. My career isn’t really great preparation
for ophthalmic surgery – but I’m a hard working girl,
I’ve done my research, and if I can help shine a light
on their work, well then I am all for it. I’ve decided to bring my daughter Kaia
along on this journey. She’s only 13 years old
but she’s pretty switched on and we’re both looking forward
to this experience. To prepare ourselves we’ve gone up
to the mountains and seen Machu Picchu, we explored the coast and got a feel for the living
and ancient cultures of Peru. Even before the Orbis plane landed we were both already
a little bit in love with Peru. There are 3 primary environments in Peru,
and all of them are challenging. Along the Pacific coast
are the arid deserts, then the thin air
of the Andes mountains, and in the east
the humid jungles of the Amazon. It seems wherever they choose to live,
the people of Peru walk a precarious path. The landscape
is undoubtedly spectacular, but it is the product of that majesty,
its people, who are the real prize. As harsh and barren as the environment is,
the people are dazzlingly colorful. It’s the changing of the seasons and springtime
brings the people out in a festive mood. On any day of the year
somewhere in Peru there’s a festival which showcases that palette of colour. This one is a celebration of Mothers. In the remote highland town of Otuzco the mothers are dressed as beauty queens
and paraded around the city. The bands and supporters
sing their praises. What a beautiful idea. A parade of Mothers
for all we do. And in this town, in one house there is a very special
mother and daughter. This is Camilla. As her eyes struggle to focus
on the passing parade her mother Anna is worried. (Spanish)
When she started crawling
she fell a lot and knocked herself here. Then at 2 years old
she became like this. She was not like this as a baby. The doctor just called saying I should go on Monday 7:30am because there are 27 children going but only 10 will be selected. So he told me to come in early to see if she is chosen or not. The glasses are a temporary fix. Her condition is known as strabismus. The inability of the eyes
to lock together as one. It affects her vision in many ways but most importantly
it affects her depth perception. Living in a place like Otuzco
with its steep paths and dangerous cliffs,
good vision is critical. If left untreated
then her condition will get much worse. Camilla and her mother
will wind their way down the coast out of the mountains by bus and pray that she is
one of the lucky ones chosen for surgery. It will be a long and tiring journey
for them and they are given no guarantees. Since 1982,
Orbis has visited 92 countries, trained 325,000 eye care professionals and provided 23 million treatments
to blind and visually impaired people. All of their missions begin the same way. With a deep breath and a leap of faith. Dr. Fredrick is a surgeon and professor
of ophthalmology at Stanford. He’s a volunteer. As well as Spanish,
the national language of Peru, he also speaks Russian and Vietnamese. He also happens to be
a really, really nice guy. Screening days can be intense. Quick decisions have to be made
that will profoundly affect the future of each person’s life. 5 year old Dayana’s mother hopes
she will be chosen for surgery. Ok, so this young girl, her eyes began to cross
when she was 3 months old. (Spanish)
Look at Dora, over here. She still uses this eye
because it’s not amblyopic. For sure she needs surgery
to have any chance of fusion. I think she’s a good candidate. So what possible surgery
would we recommend? I don’t know, I think in both eyes, and lateral rectus
maybe in one eye, emelial in both eyes Or an Infer.
Oblique correction. Maybe a transposition? Yeah maybe we can do a transposition
like the other one right? But a lot of surgery you know? (Spanish)
One, two, three, four, five. Yeah so I think we have a plan for her – maybe we do her here
just because it’s a long operation, longer, since we only have two
on the plane let’s do her tomorrow. As well as hindering their vision, strabismus sufferers are often treated as less-intelligent, teased
and ostracized. Dr. Fredrick explains the benefit
of treating blindness to the wider community. Vision should be a sacrosanct right
that every patient should have. Every individual should be able to see. But if you look at it from the cold hard facts
of economics and pragmatism, there’s limited amount of resources
to take care of health problems, whether they be ocular or cardiac,
pulmonary, what have you. I think that when you look at the value that you’re adding,
not just to the quality of their life but being able for a patient now
to take care of their themselves, to take care of their family members
and take care of other loved ones, the investment of resources
into restoring vision is going to prove to be one
of the greatest values that we as a world can invest in in determining
where healthcare dollars should go. When we make people see better
they’ll be less of a drag on the economy, the economy will get better
and that’s been actually clearly shown – I’m lucky to work at the graduate
school of business at Stanford – where they’ve clearly shown
that if you give kids glasses the economy of that city
improves over a 3 year time period – it’s something
that seems like a no-brainer. Think about what the difference will be
when you not just give kids glasses but you take away blindness
from large percentages of the population where you have dependent individuals
who can’t care for themselves or others. There are only
a limited number of spaces available and Camilla
is still waiting outside. There are many other little girls and boys,
with a similar condition. Luckily though,
she’s already made a friend. This is Francheska, one year older
and also hoping for an operation. While Dr. Fredrick does his best
to entertain his little patients, Dr. James Lehmann examines
elderly patients blinded by cataracts. Peru has an unusually high incidence
of blindness in people over 50 years of age – due mainly to the increased UV levels
found in the high altitudes of the Andes. Being elderly and blind in a bustling city
or in a high mountain village must be both frightening
and life threatening. It’s incredible to think
that 80% of impaired vision is either preventable or easily fixed. This is Hortensia. She has cataracts. Her husband’s sight
is even worse than hers. Blindness affects so much more
than the sight of the individual. The blind become
a burden on the family. They can no longer work
or contribute in income. When one person is blind
the whole family suffers. In the case of cataracts the surgery
is relatively easy to perform. And has life changing benefits
for the entire community. 20 / 800 in the right eye, and 20 / 100 in the left eye, so pretty terrible vision. Pretty terrible vision so,
she wears thick glasses because as her cataracts
have gotten worse it makes her more
and more near-sighted. (Spanish)
Ma’am, how old are you? (Spanish)
72. Ok, 72, she’s 72 years old. (Spanish)
Why did you wait so long? (Spanish)
They told me
the operation was expensive, I couldn’t…
then my vision got worse and worse. So she put up with it
because it was expensive and then finally she got to a point
where she doesn’t want to…, she says it definitely needs to be fixed. (Spanish)
Camilla look, who is this? What’s her name? And finally
it’s Camilla’s turn to be assessed. Dora And her friend?
– Monkey! Monkey. Look, look, look… So, not much deviation, yeah… but up close… she does have deviation. (Spanish)
Look this way, look, look, look… So she’s measuring about 15. At first she was measuring less, so… …first you want to make sure
that her refraction is correct because this is a year old, about. It means, I’ll bet you
she has more hyper-corrections, so let’s do this,
let’s give her some drops today and have her come back
– so she’s on the waiting list. (Spanish)
Here you go, for you.
– Thank you. You’re welcome, ok. To better diagnose Camilla,
Dr. Fredrick asked the nurses to administer special eye-drops
which will dilate her pupils. He needs to be sure that whomever
he puts forward for an operation is the best possible candidate. Sometimes the mission
is a little complicated to figure out who the best patient is. If they see well in one eye,
and they don’t see well in the other eye… it’s better
if they don’t see well in both eyes because then you’re really helping
their quality of life. For example this lady
does not see well in either eye that’s why she’s a good candidate. You also don’t want to just pick
the hardest cases because you’re training folks – they’re just beginning
and they don’t want to have the hardest cases. Let’s just wait and see.
Put him on hold about whether we’ll do him or not
– so we’ll see some others. So he’s on standby. Doing cataract surgery on him is worthwhile but he won’t have quite the improvement
in his quality of life and vision that somebody else would, so it’s one of those decisions you kinda
have to weigh the pros and cons of – he’ll have surgery here later but we’re
probably going to pass on him – he’s not the greatest teaching case and
plus that question of improving the vision. (Spanish)
Open, open, open.
A little bit more. Well done. Open again a bit. Well done. For some patients
the journey has been worth it. For others the IRO will have
to get to their children later. And in some cases
treatment may not be necessary. (Spanish)
Look this way… well done It’s a pretty big deviation. Again, she’s trying
to accommodate but she can’t. But she can still converge just fine. (Spanish)
Look this way. Look this way, Well done, well done. So this is one of those situations where without the glasses she’s really crossed, so with the glasses she’s a lot better. so if you were to do a procedure the goal of the procedure
would be to try and get her to a point where she could fuse right? Right now with a 15 diopter
she can’t have any fusion. So what do you think we should do? Do the surgery. Do the surgery, ok good. Is this something Mom wants? (Spanish)
Do you want this for the girl? Yes. One more sticker?
She’s falling asleep. You like Diego?
We’re going to fix that afterwards yeah. Camilla has made the list.
It’s great news. She will be getting surgery
on both of her eyes. Meanwhile back at the airport
the plane is ready for passengers. The stairs are a little steep
because we’ve had to attach them here – they don’t have an airplane this big, this is the biggest airplane
that’s ever been here. Now, it may look like
a regular passenger jet from the outside but on the inside
it’s a total hospital make-over. It contains a 48 seat classroom, an audio visual room, the laser treatment room, operating theater, sub-sterile room and recovery beds
for pre- and post-op patients. …oh yes, it was a commercial for 20 years,
and then when we got it in 1993… In the theatre
an operation is underway. There is something again
unique about this facility here – Kaia, that’s where
they’re actually doing the surgery. This is the OR now. – he is now, what he’s doing is outside
the eye itself, outside the eyeball but despite this we can still take the video
and transmit to the classroom. This, because we have cameras
fixed to the ceiling here. Students in the front of the plane can watch
the operation as it happens, they can take notes, they can even ask
the surgeon questions while they operate. It is a training institute. In order to show the best practice
you have to have your own facility where you work as a team to show the standards, because yes you can
do a program in the hospital but you are not
in control of many factors. Here, it is our hospital
– we have our own team, and we can show what it takes
to deliver the best care. It’s a self-contained
state-of-the-art facility. The idea started
with a group of ophthalmologists who were really interested
in teaching doctors in other countries how to deliver the best practice and how to deliver
quality eye care to their people. It is difficult to get people to travel
to have their training in countries like the States or the UK
where you need a visa you need credentials,
you need a license to practice. The idea was actually to get the trainer to go to the trainees
in their own hospital, in their own environment,
with their own patient, with their own resources and do the training
in their own hospital and I think this is
a very good idea for two reasons – first to overcome all the challenges
I mentioned before about getting them to travel, but also, it is very specific
to where they work so we are realistic
and it is more sustainable this way. Oh, three little girls
and three little bears… Overnight the patients
are instructed not to eat anything. For this reason
the kids are first up at the IRO. – And what about this one?
– Who is this? We call him Goofy. The little girls chosen
from screening day are bouncing around
in the waiting room. This is the moment
my daughter Kaia has been waiting for. (Spanish)
The right one. There are four little pink girls in total. The first girl Dayana is already in surgery. Her mother is understandably distraught and Orbis staff
do their best to comfort her. (Spanish)
I’d like to say,
it’s normal to be worried, but there’s nothing you can do. The teddy bear
is an Orbis tradition all over the world. It seems to work just as well
for the moms as for the patients. The mommies are a little
more nervous than the babies, but… they seem pretty relaxed
which is good. A hospital with all its strange noises,
machines and masked people is an intimidating place. – even more so
if you’re not from a modern city. These parents are putting
everything they have into the hands
of the doctors and nurses. And I am too in a way, I’m about to witness
my very first eye surgery. Ok, let’s do it. – I’ll go scrub up.
– Let’s rock and roll. I’ve never watched an operation before, and I really never thought I would. – once I get over the initial shock… and with a bit of explanation about what the surgeons
are actually doing, it is pretty incredible. … the muscle is suspended
on this suture, you see like a man
hanging from a trapeze and what we’re going to do
is we’re going to suture it back, reposition it further back on the eye
so it can’t tug the eye in as much – because there’s another muscle
over here that pulls the eye out, so this just rebalances
the alignment of the eye. So when you reattach it
you are stitching it to the actual eyeball. Yeah, he does partial thickness
to the wall of the eye to reattach it back. – You’re doing good!
– I am yeah, I don’t feel queasy. So, Manuel has beautiful technique and again it’s just knowing
really what to do, a few little hints, so when I leave I know that these children
are going to be in good hands. It’s true. One reason Orbis
also does surgeries at local hospitals is to train their residents
with the tools they have at hand. It’s no use working
with instruments and machines that disappear once the mission is over. Perfect is the enemy of good. You want to do surgery safe and well
but you don’t want perfection, because perfection, the longer you kinda
fiddle with something during surgery the higher the chance
of having a problem. It is more difficult
to operate in another country, you don’t realize that the operating room,
the instruments are different so you do what you do at home and
you try to do it as well as you do here. You go slowly, methodically and you teach
the folks up as much as you can teach them but you don’t try to change everything. For example you work with
the instruments that they have, you use everything that they have
so they can continue to do it when you’re gone. It may not be perfect but if
you’re too much of a perfectionist you probably wouldn’t want to do
stuff in the developing world. Orbis has a saying and it is
apparent in everything they do: “We are not here to show off,
we are here to show how.” The doctors, in any country, are the same
as doctors in any country in the world – we all want you know
to minimize the burden of disease and it’s just a matter
of trying to be resourceful. Use the other way,
turn it over, perfect. You know strabismus, or crossed eyes, although it often
doesn’t lead to vision impairment – it’s a debilitating condition
– you can imagine as a child… well anybody
because it’s such a social thing where you look someone in the eye
and I think if people don’t know
where to look then… Yeah, it’s a huge stigma. They can’t get jobs, people think
that their intelligence is not as great. About half the blindness in the world is pediatric blindness so teaching the doctors here
to fix this early, it’s really valuable, it’s going to give people
years of productive vision and productive living
and not have to be dependent. Like, at this age did she even understand
that her eyes were different, like, is she excited
to be having this surgery? Does she know that…
has she gotten teased yet? She doesn’t get teased,
so kids are nice until around the age of 7
and that’s when kids get mean. One of the challenges
of working with children is the children really could
care less about their conditions – the parents care deeply so you know that what you’re doing
is really making an investment the kids eventually understand
why you did what you did and they are very happy for it – the parents know right away. Like all pediatric specialties, you’re
treating the parent as well as the child. Perfect, well done, beautiful, good. Would like me, you know,
to dab your brow? Then he’ll start sweating. And just as I’m feeling confident,
I start feeling a bit weak in the knees. I’m going to step out
for one minute so I don’t get a little… I’m fine, I just need a little… Oh well I’m still a rookie. Well I think what’s incredible also is
they just kind of man-handle the tissue. Like, that way that
he’s poking the worm out… I mean they had that thing
that looked like a dental tool… I get a second wind and I really
want to see the end of Dayana’s surgery. I was just feeling
a little queasy for a minute. Yeah, that’s normal. Is this the same muscle that you are just
now finishing up? So this is a new one. So this is the last one
so we’re on the home stretch here. This is the outer one.
The one that pulls the eye out. So in order to make it stronger
we cut a piece of it out, so it’s like taking a rubber band
and shortening the rubber band, you know, if you shorten the rubber band
it’s going to be harder to stretch it out so it’s going to have more force. The surgery takes about 3 hours. Five muscles have been adjusted in all. There’s very little rest for the staff. As Dayana is taken into recovery,
Camilla is prepared for her surgery. Our little patients
have been fasting since yesterday. Some of the staff have developed some
unique ways to keep their minds off food. She seems to be a natural with them, the three triplets,
these little girls could be sisters. and probably when the fourth was in,
they all looked the same – they’re so sweet. Kaia has just loved
spending time with the girls. And I really feel for the mothers. It’s so tough
watching your child in pain. The doctors have told me that tomorrow these little girls will see the world
in a whole new way. I can’t really believe it.
I guess I’ll have to see for myself. – Is this Hortensia?
– This is Hortensia yeah, she’s going to be
the last surgery of the day. (Spanish)
Hello, nice to see you. Hi how are you?
Your daughter, oh it’s your niece. (Spanish)
Thank you for being here.
It’s what I want most, my vision to improve. I’ve been able to watch
some of the work they do and it’s just incredible,
you’re in good hands. (Spanish)
I had a good feeling since the screening day,
the doctors gave me hope. I thought, I thank God, I was really
hoping to be chosen for surgery. Well good luck. I still can’t get over the fact
that many of the staff are volunteers. What motivates them to spend their holidays
doing the same thing they do back home. Why is it so different? Most of us want to do it because we realize
that it’s gratifying, fulfilling work, that’s serving a greater goal
of helping somebody with a condition. Make them feel better.
Restore their potential. And that’s what every single one of us
wants to do when we go to medical school. And you go through medical school
which is four years, and then you through residency training
which is anywhere from 4 to 10 more years, and then you get out
and you get involved in private practice and then the pressures of being not just
a physician but someone’s partner,
a father, a mother, a business person – all these pressures are added on and you can sometimes forget
what motivated you in the first place. When you come on an Orbis trip your only job is to try
to make people feel better and help other people learn
how to make them feel better. It’s invigorating and restorative. In the waiting room
it is Hortensia’s turn for her operation. It might be a big day for her
in terms of undergoing surgery. But take into account
she has never been on a plane before. Compared to
the complexity of strabismus cases, cataract surgery has been refined
to a relatively simple 15 minute operation. …the front of the eye, it is clear. It is exactly
like the glass of my watch right? Behind it we have the iris
and then comes the lens. The lens is still clear. It has to be clear for us to see because the light is coming
all the way across from here. to the back of the eye. The cataract happens when this part
which is crystal clear becomes cloudy, white and that’s when the patient stops to see
with the eye and we have to remove it. We go through a small hole here
and we open this lens, we suck the contents out,
and we put a new lens in the eye. And then right away they can see? Right away – 6/6 vision, yes. While Hortensia is in surgery, Kaia and I are given a crash course
in surgical technique. Ok, I would blind somebody. Go a little bit deeper, exactly… Excellent. Good, look at you! Hold it like a pen. All movement is coming from your wrist. This task is just about
how you control your depth inside the eye without touching other structures
that you are not interested in. When you complete this task
you will be able to tell where exactly in the eye
you want to be, where is the depth,
and what to touch and what not to touch. This is a step to prepare you
to go for actual cataract surgery. Well done, perfecto! Thankfully for the patients
our journey into surgery stops there, and for the time being at least,
so does Hortensia’s. The following day, patients
return to the IRO for check-ups. Our little girls have removed
their patches overnight. (Spanish)
What is the name of this princess? Princesa Sofia For some recovery is very quick. Can you see how the light reflects? Can you see
how the lights is shining in their eyes? Yeah. Can you see how the light is
in the middle of both eyes? Before it was way turned in, so in other words you know if you look
at my eyes and see how it’s crossed and see how the light in is the middle? So when we teach parents
how to look for crossed eyes, that’s an easy way to do it.
Her alignment is excellent. We can see that there’s a little
bit of redness on the inside, that’s where we were working on.
– Right. That’s that filmy material
and that will heal up. Within a week it’ll be
almost, almost white again. Camilla has bounced
right back to her cheeky self. I did one side and our trainee did
the other side again… and so… Yay, good job! …and both eyes were straight. The chance of her needing another operation
is very low. And the chance of her not needing
glasses when she’s 8, 9, 10 – she’ll have grown out, grown
out of her glasses by then. That’s great.
A distant memory, that’s great. Sitting and watching someone
recover their sight is astounding, something so simple
that we all take for granted. This 13 year old became so blind
that he stopped going to school. My very first Orbis mission
was into Burma. And our job
was to teach pediatric cataracts. Cataracts can occur in children. And there was a patient there – in the old days we had not just numbers
but people would get nicknames and he always came in in green pajamas,
so we called him “greenpants”. He had cataracts in both eyes,
so we had to do surgery on both eyes. And the surgery went well. And I was lucky enough to go back to Burma
the next year on the second Orbis trip. The father brought the boy back
and he was seeing, he was now about 2 years old, he was running around and playing with toys
and other kids just like every other kid. The father had carved
this wood carving of a hand holding an eye and he said: “I want you to have this because
your hands helped our child to see and want you to remember us
– and it says on the back “from greenpants” – so, I remember that and I think how even though I only helped
one individual on that day it changed that little boy’s life,
that family’s life. When you have an opportunity
for that to happen in your life, you can’t help
but be permanently affected so, even though I’ve changed jobs,
I’ve taught at lots of places, Stanford, UCSF and Dartmouth – who knows where I’ll be
in another five years but I know that
I’ll always be coming back to Orbis. Francheska is resisting Dr Fredrick’s efforts
to check the results of the operation. (Spanish)
… no? A little bit?
Please, real quick ok? Not much. Look here what is this? Sofia. Sofia yes well done! Is it possible to try just a little bit?
It won’t hurt. – well done! So the goop kind of welds the eye shut and so that’s why
we have a hard time opening them. Maybe a tissue…? It won’t hurt.
Perfect love. Clean it. … open your eye more. Won’t you try for me?
Open both. I don’t want to. I’ll help you a bit ok? Just once ok? Try…? If you do,
I’ll give you a sweet. Well done. Well done. Just a bit you see it doesn’t hurt. Well done, look at the light. Hi honey, how are you?
Good girl. Just a bit more ok? Look at the light. So again see,
look how the light reflects, it’s centered within both eyes,
and before… ok good so we always check and make sure that she sleeps ok
and that she’s eating right… Now I know why these guys do it for free. Thank you! The joy in people’s faces, the sheer relief of the parents
as they walk towards an entirely different future is – pardon my American
– totally awesome. This is for you, it’s your friend. Back in the village of Otuzco, high in the mountains,
Camilla is home again. Clearly her depth perception
is in full working order as she uses the beds as trampolines. (Spanish)
She’s doing great. It’s an opportunity that we have had,
to be able to operate on our girl. Look at yourself in the mirror. Look at those beautiful eyes,
aren’t they? Aren’t they? You are beautiful. On the day of her return
there is another festival. When we first met Camilla
it was the festival of the mothers, and now incredibly
it is the festival of the children. And, it might even be more spectacular and more colourful
than the mother’s festival, if that’s even possible. Well I was invited to come and visit first-hand
the Orbis flying eye Hospital and I’ve got to do a lot of amazing things
over the years but honestly I think
this trip and this experience, is definitely the highlight. You know the plane is cool
and it’s impressive but it’s almost symbolic. I think
the real work is the community outreach and they’re just travelling
around the world helping people and not just helping people
and then leaving but really committing to the communities
where they’re doing the work, and teaching and leaving something behind. It kinda puts you in your place. It is an explosion for the sense
we perhaps hold most valuable. Our own window on the world. Now open again for so many people who had perhaps silently drawn the curtains and resigned themselves
to a life in the shadows. But it is more than sight that has been
recovered for these patients and families. Doctor Fredrick did a good job teaching us. I think we’re going to help
more people actually. Through their work
Orbis has rebalanced the playing field, evened the equation and given these children fresh opportunities
to take on the challenge of life. To grow, to learn new things, find passions, find a job, and even find a partner. It’s what we all want for our children.
I know it’s what I want for Kaia. A chance to shine.
A chance to blossom. In Africa, Asia, the Middle East
and here in Peru. The hospital in the sky transforms
the lives of all those who come onboard. Even Kaia and I are not the same. The volunteers, the staff and the patients
have reminded us that our lives are not measured
by what we accumulate, but by what we give.

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