Fresh off a project in Cameroon, the Orbis Flying Eye Hospital paid a special visit to the San Francisco Bay Area for fundraising activities and a resupply before spending the holidays in Arizona for maintenance and its next project in Peru. Medgadget was given a private tour and got a close look at everything from the cockpit to the converted cargo hold below.
Our tour began as we approached the massive mobile hospital, which was parked on the tarmac at Moffett Federal Airfield in Mountain View, CA. A McDonnell Douglas model MD-10, this plane had previously served as a cargo transport plane for FedEx. FedEx not only generously donated the plane, but also provides the volunteer pilots and maintenance technicians, jet fuel, and its logistics services to ensure that the plane is always equipped and ready for a project. Compared to the previous Flying Eye Hospital, this third-generation hospital can fly twice as far, requires only two pilots instead of three, and is equipped with the latest ophthalmological technology that some teaching hospitals on the ground might not even have. The rooms are also designed as separate, removable modules, which, from an FAA perspective, are actually “shipped” as cargo from country to country, eliminating the need to certify medical items for flight.
Step into the front of the plane as you reach the top of the stairway, and it looks a lot like a regular jet; to your left is a standard looking cockpit, and as you walk to your right, you walk through several rows of brightly-colored passenger seats. But this isn’t Orbis’ economy class; this is the Flying Eye Hospital’s classroom. Nearly every day, local eye doctors and staff can board the plane and watch and interact as surgical procedures are broadcast live from the other end of the plane to a television monitor in the front of the classroom. The monitor is 3D-capable, so attendees can don 3D glasses to get a better idea of the depth required to perform these delicate procedures. The training isn’t restricted to the local doctors, however. Orbis has developed a special telemedicine education platform called “Cybersight” where eye health professionals can join and view the procedures live and on-demand from anywhere. They can collaborate with other eye health professionals or Orbis volunteer faculty, and can even use a cardboard VR viewer or VR headset to get a similar 3D experience as the in-person attendees. In case you’re curious, the classroom also acts as a traditional passenger compartment while the plane is actually flying; no procedures are done while the plane is in the air, and the rest of the plane is closed off and locked.
Our next stop was a large room that serves many different functions. On the left side were several state-of-the-art simulators to train on how to perform a variety of ophthalmological procedures. From basic eye examination techniques to delicate procedures inside the eye to cauterize blood vessels, these simulators can train users on many different skills and even throw in a challenging, unique scenario from their databases of cases. It was a reminder that the Flying Eye Hospital is first a teaching hospital; Orbis doesn’t focus on the quantity of procedures they can perform, but rather the types of procedures that will be most useful for the local doctors to experience to bring back to their clinics. The right half of the observation room had windows that looked into the adjacent operating room and also contained various optical and ophthalmological diagnostic devices that you might find in a doctor’s office. Some of the devices also had medical lasers attached that allow doctors to perform less-invasive procedures without the use of the operating room. Finally, the staff shared that the observation room is frequently turned into a makeshift waiting room for families of children undergoing surgery; one of the nurses proudly showed me the collection of DVDs for the kids to watch on one of the room’s monitors.
Next, we stepped into the hospital’s operating room. Though the room was significantly smaller than a typical OR, it was packed with some of the most advanced eye surgery equipment currently on the market. The entire room was wired with cameras, and microscopes were fitted with 3D cameras so those in the classroom or online could observe a surgery. Tucked away in one corner were the latest cataract surgery laser systems from Alcon. We couldn’t imagine how cozy and cramped this OR could get when real procedures were taking place, but the clinical staff shared that their close camaraderie helped things to flow like a well-trained orchestra. And despite the heavy use of all the equipment, as well as the movements of the plane itself, the staff said that the equipment hasn’t needed any more maintenance or repair than normal; there’s only been one instance where some turbulence slightly damaged a lighting fixture.
Just behind the OR was the pre-op and recovery room which was large enough to accommodate several beds, as well as vital signs monitors and rescue equipment. During our visit, this room and much of the plane was littered with boxes of medical supplies being counted and unpacked by the international crew. They shared that a full time staff member’s career with Orbis tends to average around 2-3 years. While it undoubtedly can be a difficult lifestyle being away from family for extended periods of time, you wouldn’t be able to tell from their big smiles and constant sharing of stories of some of the lives that were changed. And while most of the staff that I met were full-time, Orbis also relies on the help of volunteers for numerous medical and technical functions.
Our final stop on our tour was the underbelly of the plane where much of the behind-the-scenes action takes place. As we descended down a ladder hidden in what could be mistaken for an office closet, we entered a cargo hold and maintenance office area. While in flight, this chamber houses the generators, batteries, HVAC systems, and other equipment; once on the ground, the equipment is unloaded and set up on the tarmac next to the plane. The maintenance staff shared that all medical gases are produced on site, the generators run on jet fuel, and water can be sourced locally and filtered, so the plane really only needs jet fuel and water to function as a hospital for its 3-4 week stay. One section of the cargo hold also contained medical supplies and equipment for the local hospitals to use. We learned that while Orbis ideally seeks to train doctors using newer and safer techniques and equipment, some areas are so poor that they sometimes can only train using the limited basic tools and resources these doctors already have in their clinics.
While the Flying Eye Hospital is an impressive and iconic facility for Orbis, it only represents 25% of their business. Their other work includes hospital-based training programs, community outreach, advocacy programs for increased awareness of eye disease, and online education through their Cybersight platform. Even a potential Flying Hospital project takes about a year of planning and partnership forming before the plane touches down in-country, and the work continues long after the Flying Hospital has departed for its next destination. It is these key partnerships that Orbis says makes their business model work and has kept them airborne (pun intended) since 1973.
Every year, Orbis operates the Flying Eye Hospital for 15-18 weeks in about five different countries. None of the projects would be possible without the support of generous donors and volunteers. If you want to help contribute to Orbis’ mission to transform lives through access to quality eye health this holiday season, visit their website to learn more and give financially or sign up to volunteer.
We had a great time and would like to thank the Orbis team for the tour and wish them success and safe travels in the coming year!