Volunteers' Week: A catch-up with Orbis trustee and volunteer Larry Benjamin

The Orbis Flying Eye Hospital may not be travelling, but its mission is still in flight. Over the pandemic, Larry Benjamin, Orbis medical volunteer for 17 years, delivered virtual surgical training to a team in Cameroon working closely with surgeon Dr Ted. The training focused on cataract surgery, the leading cause of preventable blindness worldwide using phacoemulsification, a modern cataract surgery method in which the eye’s internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. Larry said, “I can see down the microscope at what he is doing and talk live to him. It’s not quite the same as being there of course. You have to think ahead a lot more. But it worked well.”

The good WIFI connection meant Larry could see a clearer picture and interact in real time better but, as he explains, in order for this virtual surgery to work well, prior face to face training is a vital first step. “Dr Ted is operating on real people, which is what he does routinely. I am adding to his technique, I’m not teaching him from the beginning. You couldn’t use this method in real life surgery from the beginning. It’s just too remote. For this method you need to have done the basics live, and to have done some simulation training before, for it to work.”

Larry has also seen the benefits of virtual training in the UK when he recently delivered simulation training to students from the Royal College of Ophthalmologists using model eyes. While the majority of students were taught face to face, the two who could not attend were taught using portable microscopes via their phones. The pros of the virtual training are clear, “you don't have to travel, so it saves huge amounts of time. And I think it gives you instant access to things from around the world which you might not have access to otherwise. So, it's suddenly broadened everyone’s horizons.”

But with the technological advancements, Larry reminds us that a blended approach of face to face and have to supplement virtual training with online training as well. “There are facets to surgical training where if you're not there in the room it's much more difficult to take forward. How to do something simple - like putting a stitch in a tissue – is much more difficult to see and supervise from a detailed point of view remotely.” However, he does say that “once you’ve got the basics under your belt, I think there are sort of nuances and techniques that we can take further much more easily remotely.”

The blended approach also gives students the benefit of being able to practice more at home crucial for growing into a truly great surgeon. He says, “the kit you need is very expensive, but now we've got the portable ones that you can actually take home.”

Prior to the pandemic, the need for trained ophthalmologists was already outpacing the number of trained ophthalmologist, but virtual training has curtailed this, As Larry explains, “online teaching has become a really important part of them being able to continue their training, rather than putting everything on hold for a year.”

Larry had a message for Orbis UK volunteers and medical teams around the world:

“My message to teams around the world is to keep going. Hopefully things will get a bit easier and the Flying Eye Hospital will take off again soon and we'll get back to something a bit more akin to normal.

“You see people's true nature at times like this and the Orbis family has been remarkable. Thank you all and to Orbis for facilitating it all.”