Orbis Flying Eye Hospital

Did you know that 75% of the world’s blindness can be cured, and 89% of those cases occur in low to middle income countries? The Orbis Flying Eye Hospital works to decrease preventable and curable incidents of blindness with its mobile operating room and teaching facility.

The Orbis Flying Eye Hospital started in 1982 with a DC-8 plane that flew to locations around the globe that are in desperate need of basic eye treatment for preventable and curable conditions. Now, Orbis boasts an MD-10 outfitted with an operation room that can be set up and sterilized in 6-7 hours, and that can serve as a teaching hospital for doctors to learn procedures that they can implement in their own communities.

This week we interview Dr. Hunter Cherwek, who joined Orbis as soon as he completed medical school and hasn’t looked back since. He calls the plane “an engineering masterpiece both in healthcare and training and teaching.” And at the end of each day, Cherwek knows that his work with Orbis is making a difference.

Transcript after the player.

Did you know that the Museum offers special tactile tours for individuals with vision impairments? Get more information here.

Producer: Keny Dutton
Host: Sean Mobley
Webmaster: Layne Benofsky
Content Marketing Manager: Irene Jagla

Episode Transcript

SEAN MOBLEY:       Hello, and welcome to The Flight Deck. The Podcast of the Museum of Flight in Seattle, Washington. I am your host, Sean Mobley. The Museum of Flight hosts many interesting people and organizations every month for programs or outreach, but one of the most unique I’ve seen here is Orbis International—an entire eye hospital contained inside a McDonnell Douglas MD-10 converted jet airliner. Orbis flies their plane all around the world to developing countries not just performing surgeries to treat preventable blindness, but, more importantly, teaching the local medical communities the skills to perform the surgeries themselves so that blindness can be prevented long after the flying hospital leaves. During Orbis’ stay at the Museum of Flight, I sat down with Dr. Hunter Cherwek, Orbis’ Deputy Chief of Clinical Services, to learn more about their mission and how one special 45-year-old airplane is changing lives all across the world.

SM:     Hunter, thank you so much for joining me today.

HC:     Yeah, no, it’s great to be here. Our plane is here. We want to thank you for giving us a home and giving our plane a home until we take off for Mongolia in early August, and we’ll be spending the rest of the month there working with our partners, both with pediatric ophthalmology and adult ophthalmology.

SM:     So let’s just take a quick step back because I don’t think a lot of people know the difference between an optometrist and ophthalmologist.

00:01:53

HC:     Sure.

SM:     Do you mind explaining a little bit about that?

HC:     And at Orbis we work with both, so we have volunteer optometrists as well as volunteer ophthalmologists. Ophthalmologists go through a traditional med school and then do more surgical eye care; optometrists go to an optometry school. They are also doctors. They focus on refractive error and glasses and medical treatment of the eye.

SM:     What does Orbis do?

HC:     Orbis is a non-government, non-profit organization that works with local partners in low- to middle-income countries to treat and prevent blindness.

SM:     How did you get connected with this? I saw that you joined almost immediately out of med school.

HC:     Sure. Yes, I finished my residency and that night flew commercially to join Orbis, and the plane at the time was in Western China. Orbis has really grown since we first took off in 1982 with a DC-8 plane. The plane on your tarmac today is a third generation MD-10 plane. What’s been exciting is as we’ve grown the planes, we’ve also grown the program so that we now have permanent offices throughout the world; we’ve built children’s eye hospitals; we have many, many surgical programs that take place without the plane every week of the year.

SM:     You mentioned preventable blindness.

HC:     Sure.

SM:     So what are some examples of preventable blindness?

00:03:15

HC:     Absolutely. Some nutritional problems or diabetes; things like cataract—which, with the proper access to surgical care, their sight can be restored.

SM:     About what percentage of the population who go blind have some form of preventable blindness?

HC:     That’s a great question. So 80%--eight zero—80% of the world’s blindness can be prevented or cured and 90% of that blindness is in low- to middle-income countries and that’s where we focus.

SM:     So we’ve kind of hinted a little bit about the plane.

00:03:47

HC:     Yes.

SM:     Why don’t you talk a little bit about what the plane is?

HC:     The plane is really an engineering masterpiece, both in healthcare as well as in training and teaching. It is a US accredited hospital. It’s an ambulatory surgery center. We do not have in-patients—no one sleeps on the plane overnight—that travels the world doing eye surgeries, not just to help the patients but to train and work with the partner physicians in those countries to exchange skills and upscale their ability to treat blinding conditions in their country. It is also a broadcast studio. All the lectures and surgeries are recorded; they can be edited and put on our telemedicine distance learning website, called Cybersight—cybersight.org—which provides materials for doctors, nurses, and community eye-health workers to treat blindness in their communities.

SM:     So that’s where the term “flying hospital” comes from?

HC:     Correct. Now, we do not operate in flight. So when we fly, all the sensitive medical equipment is put in protective cases. It is latched to points on the floor like cargo, but when we land, the entire team rolls up their sleeves and, for six or seven hours, sets up the hospital, unpacks the sensitive medical equipment, and then cleans and sterilizes the OR.

SM:     You have some pretty sophisticated top-of-the-line stuff.

HC:     Absolutely. Our goal is to provide the highest level of eye care no matter where we are in the world, but we’re also able to adjust the technology for what is appropriate, sustainable, and transferrable in that country. So before we ever land the plane, we spend about a year working with the partner hospitals understanding their needs; understanding the local healthcare systems; and adjusting the technology so that we teach what is appropriate for them at this time to help their patients.

00:05:39

SM:     You just kind of came to my next question. I think what’s unique about Orbis is you don’t just come to do surgeries and leave, you teach the doctors there how to do it but then you have the top-of-the-line equipment, how do they keep doing it?

HC:     Absolutely. And that’s all about planning and we actually have a team of ophthalmologists, nurses, anesthesiologists, and the last one’s the most important—the biomedical engineers that look at all the clinical equipment, one year before the plane lands, to assess what technologies are appropriate and sustainable in that country. For example, we can teach cataract surgery that does not use electricity for the really low-resourced countries but then also we can teach in the middle-income countries the most advanced technologies that they want to learn. Now, our goal is to always push our partners to best practices and look at what is currently available and achievable and built off a five- or ten-year program to help them get there.

00:06:39

SM:     You talk about the technology evolving so quickly. It makes you kind of imagine if you are a person, especially a low-income country—and you have never seen for your whole life or maybe haven’t seen for much, and you have this surgery and now you’re able to see and you wake up in this state-of-the-art hospital. It must be quite a reaction you get from—

HC:     Certainly. We have patients who haven’t seen for literally a decade and they’ll come on the Orbis plane and they’ll be surrounded by funny looking people like me wearing masks and speaking a language they don’t understand, and that’s why we always have translators. We have an incredible nursing team who are incredibly compassionate; they take such good care—not just of the patients, but their family members. One of the things we have as a rule is every patient must come with a family member—not only to provide support but also to help go with them when they go back on the ambulance to the local hospital to be discharged.

SM:     Let’s shift to the plane a little bit.

HC:     Yeah, yeah.

SM:     It must be quite a logistical challenge to move an MD-10 anywhere in the world?

HC:     Well, absolutely, but we have great aviation partners—we’ve got companies like Boeing, UTC Aerospace, FedEx—that all of these giants in their field want to see us succeed and they provide not just their technology, they provide their talent; their engineers; their design teams to help us overcome those challenges. So, certainly, the concept of flying a hospital around the world, especially to low-resource places, it sounds not even achievable but yet we’ve been doing it since 1982. So, for me, that’s very exciting that we have such great corporate sponsors like FedEx and United and Boeing and UTC Aerospace, but what really is incredible are the pilots and the people that they bring out to help us and help us get over these challenges when we’re designing something or we need to go for hospital maintenance or an aircraft maintenance, like a B check or a C check.

00:08:33

SM:     Right. And you just got this current plane pretty recently?

HC:     Correct. The thing that’s exciting is that this plane, the DC-10, was an integrated hospital where the hospital is part of the plane which to make any change or modification was a big deal and would have to take a lot of regulatory approvals. The interesting thing about this plane is we made it modular and that it’s actually cargo, so we can pull out the hospital, do modifications, and put it back into the plane and obviously we do this with, you know, every person onboard has backgrounds in medical safety, flight safety, engineering—all of these things—to make sure that anything we do, the hospital is the best for our patients and anything we do to the plane is best for the passengers.

00:09:20

SM:     Where have you, personally, traveled with this plane?

HC:     I’m really excited that just in the last—less than a year—we’ve gone to Bangladesh; we’ve been to Peru, and what really makes me excited is going to Mongolia next month and then also going to Ethiopia. Those are two very special countries for me. In Ethiopia the plane is landing to celebrate world sight day but also to celebrate 20 years of our office being in Ethiopia, working day-in-and-day-out with our partners throughout the country, not just at the airport.

SM:     Because besides the plane you have offices in—

HC:     Absolutely.

SM:     . . . it looks like about a dozen countries or so.

HC:     Yes, you’ve done your research exactly right.

SM:     With all this travel, I do understand that you, personally, can be a bit of a puzzle to some of the border security agents?

HC:     Yes, certainly. People look at my passport and try to figure out who I am and what I do and then when I tell them that I’m this plane hospital that goes around the world, I think they look at me kind of funny like maybe I have had too many drinks on my flight or something like that. I can tell you that when you start talking to the airport officials, and then they hear about Orbis, they’re mesmerized. And it always is shocking to me how much I travel and work with these thought leaders in aviation and how few of them even know that Orbis exists.

SM:     Are there any stories that come to mind that just really resonate with you?

00:10:42

HC:     I mean, every patient who comes on board that plane is a miracle and having someone who has not seen for 10 years take the patch off and see a family member—whether it’s a child or a brother or sister— for the first time it’s pretty powerful. You don’t get tired of seeing miracles. For me, I would tell you that one of the things that I’ve really appreciated is how quickly people now can recover from cataract surgery. We had a patient who had not left their house in over 10 years and really could barely see a light in front of their eyes. They couldn’t count fingers; they couldn’t see the hand waiving in front of their faces. They could barely see a flashlight, whether or not the flashlight was on or off. And the next day they were seeing 20/40 with less than 24 hours of surgery and they were getting better with each hour. And the tears of joy that they wanted to rub their eyes and see it better and I’m, like, no, no, no. Don’t rub your eye; you need to heal another few days. But they had never seen a TV and so they were watching Mr. Bean—I don’t know if you know, it’s a British comedian who does physical comedy. He doesn’t say anything so it doesn’t need translation. And the funniest thing was they had never seen a TV before; by 20 minutes they were laughing and we had the ambulance ready to take them from the airport back to the local hospital, and they didn’t want to get in the ambulance because they wanted to see how the movie ended. So it is funny that you see all these amazing miracles and then you touch these people’s lives and their families’ lives and you leave work, even after working for 14 hours, with a smile and a story every day at Orbis.

00:12:16

SM:     Do you have any thoughts before we wrap up here?

HC:     No, I just want to thank you guys. You know, we all live out of—the Orbis team—lives out of a suitcase a lot of the time and we don’t always get a home and your museum and your team have volunteered every day to help us whether it’s cleaning the plane or helping the people that come for the festivals or the tours, you guys have really stepped it up. This is an incredibly special museum and it has really special people, and I just want to thank you for that.

SM:     Well, thank you. I hope you enjoy the rest of your visit.

SEAN MOBLEY:       Thank you for joining me today on The Flight Deck—the podcast of the Museum of Flight in Seattle, Washington. As you hear this, Orbis has already left the museum, but you can learn more about their organization at their website, orbis.org; that’s orbis.org. The Museum of Flight is committed to accessibility at our own museum and you can learn more about our tactile tours for visitors with low or no vision in this episode’s Show Notes. And while you can’t take a tour of the inside of the MD-10 flying hospital, in the aviation pavilion we have five different commercial jet airlines that you can walk around inside. If you like what you heard, please subscribe to The Flight Deck to stay up to date on our episode. And please also rate and review us on Apple Podcasts or wherever you downloaded us from. Thank you to listener Jim94539 for leaving a five-star review on iTunes. We appreciate your feedback. You can e-mail the show at podcast@museumofflight.org and find more content at museumofflight.org/podcast. Until next time, this is your host, Sean Mobly, saying we’ll see you out there, folks.