• Public-Private Partnership marks 25th mission of U.S. kidney, cornea transplant team

    Dr. Jindal teaching the importance of noncommunicable diseases to a woman while one man watches and another photographs. (Image credit: Jan Pasternak)
    By Vivian Mason

    A celebrated theologian once asked: “Show me your hands. Do they have scars from giving?”
    If, indeed, that is the question, then for Dr. Rahul M. Jindal and the experienced U.S. kidney and cornea transplantation team, the answer has to be a resounding “yes!” Together, they provided free, life-altering renal and corneal transplant surgeries to patients in Guyana from 2008 to 2017.

    The team’s 25th mission in July of this year was especially significant. There was a record 62 corneal transplants successfully performed at Georgetown Public Hospital Corporation (GPHC) in Georgetown, Guyana, as well as several other eye procedures. Notably, throughout the various missions to Guyana, 34 kidney transplant operations have also been performed in addition to various pediatric heart surgeries to date. These critical procedures were complex, requiring well-organized teamwork and meticulous follow-up that were not available in Guyana before the intervention of the U.S. transplantation team.

    Dr. Joseph Pasternak conducts an eye exam on a patient whose head is resting on the bars for that purpose
    Dr. Joseph Pasternak conducts an eye exam. (Image credit: Jan Pasternak)

    Jindal, a professor with the Department of Surgery and Division of Global Health, School of Medicine (SOM), Uniformed Services University (USU), led the surgeries along with a team of professionals, including USU SOM alumnus Dr. Joseph Pasternak, an ophthalmologist and specialist in cataract, refractive, and corneal surgery at Walter Reed National Military Medical Center.  Dr. Stephen Waller, a retired Air Force colonel, USU alumnus, and professor in the SOM Department of Preventive Medicine and Biostatistics, was instrumental in procuring donations of human corneal tissues from U.S. eye banks. Two local ophthalmologists, as well as local nephrologists, operating room nurses, dialysis nurses, and an anesthesiologist, also supported the transplantation team. According to Dr. Jindal, local Guyana health care providers are now well trained to manage transplant and dialysis patients, so the visiting team is smaller.  “Over the next few years, our role will mainly be support via telemedicine,” he said.

    Media outlets in Guyana promoted the corneal transplant program’s mission and goals, which resulted in additional support from the community.

    Depending on the passage of legislation, Guyana may likely be able to conduct corneal transplants independently, harvest its own corneas, and establish an eye bank to eventually serve the entire Caribbean region of 15 countries to meet the needs of patients desperately in need of corneal transplants.

    Dr Jindal lectures to a small room of around ten people who are all holding sheets of paper
    Dr. Jindal lecturing at a community meeting. (Image credit: Jan Pasternak)

    Another very important part of the 25th milestone mission is the SEVAK Project (Sanitation and Health, Education in Village communities through improved Awareness and Knowledge of Prevention/Management of Diseases and Health Promotion). This project was initiated and maintained by retired Navy Captain (Dr.) Thakor G. Patel, first in India and then extended to Guyana. It is based on the U.S. Navy Independent Duty Corpsmen model wherein the SEVAK workers (local lay persons who live in the villages) actually educate people in their respective villages about basic healthcare services. Their training includes learning techniques for good sanitation practices, safe drinking water, smoking cessation, and malaria prevention. The SEVAK workers also monitor blood pressure/blood glucose, observe for fluid in the legs, emphasize lifestyle modifications, etc. The SEVAK project has been successfully extended to more than 24 communities in Guyana (approximately 5% of the population) and has screened more than 10,000 people.

    According to Jindal, “The PPP strategy is a win-win for both the U.S. and the host nation, and could be adopted by U.S. humanitarian agencies with minimal costs to the taxpayer. Our team has been able to sustain this program since 2008 by making incremental gains.”

    Success has been steady and shows that specialized surgical services can be sustained through training, commitment, teamwork, and support.

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