Unlike most ophthalmologists, Keith Dahlhauser’s training was provided free of charge thanks to the U.S. Air Force, and the Cascade Eye & Skin Centers employee has been paying it forward ever since.
Following his training, Dahlhauser was stationed at the Madigan Army Medical Center at Joint Base Lewis-McChord, where he served for 10 years. During that time, he went on several medical missions, both as physician and as mentor, to train others on how to provide care in austere environments.
Since separating from the military in 2004, Dahlhauser has continued to travel on these medical missions as an expert volunteer through the American Red Cross, performing free cataract surgeries for people who could not otherwise afford treatment in myriad locales, including Honduras; the Dominican Republic; Costa Rica; Nicaragua; Trinidad; Peru; and Malawi, Africa.
Traveling with a team of surgeons, nurses, and technicians, Dahlhauser and his cohort rely on host-nation volunteers, such as the Honduran Boy and Girl Scouts.
The surgical volume of these trips varies, with the most productive mission providing more than 400 surgeries. Unlike when they are performing cataract surgeries in the United States, the medical staff does not have the same access to expensive, disposable equipment, and the cataracts themselves are extremely solid, which means they cannot be broken into pieces and removed, as is the standard domestic procedure.
As a result, military doctors and medical volunteers like Dahlhauser had to develop new techniques that allow them to remove the cataract in one piece through a uniquely constructed wound that can be closed without sutures, providing rapid visual recovery. This procedure is not only incredibly effective but costs a fraction of the price.
While on these trips, Dahlhauser provides this surgery free to his patients while also training surgeons from the host nation on his team’s techniques so patients can get the care they need long after the volunteers have left.
“Medical volunteering has great impact,” Dahlhauser said. “(Physicians) all have unique skills and abilities, and our training in the United States is exceptional. We do not just do a job; we are altruistic in our professions and are in a unique position to give medical care.”
Read on to find out more about Dahlhauser’s travels and what he thinks businesses can do to better support humanitarian causes like this one.
What’s the impact these surgeries have on people’s lives?
Cataract surgery has a big impact on patients. Our patients are blind, and we are giving them sight. My strongest memory among many is taking the patch off the eye of a blind grandmother the day after surgery, who then proceeded to cry tears of joy. She held my face, kissed my cheek, and told me in Spanish that she could now see her grandchildren for the first time. Not only do we help them function better, but sometimes this will free up a family member who has been needed to provide constant care to the blind relative.
How do you go about finding patients for these operations, and how are the surgeries funded?
We advertise on the radio and other local means and get lines of hundreds of patients, and then an advance team screens out those that can be treated. The main team then comes, and we spend two weeks doing surgery. We must do it in a way that is cost-effective, so we don’t do the same type of expensive surgery performed in the United States. We’ve modified techniques that allow us to do a fast, efficient, sutureless cataract surgery with high-quality results, but at a low cost.
How are these trips funded? Do you pay for them out of pocket?
I am not funded for these missions and pay my own way out of pocket. I just use my vacation time from my work at Cascade Eye & Skin. The military does all the planning and funding for the other members of the team. The planning for a mission takes much more time than the actual mission itself.
Is there special training involved or different procedural precautions to make while performing these surgeries abroad?
It’s good to have military training because we learn to deploy in austere environments, where electricity is in question and sterile environments are difficult to maintain. It’s not unusual to have dogs roaming through the hospital, or flies in the operating room. Our microscopes need to have battery backup so we can maintain a view of the eye during surgery when power goes out. We typically have three or four surgeries going on at a time in one operating room, so it is a dance to keep everything sterile and moving. Most of the time, the patients don’t speak English, so we need to learn local languages or have interpreters. A normal operating room will have four patients, four surgeons, four surgical assistants, one circulating nurse, and one interpreter.
What are some of the biggest challenges you’ve come across during these missions?
We have had various challenges over the years; acute appendicitis in our leader, GI sickness frequently with role transitions needed to fill in, lack of supplies, and a need to improvise. By the end of the mission, we get everything down perfect, just to start it all over again with new issues the next mission.
What inspired you to keep returning as a volunteer after your military service?
There are many reasons that I volunteer for these trips. I enjoy helping people that would not get help in any other way. I enjoy seeing a new location, not as a tourist but as a doctor giving service to their people. I get a much more personal look at those locations through the eyes of my local co-workers. We are invited into their homes and to experience their culture as friends. I also like the teams that I work with; they are the best of the best that made it to this level to be invited on a mission trip. These missions have been the favorite part of my military career, and luckily, I found a way to keep this going.
What are some smaller, everyday ways individuals can help with these issues, either at home or abroad?
Not many people are in an occupation or situation like mine that allows them to volunteer in this way. However, there are still many ways to volunteer with money or time. Find a cause, interact with those people and organizations that have the same goals, and make the lives of those around you better.
What are some ways businesses can be of service toward humanitarian causes?
Businesses could help by approving and sending employees to assist in the causes they find important. For me, it has been the American Red Cross and the U.S. military. We as physicians are in a unique position to give medical care. Some of us do that by providing free care to some underprivileged patients in our practice. We do it by providing low-payment care to patients on Medicaid. There are services in the area that help us provide free care, such as Project Access. My practice, Cascade Eye & Skin, has donated two free cataract surgeries per month over the last few years through Project Access. There are free clinics and community health services to which we can volunteer our abilities as physicians.