Overseas Adventures: Friday Post-ops

Today we saw our post-ops. When Dr. Pons does cataract surgery, the patients stay upstairs in the clinic. They often travel long distances, so included in the price of the surgery is two night’s lodging at Good Shepherd. They come in for their pre-op visit and biometry (lens calculations) the day before surgery (Wednesday). They stay overnight on Wednesday night, have surgery Thursday, spend the night on Thursday and are seen in clinic for post-op on Friday. They are then free to travel home.

On Fridays, post-operative day #1, the patients are brought down to clinic at about 8 a.m. The morning starts with singing and prayer, led by a local pastor. Then, Sister Senani gives a lecture to the room full of patients about post-operative instructions. She instructs them on proper use of their eye drops and tells them when to return for follow-up visits. This is all done in siSwati, one of the official languages (in addition to English) of Swaziland. So, I understood nothing. However, Q (short for her full name which starts with a “Q”), helped translate. Q is a nurse in the clinic, and she is young and fun. I asked what all the murmuring amongst the patients was and she said they were saying things like, “It is too expensive for me to come back. I cannot come back to clinic. I didn’t know we had to come back to see you after surgery…” Of course, this was all explained to them pre-op. Jono said he thinks the follow-up rate for post-ops (seen at Day 1, Day 10, and post op Week 6) is about 10%. That is to say about NINETY percent do not come back to see us after post-op Day #1!! And, he said, this is important for two reasons:

1. It stresses the importance of the Post-op Day #1 visit. We have to presume we may never see the patient again. Therefore, this visit is vitally important to make sure they are doing well and that there are no signs of infection.

2. This poor rate of follow-up indicates that the patients are doing well. He said, “Do you know why the patients don’t come back? It is because they are so happy!” Of course, we would like to see them back, but it is often not feasible for the patients.