Volunteer Interview with Dr Peter Kertes

In February 2021, Orbis photographer, Geoff Oliver Bugbee, had a interview with one of our fantastic volunteers Dr Peter Kertes from Canada.

Dr Kertes

One of the things I’ve learned cer­tain­ly with Orbis, in many con­texts, is how adapt­able and resilient an orga­ni­za­tion like Orbis has been. One day this coro­n­avirus will be a bad mem­o­ry and we can get back to some type of nor­mal life and hope­ful­ly Orbis will be able to resume (Fly­ing Eye Hos­pi­tal) pro­grams. But Orbis is con­stant­ly evolv­ing and it nev­er real­ly lets any­thing slow it down or put it on hold. Covid-19 is no excep­tion. These Cyber­sight webi­na­rs and Fly­ing Eye Hos­pi­tal Vir­tu­al projects are a great exam­ple of that. The learn­ing has to go on. There are patients that still need urgent oph­thalmic care — and many of them need it des­per­ate­ly. The more knowl­edge and exper­tise that can be shared around the world the bet­ter. And I think those patients will be well served by Orbis’s efforts and its resilien­cy, ver­sa­til­i­ty and adap­ta­tion to this unique environment.

Speaking about his work in Canada over the last year, Dr Kertes said:

"Things have changed enormously in the way we manage and take care of our patients. Even in the year that we've been suffering and dealing with COVID, we have evolved quite a bit. I would say we're pretty close to being back up to normal, back to our normal volumes of patients that we're seeing. But patients come in alone now — they're not allowed to come in with their caregivers, as you well know.

"Many of our patients are elderly, and some of whom may be a little bit confused. And it's a big deal for them to come alone without help. There are certainly exceptions that are made. I see a fair number of children as well, and obviously, the children are allowed to come in with one parent, but not with both parents. And it's difficult, especially when there are important decisions to be made and questions about surgery that might be planned.

"And we try and keep the flow going, so we're very respectful of people's time. So they come in and out as quickly, and as efficiently, as possible. But we're continuing to limp along. Patients need their care and they value their vision. So we keep forging ahead and we look forward to a time where things will be back to normal. I think it'll always be different, but I hope it'll be closer to the normal that we were used to, where their family members were allowed to come in. We didn't have to wear masks. We could look at their facial expressions. You know, it's funny how much we rely on seeing a patient talking or seeing a person talking to understand what they're saying. So with their masks, I feel like I have to talk louder, I have to enunciate more, because it's hard to understand people with their masks on."

Dr Kertes taking part in an Orbis training programme prior to COVID.

"I feel enormously indebted to Orbis. I've had some great experiences on a bunch of different trips around the world. I first got interested because when I was a resident, when I was doing my ophthalmology training at the University of Ottawa, one of my teachers, one of my mentors, Dr. Brian Leonard, was a very seasoned and frequent volunteer with Orbis. And he would often come back from a trip and share stories and share pictures and tell us about the experiences he had. And I thought it seemed almost magical that you could duck away from your practice for a week at a time and create these great associations and these great alliances with ophthalmologists halfway across the world. To teach them a few things, and create some good, and essentially leave some legacy behind to help people in places that would have difficulty accessing the care that seems so obvious, and so readily available, to us in Canada.

"So I've been to some great places. I've been to China and India—I don't know, I must’ve returned a half dozen times to both places. I've been to Bangladesh a handful of times. I was in Myanmar once and had a great experience there. I was in Malaysia. My most recent trip was with you in Ghana, which was my first time in sub-Saharan Africa, which I enjoyed enormously. And I've done some other volunteer work with some other organizations. But certainly most consistently has been I’ve travelled and served with Orbis, and I really value those trips. I’ve made some wonderful friendships over the years."

Dr Kertes in Ghana for a training programme on board the Orbis Flying Eye Hospital prior to COVID.

The Cyber­sight pro­gram has allowed me to stay con­nect­ed to my col­league oph­thal­mol­o­gists that I’ve met and worked with in these places around the world. They send me cas­es. They send me emails, they send me updates. And it’s been a great bond that has been forged over the years. And it’s great to go back to a place where you’ve been before, and sort of recon­nect with those oph­thal­mol­o­gists that you’ve worked with in the past.”

Dr Kertes' sub speciality in Ophthalmology is in Medical Retina, he explained a little about this "Well, the retina is the most beautiful and sublime of all the body's tissues. The retina works like the film in the camera. Back in the day... I'm sure you remember, Geoff, the days when cameras had film in them. But it works like the film in the camera. It's responsible for interpreting what's out there and sending that information back to the brain as vision.

"The retina is essentially the brain that is in the eye—and it's the only place in the body that you can look at the brain directly. And now we have terrific ways of imaging the retina, with optical coherence tonography, and sourcing Angiography, and OCT Angiography—we have these terrific ways of mostly non-invasively looking at the retina. So we can look at the health of the blood vessels, and it gives us a clue to what's going on elsewhere in the body.

"So somebody with diabetes, for instance, for sure they're at high risk of having eye problems and vision problems. But they're at significant risk of having problems in their kidneys and elsewhere in their body. So a view into the retina gives us a pretty good idea of how they’re doing elsewhere. It also gives us an idea of their systemic health."

Dr Kertes hosting a training session prior to COVID.

Dr Kertes spoke about his experience with virtual trainings "Orbis is a tremendously nimble organization. As you said, and as we all know, the world was a very different place one year ago. And I think a year ago it would have been hard to imagine that we would have to deal with the challenges that we've had to deal with today. But Orbis responded very quickly.

"Actually, the first virtual lecture I gave was in Cameroon. The Flying Eye Hospital was set to go to Yaoundé, Cameroon, but of course, that plan didn’t move forward. As the world underwent lockdowns, that program also had to be shut down. I was asked to give a talk on sickle cell retinopathy in French. I like to think that I'm pretty fluent in French, but I'm considerably less fluent in French than I am in English, and my ophthalmology fluency is not bad...I did practice an Ottawa for a number of years, which is a pretty bilingual city. But I can't remember ever having to give a lecture in French.

"And, of course, the rest of the world often listens to us speak in English as their second or third or fourth language, and we sort of take it for granted. But it was quite a challenge preparing this lecture in French."

Dr Kertes providing hands on training prior to COVID.

"The India Flying Eye Hospital Virtual program happened over a series of lectures. So there were three lectures that were given, and they kind of progressed naturally.

"The first was on an introduction to diabetic retinopathy. And I shared that time with an Orbis staff member who's creating the artificial intelligence platform for Orbis. So that was pretty interesting for me to see how that too has evolved. The next session was on laser treatment and diabetic retinopathy. And the last was on Anti-VEGF treatments of diabetic retinopathy.

"One of the advantages of Zoom is that you can connect people from all over India. So as I understand it, there were 10 different centers that had connected to these talks over Zoom. So these are people that connected who don't even know each other, who don't even work together. So it's an opportunity not just for me to connect with them, but for them to connect with each other—their countrymen and women—across India.

"But again, I look forward to getting back to the face-to-face encounters and real patient interactions in the near future."

Dr Kertes with local medical team prior to COVID.

"I mean, it's hard to imagine anything more gratifying than helping somebody get the eyesight back that they've lost, or helping somebody preserve the vision that they have. I feel remarkably fortunate to be in ophthalmology. I can't imagine doing anything else. And to be in a place like Canada where we have universal health care and we have an adequate supply of ophthalmologists and we all do the best that we can and we're all well qualified to do it, and patients really don't lack for anything.

"I mean, if there's a treatment available and a patient is motivated, they can get that treatment. But in the developing world where there are many fewer ophthalmologists and many of those ophthalmologists may not have the skills that are required to restore eyesight or to preserve eyesight. So to be able to parachute into a place and make a difference through teaching and training is really tremendously gratifying. I can't imagine anything better."

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