TIO

I went to TIO for the first time today, and had my mind blown. This is a place that kinda sneaks up on you, because it’s situated in the middle of a pretty dumpy area (aka Kathmandu…haha that’s just a little third world humor). No seriously, I didn’t expect it to be that nice because of its surroundings. But they have 2 large buildings, and literally about a thousand patients are seen there each day. Some of you may think that I’m coming here to help, and that it’s great for a US-trained doctor to go to Nepal, etc. But make no mistake—TIO does not provide third world eye care, and I am in no position to help because they definitely do not need my help. My role at TIO is to learn, and see as much interesting ophthalmic issues as I can since there are a whole set of different things that pop up in the eyes of patients in the developing world.  TIO is a first-rate facility providing nearly state of the art eye care, education, and outreach. It is a model eye care delivery system for the developing world, and ophthalmologists from many different countries have come here to learn. That’s a group I’m proud to be a part of.

Today I spent time in the glaucoma clinic with TIO’s 2 glaucoma doctors: Dr. Suman Thapa and Dr. Indira. It was pretty much like a glaucoma clinic in the US, except several patients being examined at once in each exam room (HIPAA violation!), and many more patients here have angle-closure glaucoma instead of open angle glaucoma (it’s by far the other way around in the US). 

For lunch, we went to TIO’s on-site cafeteria, which is AMAZING. I had a huge lunch consisting of a lot of rice and some delicious Nepali “stuff” to go over it. Don’t know what it was, and don’t care. So far here I have had delicious food, and I hope this continues and that I don’t get greedy and end up with something funky in my digestive tract. That would also be good to avoid because the toilet system here is strange. I know at some point I’ll run into the “hole in the ground” type of toilet, but so far I’ve been in buildings with toilets. And the place I’m staying has toilet paper. But at TIO, there is no toilet paper. There is only a bidet-like device, except it’s a water spigot coming out from the wall, pointing down about a foot off the ground. I have no idea how that leads to a clean bum, and honestly I don’t want to try to figure it out. Hopefully I won’t have to. But I think it has something to do with why you’re not supposed to touch anybody’s left hand here…