10 / Summer 2011 / ICO MATTERS SEEInG thE WORld ICO Graduate Brings Eye and Vision Care to Rural India By Jacqui Cook
n ikki Rai, OD ’03, remembers sitting in class at ICO, listening to a lecture about retinoblastoma and seeing pictures <strong>of</strong> how it could devastate a child’s vision and, in some cases, end up taking <strong>the</strong>ir lives. Just a few years later – with 8,545 miles separating her from <strong>the</strong> comforts <strong>of</strong> ICO – Dr. Rai witnessed <strong>the</strong> ramifications <strong>of</strong> that same disease for herself multiple times when she left <strong>the</strong> United States to work in Bangalore, India. For two years, she built and <strong>the</strong>n managed <strong>the</strong> “Nanna Kannu” program, which in <strong>the</strong> local Kannada language means “my eye,” a joint initiative <strong>of</strong> Sightsavers International, Sankara Eye Hospital, <strong>the</strong> government <strong>of</strong> Karnataka (<strong>the</strong> state where Bangalore is located) and <strong>the</strong> National Association for <strong>the</strong> Blind. The Nanna Kannu program’s goal is to screen more than 150,000 children in Bangalore and surrounding areas for vision problems, <strong>the</strong>n get <strong>the</strong>m free treatment, whe<strong>the</strong>r through glasses, medicine or surgery. Under Dr. Rai’s leadership, <strong>the</strong> program grew and thrived, moving closer to its goal <strong>of</strong> eradicating preventable blindness in children from birth to 18. “Probably <strong>the</strong> most amazing fact is that through our program, 44 children are receiving treatment for retinoblastoma via ei<strong>the</strong>r chemo<strong>the</strong>rapy or enucleation <strong>of</strong> <strong>the</strong> eye,” Dr. Rai says. “So we not only have helped save vision, but also saved <strong>the</strong> lives <strong>of</strong> <strong>the</strong>se children.” After graduating from ICO, Dr. Rai, a native <strong>of</strong> Toronto, worked in Binghamton, N.Y., and Detroit before landing in New York City. It was <strong>the</strong>re she began to really focus on treating <strong>the</strong> underserved population. As part <strong>of</strong> her work with Helen Keller International, a nonpr<strong>of</strong>it organization dedicated to preventing blindness and reducing malnutrition in school children, Dr. Rai would go to schools in impoverished neighborhoods to provide eye care for students. She also worked for a hospital that had a mobile unit to bring eye and health care to immigrants’ homes, community shelters and o<strong>the</strong>r areas with underserved patients. In 2008, Dr. Rai’s husband wanted to go to India to explore a business opportunity, so she began exploring what she could do <strong>the</strong>re. She had done some fundraising already for <strong>the</strong> Sankara Eye Foundation, a San Francisco-based organization that has a goal to make India 20/20 by 2020. The Sankara Eye Institutions are set up so that fees charged to 20 percent <strong>of</strong> <strong>the</strong> patients support <strong>the</strong> 80 percent <strong>of</strong> patients brought in by outreach camps in rural areas. Dr. Rai had helped raise money for <strong>the</strong> Sankara hospital in Bangalore, so she used that connection to ensure she could continue practicing once <strong>the</strong>y moved. “We packed up and moved our stuff to Toronto, stored it in my mom’s basement, and went to India,” she says. “First, I volunteered at <strong>the</strong> hospital, teaching <strong>the</strong>m how to do a good case history, recording methods, what a good binocular vision workup is and how to present options to patients. They don’t have that concept <strong>the</strong>re. These things are so simple that we know <strong>the</strong>m like <strong>the</strong> back <strong>of</strong> our hand, but unfortunately some <strong>of</strong> <strong>the</strong>se things are foreign concepts to <strong>the</strong>m.” For example, Dr. Rai had to teach <strong>the</strong> staff to ask some family members to wait outside while she or ano<strong>the</strong>r optometrist was performing an eye exam. In India, it is common for parents, grandparents and siblings to all accompany a child into <strong>the</strong> exam room. “So we not only have helped save vision, but also saved <strong>the</strong> lives <strong>of</strong> <strong>the</strong>se children.” “Truthfully, <strong>the</strong>y don’t want <strong>the</strong> child to have glasses, so if <strong>the</strong>y were in <strong>the</strong> room, <strong>the</strong>y would coach <strong>the</strong> child about <strong>the</strong> letters,” she says. “I had to teach <strong>the</strong> staff to be strong with parents and ensure <strong>the</strong>m that it is in <strong>the</strong> best interest <strong>of</strong> <strong>the</strong>ir child that all but one family member wait outside.” Working in <strong>the</strong> trenches Once she obtained a work visa, Dr. Rai went to work on <strong>the</strong> Nanna Kannu project. She was chosen because <strong>of</strong> her experience at Helen Keller. However, even that could not fully prepare her for <strong>the</strong> challenges she would encounter working in extremely crowded schools and impoverished areas where sometimes <strong>the</strong>re were no bathrooms or basic necessities such as fresh water. Summer 2011 / ICO MATTERS / 11
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