In the past, U.S. Army Africa has held Medical Readiness and Training Exercises to conduct ophthalmologic surgery in different countries in Africa to cure its residents of cataracts. To date, there have been more than 800 cases of cataracts cured in countries including Malawi, Zanzibar and Burkina Faso.

The latest exercise has U.S. ophthalmologists traveling to Mauritania to conduct cataract surgery from March 25 through April 5 during MEDRETE 13-2. MEDRETE 13-2 not only had U.S. personnel conducting surgery, but they brought a Burkina Faso doctor trained in previous MEDRETEs to help train and mentor three Mauritanian doctors.

Dr. (Col.) Casey Carlton, lead surgeon on MEDRETE 13-2, said Dr. Diallo, the Burkina Faso doctor, had done remarkable work since he was taught the Small Incision Cataract Surgery. Out of 111 surgeries in Mauritania, Diallo completed 40 of them.

“What’s unique about this one in particular is participation of a host nation doctor from Burkina Faso where we were in September of last year that we trained in our procedure. I think it’s incredible what Dr. Diallo has been able to do here. In September [he was] learning this procedure just like anybody else, and [he’s] as good as our best surgeon. We were giving him the more difficult cases. I think the presence of Dr. Diallo here in West Africa might signal the dramatic change in the quality of cataract care. There are a lot of places in the world where this is not the standard procedure where it’s still the traditional procedure, which is ok, but it’s not nearly as good as this one. Hopefully we will be able to continue this collaboration,” Carlton said.

Diallo said he was very thankful for Carlton’s team to teach him the SICS so he can continue to practice.

“I got an opportunity to [train] with Col. Carlton and his team [at the MEDRETE] between the Burkina Faso and U.S. Army Africa last September. Dr. Carlton took [his] time to [help me learn how to do the surgery] step by step, and I did 10 or 12 cases before they left. They left me some [equipment] to continue to practice this technique. And now after 6 months I did 200 cases and [when I talked to Dr. Carlton] he gave me an opportunity to come here to see if everything is well and to continue to practice this technique. So I would like to thank Dr. Carlton and his team and also U.S. Army Africa to give me that opportunity,” Diallo said.

With Diallo helping to perform cataract surgery on patients, Carlton said this helps with sustainment so the host nation will continue to learn the technique after U.S. personnel leave.

“Dr. Diallo is working with us helping to develop relations and interoperability with the Mauritanian folks. Ideally we should reach a point where we impart what we what we want from a medical or military perspective and then it sticks around, that’s sustainment,” Carlton said.

Before MEDRETE 13-2, Carlton said Mauritania was doing the traditional procedure, which was the ExtraCapsular Cataract Extraction. The ECCE had decent results, but nowhere near as good results for the patients than with SICS.

“Surgery isn’t easy. There’s always a learning curb associated with it. When you’re learning a technique, it’s kinda difficult, but once you get it, you get it and you keep it. That’s where Dr. Diallo is now. We’re hoping to get the host nation docs and the individuals doing it too so it will really improve their patient outcome and improve their standing in the country because they’ll be able to do a better job and that way it will be sustainment for them and for us,” Carlton said.

Diallo also agrees that the new technique is more successful than the older one.

“This kind of mission is very important for Africa because cataracts is the first cause of blindness in Africa. In Africa we didn’t have enough ophthalmologists who treat all the cataracts so they [Americans] come and they help us. Dr. Carlton gave me the opportunity to come here [Mauritania], and I am very happy. I think the mission is very successful. This technique is very important for African ophthalmologists to practice to get better results in comparing the old technique we use. Our patients are very happy and they get better vision. I hope this won’t be the last I do,” Diallo said.

As far as training, Carlton said MEDRETE missions are also beneficial for U.S. personnel because it enhances their surgical skills and they learn to train in austere conditions.

“They [Soldiers] are going to be able to do eye surgery in the future because they’re learning a new procedure. When they deploy and an eye case comes in, they’re not gonna freak out. I’m very pleased with U.S. Army Africa’s support. This has been a very challenging mission,” Carlton said.

Along with sustainment, Carlton said learning the new technique is beneficial to Africa because it is inexpensive. Mauritania is one of the countries where it lacks the resources and surgical expertise to perform the surgery.

“The Ministry of Health doctors and the Ministry of Defense folks are very competent at what they do, but they lack resources. Typical cataract surgery in the states is very technology dependent and very expensive. You have to find something that has good results and costs a lot less. This procedure we’re doing costs about 15 dollars in terms of supplies whereas the surgery we do in the states, we’re talking 600 dollars probably just for supplies. [This is a] procedure that is inexpensive and fixes [the patient’s] vision in 20 minutes or less with a low complication rate and there is not a whole lot of follow up requirements on our part. It’s like a win, win, win, win, win type situation,” Carlton said.