In Nepal, high proportions of children are blind from preventable causes. Unlike restoring the sight of adults, which has become relatively simple, providing high-quality care to children requires specialized staff and equipment, strong referral and follow-up systems, and an ophthalmologist with sub-specialty training in pediatric eye care.
Canada has 1 ophthalmologist per 30,300 people, while Nepal currently has only 1 ophthalmologist per 142,860. Furthermore, one-third of the Nepali population is under 16 years old but only a few of these ophthalmologists are trained to treat children.
Dr. Manisha Shrestha, an ophthalmologist from the Seva-supported Bharatpur Eye Hospital in Chitwan District, Nepal, is looking to improve these odds.
Dr. Manisha Shreshtha is currently doing a pediatric fellowship at the BC Children’s Hospital in Vancouver, BC, where we had the opportunity to ask her about her work.
Q: Why did you choose to become a pediatric ophthalmologist?
Dr. Shreshtha: I like being with kids. Also there are not many pediatric ophthalmologists in Nepal so I chose to become one. My husband is also a pediatrician so I thought it was good to have something in common in our profession.
Q: Why did you decide to do your pediatric fellowship in Canada?
Dr. Shreshtha: While I could have stayed in Nepal to complete my studies, I decided to come to Canada because I have always wanted to receive training in a developed country and see what it is like. I am also excited to bring this training back home.
Q: How did you come to work at Bharatpur Eye Hospital?
Dr. Shreshtha: My family donated funds to build a city eye clinic for Bharatpur Eye Hospital while I was working as a medical officer at Chitwan Medical College. I became interested in ophthalmology as a career and Bharatpur Hospital offered post-graduate training. They offered me a position and I decided to join the hospital.
Q: Can you tell us a memorable story of one of your patients?
Dr. Shreshtha: I had a small girl around 4 years old from a remote part of Nepal which was at the epicentre of the most recent earthquake. Their home was destroyed so they were living in a temporary camp. The child developed red eyes which she could not open so her family had to make the difficult journey to our hospital. When I examined her, which was not easy, I found caterpillar hairs embedded in her upper palpebral conjunctiva (inside membrane of the eyelid). I tried hard to take them out but it was not possible in one session. I made arrangements for them to stay in the ward and I saw them early every morning to take more of the caterpillar hairs out. It went on for 3 days, and on the third day, the girl was standing there with her eyes open when I arrived. That gave me immense pleasure as my hard work had paid off and I could make her eyes better.
Girls at an eye camp in Nepal © Ellen Crystal
Q: What is your biggest current challenge?
Dr. Shreshtha: To make the pediatric ophthalmology service better at Bharatpur Eye Hospital as it is currently in its infancy. I hope my training here at BC Children’s Hospital will make me competent enough to help people in my community and country as a whole.
Q: What has been your greatest achievement?
Dr. Shreshtha: Every time I have been able to relieve people from their ailment and they give me a smile back in return I think is my greatest achievement.
Q: What is your hope for the future of eye care in your country?
Dr. Shreshtha: I hope the field of eye care becomes more technologically advanced but within the accessibility of all people.
