Eye Madness

From all over India's province of Bihar and across the border from Nepal, the blind and the nearly blind arrived on foot, by oxcart and crowded railway car. They had come for the seventh annual eye clinic at the town of Darbhanga (pop. 69,203). Some sang and some prayed as a troop of Boy Scouts, led by a betel-nut-chewing Scoutmaster with a voice like a sideshow barker's, herded them in & out of 20 weather-beaten tents that formed a temporary hospital. Their hospital beds were pallets of straw; their only covering was the dirty robes they wore. But within a week of their arrival, the most energetic surgeon in India had examined each of them and removed exactly 1,565 cataracts from their failing eyes.

Every 40 Seconds. "It's a kind of madness with me, this removing cataracts," said grizzled Dr. Mathra Dass Pahwa, 71, last week. But it was a madness full of method. Local doctors believe that cataracts and other eye troubles are commoner in the Bihar area than anywhere on earth. Just out of medical school in Lahore back in 1902, Dr. Dass determined to do something about it. His first eye operation, he remembers, was "terrible." But in three years, he had improved considerably. "I spent my own money sending people out to villages to bring me cataract patients," he recalls. "I even paid the patients to come to me." In time, Dr. Dass's eye clinics had become famous all over India. By last week he had removed more than 200,000 cataracts.

Dust floated thickly in the air of the canvas tent that was Dr. Dass's operating theater in Darbhanga last week. Amid a raucous babble of several hundred patients, squatting on their haunches to await their turns at one of the makeshift operating tables, sweating coolies carried off postoperative patients at the rate of one a minute. As each new patient was placed on the table, an assistant washed the clouded eye with a mercury solution and applied a few drops of anesthetic. Then, while another assistant held a flashlight, the surgeon slipped his knife into the patient's eyeball at the exact junction of the transparent cornea and the white sclera. With a snip of his scissors, he cut out a tiny section of the iris. Then, with a deft motion, he flipped out the cataract-clouded lens. One of the assistants slapped a wad soaked with boric acid on the eye, tied a bandage in place, and the operation was over. Average time: 40 seconds.

Miracle Enough. Using this rapid technique, Dr. Dass officiates at an average of 15 eye clinics throughout India every year. Free to the patients, the clinics are paid for by local institutions and public-spirited citizens. At the end of two weeks' care in the tent-hospitals, his patients get a pair of thick eyeglasses to replace their natural lenses, and are sent home. Each patient also gets a questionnaire to fill out and send in later for the doctor's records, but few bother.

"These people are illiterate," said Dr. Dass, as he prepared to go home and rest over the weekend for his next clinic. "If they can have enough sight to go about their work, it is miracle enough for them. That is all I try to give them."

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