FOCUS Eye Care in Haiti and Nigeria from 1961-1996.

James E. McDonald, MD, Ron Fishman, MD (Editor), McDonald CJ (Editor)

E-book (1st edition 2010, 2nd edition 2014).


Dr. James E. McDonald's firsthand journal accounts, photographs, and memoir about establishing a volunteer ophthalmology medical and surgical eye service in Haiti and later in Nigeria called FOCUS (Foreign Ophthalmological Care from the United States). E-book (1st edition 2010 edited by Ron Fishman, MD; 2nd edition 2014 edited by Clem McDonald, Jr, MD). Forward 1st Edition (2010) This book is a journal kept by Dr. James McDonald of his experiences and those of his wife, Dr. Evelyn McDonald, in Haiti between 1961 and 1970, setting up and running an eye service at various hospitals in the poorest country in the Western Hemisphere. Dr. McDonald, Dr. Arthur Light and Dr. Thomas Stamm, all ophthalmologists practicing in the Chicago area, founded FOCUS. (Foreign Ophthalmological Care from the United States), a non‐profit organization, with the intention of providing free medical and surgical services to people sorely in need of them and they did this without remuneration, as did the many ophthalmologists who also volunteered to work in these clinics, all of whom paid their own transportation and incidental costs themselves. They were compensated by a sense of accomplishment, but it may not be immediately evident to the casual reader what an onerous task they had set for themselves. The shock of transferring from a comfortable life style at home to living and working in a poor and alien culture comes through quite clearly in the journal, as well as the fascination this culture had for the author. Not every physician does well with the challenge of translating modern medical care to an environment where many compromises have to be made, every day and almost minute‐by‐minute. The ones who do best have what has been called a sanguine personality: optimistic, flexible and tenacious, not easily discouraged. An abiding sense of humor also helps, and the reader will recognize these qualities in the author as he tells the story. Even with best of intentions, such an effort as here described depends on conditions in the host country over which the volunteer has little control. The medical and political establishments have to be welcoming and supportive, and there has to be peace with law and order. If the roads are not safe, patients cannot come to the doctor, nor can the doctor get to the patients. Conditions in Haiti deteriorated with the death of the elder "Papa Doc ' Duvalier in 1970 and the clinics unfortunatelyhad to be closed. Undismayed, within a few years Dr. McDonald was starting a new program in Nigeria. But that is another story. I have edited this journal with a light hand so as to retain Dr. McDonald's own voice. The illustrations are largely taken from the McDonalds’ personal collection. At the end of this journal is an anecdote that I solicited from Dr. Larry Chapman, who was a FOCUS volunteer in the later days of the Haiti program, and whose memory of his experience, and that of his wife Patty, is too good to pass up. It mirrors Jay and Lyn McDonald's experiences of 7 years previously. --Ron Fishman MD Forward 2nd Edition When I visited Jay – (James McDonald), my uncle, in 2014, he pulled out a copy of his Haiti Focus book and showed it to me. He was obviously proud of the book and the work it described, and rightly so. It was a black and white Xerox copy of an original version with wonderful prose, but blurry grey‐scale pictures. No electronic version of the book existed – as best we could tell. There were indications that the pictures were pasted into a master hard copy to make the book. The book tells the story of the FOCUS organization. In Haiti the FOCUS doctors made the blind see. At least 1000 Haitians regained their sight through surgery. Tens of thousands received treatment for other eye problems: refraction problems treated with prescription glasses, and glaucoma and tracheotomy treated with medications. A focus ophthalmologist could only operate on 10‐12 patients per day on their surgery days, but could see 100‐150 patients on their outpatient days during which they would fit glasses and treat eye problems medically. The original book didn’t say much about the FOCUS Nigeria years, which lasted longer, and were even more successful than, the Haiti years. That Nigerian FOCUS project probably restored sight to another three to five thousand people counting the surgeries that the American FOCUS doctors and the full time Nigerian ophthalmologist whom they attracted, performed. So I added a too brief summary of that work and solicited an eye witness account of Jay in action in Nigeria from my brother Ray. Brother Michael also did a tour of duty with Jay but do not have narrative on that. Jay’s FOCUS story deserved a wider distribution and a better presentation. So with Ginger McDonald’s (Jay’s physician Daughter) help, I obtained a clean hard copy of the book and two boxes of photos. I scanned the clean copy, ran it through an Optical Character Recognition (OCR) program, edited out the mis‐reads and the many unwanted formatting characters, and changed the layout and the format. In the boxes of old photos, I was able to find the original color prints for all but three of the photos in the Xerox copy, scanned them, and inserted them into an electronic document. I added a picture of Lyn and Jay’s wedding because the wedding was mentioned in the book. I also did some light editing to clarify meaning, added a small amount of information about the Nigerian, Abak years, narrative from my brother, Ray McDonald about his travels and work with Jay in Abak, Nigeria in 1981, and about my visit to Port du Paix and La Tortue in 1964, (derived from letters I wrote to my family which my father faithfully saved and returned to me 20 years later). Unfortunately, Jay was not in Haiti at the time of my visit so I did not have special opportunity to work with him that Ray enjoyed. I am sure this version contains some errors of fact and typing. I have some hope in the long term of producing a version with more content from the Nigeria years. This work I did in thanks for guidance and love I received from Lyn (especially) and Jay both of whom shaped my life in many important ways. --Clem McDonald Jr MD

James E. McDonald, MD, Ron Fishman, MD (Editor), McDonald CJ (Editor). FOCUS Eye Care in Haiti and Nigeria from 1961-1996. 
E-book (1st edition 2010, 2nd edition 2014).