Rotary–Midday donates retinopathy equipment to General Hospital
By Jesús Ibarra

The Rotary Club of San Miguel–Midday donated a camera for detecting retinopathy caused by diabetes and a laser to correct the problem to the General Hospital Felipe C. Dobarganes.

The equipment was installed on March 11, and the official inauguration was held April 13 at the general hospital. Alberto Villarreal, head of the hospital board, and Dr. Jorge Vidargas, director of the hospital, gratefully received the equipment from David Bossman, president of the Rotary Club, and Gary Peterson, Rotary’s vice-president who is in charge of community projects. 


Diabetes a leading disease in San Miguel 

Dr. Salvador Quiroz, an internist at Hospital de la Fe and member of the Rotary Club, said that diabetes’ consequences are currently the leading cause of death in the world. The Rotary Club, he said, realized that especially here in Guanajuato diabetes was a major health problem, and it has been a priority for them. In April 2008, a conference about diabetes was held at Hotel Real de Minas, and they have been working on this diabetes project for almost 18 months. “The inauguration of this equipment is the culmination of that effort,” said Bossman. 

According to Dr. Claudia Karina Anaya, who works in the epidemiology department of the Health Center of San Miguel, the World Health Organization considers diabetes a leading disease in the 21st century and considers it a worldwide epidemic. “Currently, the consequences of diabetes are the second-highest cause of death in the municipality of San Miguel,” said Dr. Anaya.


Dr. James R. Gavin III, an endocrinologist who specializes in diabetes, explained that there are two kinds of diabetes, Types 1 and 2. About five percent of diabetics have Type 1 diabetes, which develops when the body can no longer make insulin, resulting in high blood sugar levels. In Type 2 diabetes, which is much more common, the body is resistant to insulin. “One of the things that leads to insulin resistance in most people is being overweight or inactive,” said Dr. Gavin, who added that Type 2 diabetes is more strongly hereditary than Type 1.

Dr. Gavin said that in the early stages of Type 2 diabetes blood sugar can be elevated for a long time and the person would likely not notice any symptoms. Eventually, these high levels exceed the ability of the kidneys to process the sugar, resulting in frequent urination. Deficient in insulin and unable to process blood sugar, the diabetic eats a lot but loses, rather than gains, weight. Blood sugar accumulates in the clear tissue in front of the eye, resulting in blurred vision. Unclear vision, excessive urination and eating a lot but losing weight are early symptoms of Type 2 diabetes.

“For up to 10 years people with Type 2 diabetes have no symptoms at all,” said Dr. Gavin. “That is why we are trying to get people who are at risk to have periodic check-ups to determine their blood sugar levels.”

Excessive blood sugar levels can affect the arteries, causing gangrene in the feet (making amputation necessary), heart attacks and strokes.

According to Dr.Vidargas, more patients with diabetes than with any other disease are treated at the hospital, and the new equipment will benefit thousands of diabetics who might otherwise lose their eyesight.


Diabetic retinopathy 

Dr. Vidargas explained that the retina is the part of the eye that detects light and translates it into images. Diabetic retinopathy is a degenerative process that damages the retina’s blood vessels. The deformity of the vessels allows blood to enter the retina, causing loss of vision and retinal scarring. 

Retinopathy generally takes a long time to develop, but if diabetes is not controlled in its initial stages it can cause retinopathy more quickly. Both types of diabetes, 1 and 2, can cause retinopathy. The symptoms of retinopathy are cloudy and shadowy eyesight or even blindness. Persons with initial retinopathy do not present symptoms before major bleeding in the eye occurs. “This is why we recommend that every person with diabetes should by checked periodically by the ophthalmologist,” said Dr. Vidargas. 

Dr. Marco Antonio Hernández is in charge of managing the new retinopathy equipment at the General Hospital, the second such installation in the state of Guanajuato (the other is in León). Dr. Hernández received training for managing the equipment from the renowned ophthalmologist Dr. George Bresnick, director of Vision for All Inc. from Columbia University in New York. Dr. Hernández explained that the new equipment consists of two machines. The first is a camera that takes images of the back part of the eye. “In this way we can detect retinopathy in its earlier stage and control it,” he said. “The second is a laser that helps to photocoagulate the retina and oxygenize it.”

Dr. Hernández said that when diabetes has caused severe damage to the retina it is irreversible. “The laser helps to stop the advance of the damage; in some cases it does improve vision, but if the damage is too severe, it is impossible to recover the eyesight. This is why it is very important to have an early diagnosis.” At the time of the inauguration, eight patients had already been treated with the equipment. 


Eighteen months in the making

According to David Bossman, the diabetic retinopathy camera cost around US$18,000 and the laser US$32,000. These programs were funded by the Rotary Clubs of Tallahassee, Florida and St. Francisville, Louisiana. Gary Peterson was the project leader.

“In terms of the time that we spent, since we initiated the proposal and including getting the money, dealing with the bureaucracy in Rotary, and coordinating with the hospital, we worked about 18 months,” said Bossman. “We first we had to bring the equipment from California to Dallas; it stayed in Dallas for a number of days. The process had to be coordinated in this way. Some of staff from the Economic Development Department, among them Javier Cerritos, stayed there for a weekend, completing the procedures for bringing the equipment across the border. When they came back, they brought the equipment with them.”



The Rotary Club of San Miguel de Allende–Midday

The Rotary Club of San Miguel de Allende-Midday was chartered in June 2005 with the specific purpose of identifying legitimate needs in our regional community and publicizing these needs to Rotary Clubs in English-speaking countries for consideration for their International Service projects. Once a foreign club adopts a project, the Rotary Club of San Miguel works with that club to administer the gift or grant locally.