Author: Line Felholt / Ugeskrift for læger
Gøril and Jannik Boberg-Ans are not only married, they also share the same passion for ophthalmology. Over the course of their working lives, they have operated on eyes around 25,000 times each. Some of them in the far corners of the world, where they have been restoring sight to the blind for 20 years. Now they are receiving the Honorary Award of the Danish Medical Association.
Gøril and Jannik Boberg-Ans received the Medical Association’s Honorary Award 2023 for their work to restore sight to thousands of cataract patients in developing countries through their organization Red Synet (Photo: Palle Peter Skov)
Some go skiing in Austria. Others go on a beach vacation in Majorca. Whether Gøril and Jannik Boberg-Ans do the same is totally irrelevant in this context. Because when you spend vacation weeks traveling to faraway places to give sight back to poor people in Lesotho, Myanmar, Peru, Nepal or Tanzania, well, those are the “vacations” you should send postcards home from.
Here is one such “postcard”. Because Ugeskriftet has visited the surgeon couple in their home in Charlottenlund and has returned to the editorial office almost with Africa’s red soil on the block.
Gøril and Jannik Boberg-Ans are this year’s recipients of the Medical Association’s Honorary Award. This is because for more than two decades they have traveled, often at their own expense, to perform cataract surgery on patients in third world countries. For their work in establishing the Save the Sight Association and for spreading a special surgical technique that makes it possible to help as many people as possible under primitive conditions. And not least for opening a permanent eye clinic in Tanzania, which will also serve as an academy for other eye surgeons.
For this they receive the Honorary Award of the Danish Medical Association.
‘I almost had a heart attack. It came as a complete surprise to us that someone had noticed what we are doing,” says Jannik Boberg-Ans.
“It’s so big. I can hardly contain myself,” says Gøril Boberg-Ans.
There’s no doubt that the recognition has blown the couple away. And when they have gathered emotionally at the dining table in their villa in Charlottenlund, they are immediately back at the foot of the Ngorongoro Crater in Karatu, Tanzania, where they are currently struggling to open their academy for ophthalmologists.
“The honorary award gives our work a stamp of approval. That what we do is right and important. When we look at how big a task lies ahead of us, we can hope that the honorary award will also be an advantage when we raise funds for the project,” says Jannik Boberg-Ans.
Like a rebirth
Gøril Boberg-Ans is 68 years old and Jannik Boberg-Ans is 66. He still works as an eye surgeon and medical director at the private clinic EuroEyes, while she retired earlier this year as a consultant eye surgeon at Rigshospitalet – Glostrup. Both are subspecialized in cataract surgery. A common disease all over the world. But while surgeries in Denmark remove cloudiness in the lens of the eye that can impair vision, cataracts are the most common cause of blindness in third world countries. Because there is often no eye surgery available, cataract patients in poor countries often have to go without an operation that could restore their sight in minutes.
A fact that is actually worse than that. In poor societies, when one member of the family is blind, it affects the whole family.
“It is a real burden when one of the adults in the family is blind. The children don’t go to school because they have to take care of the blind person at home. When the blind person undergoes surgery and gets their sight back, the whole family benefits, and the children go back to school,” explains Jannik Boberg-Ans.
“Imagine that a relatively small operation can mean so much for an entire family. That’s what drives us,” says Gøril Boberg-Ans.
The joy they receive from patients is palpable. Sometimes patients have traveled far to reach the couple’s temporary clinics. One example is the Nepalese son who carried his paralyzed and blind mother on his back for more than 24 hours to get her to the operating table. Or when patients from a village in the Dominican Republic were afraid to attend because the witch doctor claimed the couple stole their eyes. When a brave few returned to the community with their sight restored, the clinic was flooded with patients on the final day.
In both cases – as in so many others – patients have reacted with cheering, crying, clapping, and sometimes dancing out of sheer joy at being able to see again.
“We are so privileged to be able to make people happy. Giving people their sight back is like a rebirth. It’s a bit like what obstetricians must feel,” says Jannik Boberg-Ans.
Difficult to fundraise
It all started in 2000, when the couple was sent to Greenland from Rigshospitalet. Here they operated on patients from near and far for 3-4 weeks. The conditions were primitive, and the couple’s children, who attended school locally during their stay, made their debut as their parents’ assistants. Over the years, the children have often accompanied their parents around the world to help out, and today both are themselves trained as doctors and nurses.
In Greenland, Gøril and Jannik Boberg-Ans got a taste for helping people who otherwise would not have received it. They also liked the challenge of practicing their profession under difficult conditions. So they decided to travel with the organization SEE – Surgical Eye Expeditions – which sends healthcare professionals to 3rd world countries. They did this for a number of years, but in 2014 they started their own charity, Save the Sight.
On paper, they spend two vacation weeks a year traveling and performing free surgeries, but in reality, months are spent both before and after the trip finding suitable and sufficiently safe places to go, obtaining local permits, collecting donations from home, obtaining equipment, and following up with patients after the trip.
Many times they have ended up traveling at their own expense. Right now, they also have their own money at stake in relation to the academy in Tanzania. From time to time, they manage to get sponsors and funding. But:
“We have never been good at fundraising. It takes a longer education to figure out how to do it,” says Jannik Boberg-Ans, looking over at his wife. Because after she retired earlier this year as chief physician at Rigshospitalet – Glostrup, her entire working day is now devoted to just that.
“Fundraising is new to me. It is difficult. But I’m learning it,” she says, adding that it’s not the fundraising part that they are passionate about. They call it ‘necessary’.
Low-cost technology
During one of their stays – in the Himalayas in Nepal – they met a surgeon who would change everything for the two Danish eye surgeons. Gøril Boberg-Ans calls him her ‘guru’. Dr. Bidya Pant is his name, and the two Danes met him in a small Nepalese town, where he used a technique called MSICS – Manual Small Incision Cataract Surgery – which at the time was not routine in a Danish context. For good reasons. The technique is unique in that it requires neither large machines nor sutures and only needs power for the operating microscope. In other words, a perfect technique in parts of the world where conditions are primitive and traveling doctors like Boberg-Ans have limited opportunities to bring heavy and advanced equipment. And the technology is cheap, too. Jannik Boberg-Ans estimates that an MSICS operation for cataracts can be done for 10-15 dollars.
“In Denmark, the patient doesn’t even walk in the door for that kind of money,” he says.
Gøril Boberg-Ans explains how an MSICS operation is performed: the surgeon cuts a 6-7 mm wide tunnel opening at the corneal edge under the upper eyelid. Through the opening, the cloudy, whole lens nucleus is pulled out. It is replaced by an artificial lens and the opening then closes itself, so sutures are not necessary.
In comparison, cataract surgery in Denmark is performed using large ultrasonic machines that crush the lens nucleus inside the eye and remove it through a somewhat smaller opening.
“It’s a relief that we don’t have to take so much equipment out after we learned the MSICS technique,” says Gøril Boberg-Ans.
MSICS is reminiscent of the old gray strong technique used 40-50 years ago. Which makes sense because MSICS is particularly well suited for severe cataracts, where the lens nucleus is so cloudy that it looks like a brown Gajol.
“When the cataract is so advanced, it is difficult to remove with ultrasound. We can use MSICS, which is actually more gentle on the eye. Since we learned it, it’s almost only what we do when we’re out and about,” says Gøril Boberg-Ans.
But in fact, she is also responsible for bringing the technique home to Glostrup, so that today it is also used in the approximately 40-50 operations for severe cataracts that we have annually in Denmark.
It is this technique that Gøril and Jannik Boberg-Ans would like to teach even more. This will take place at the academy in Tanzania. The dream is that other eye surgeons can attend courses there, so that more people can operate on the blind in third world countries.
“It is not a technique that can be learned just as well in Denmark or the United States, because here you rarely have patients with such advanced cataracts that they are suitable for the MSICS technique. It’s a technique that requires you to do it many times before you get good at it,” explains Gøril Boberg-Ans.
Will be essential
When the couple travel to the far corners of the world, they also carry even more low-tech aids in their suitcase than the MSICS technique. While cataracts are the leading cause of blindness according to the WHO, lack of glasses is the second most common cause. That’s why they always carry a suitcase with used glasses.
Here, too, they have sunshine stories to tell. For example, the young mother in Peru who arrived at the clinic with a child on her back. The mother was minus 6 and was fitted with glasses to match – and cried because now she could see her child. Or a nun in Lesotho who had minus 9 and thought God was a blur. Until she put on glasses.
“These people are crying with happiness. It’s such a great thing to experience. And also a very important reason why we travel,” says Gøril Boberg-Ans.
And then there was the boy, the last time the couple went, who had fallen off a motorcycle and was rushed to the clinic. In the fall, he had been stabbed in the eye. The couple were asked to examine him. They found a deep tear in the cornea caused by a foreign body and had it removed.
“If we hadn’t been there, that boy wouldn’t have been able to see out of that eye today,” says Jannik Boberg-Ans, calling it one of those ‘special experiences’.
“There are tons of them,” adds Gøril Boberg-Ans.
Although the couple are nearing retirement age, they have no plans to stop helping out. Gøril Boberg-Ans recalls that Rome was not built in a day. So there is still a lot for them to do. They also say, almost in unison, that they can’t do much else but work. And they keep going because it’s fun. But the goal is also to make themselves dispensable one day. In other words, to pass the baton to other doctors.
“I guess that’s what life is all about. Building something so that you end up being dispensable yourself,” says Jannik Boberg-Ans.
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