 So while I'm getting set up here, I just want to thank Dr. Mifflin for going down with me. This is the second trip I had to Bolivia and the first one was in 2010. I was invited by Bill Jackson who's the Director of Deseret International. He called me one day in 2009 and said there was a need for some cornea transplant training in Bolivia. So I was able to get 10 corneas from the Utah Lions Eye Bank, and 10 from my former eye bank I used to work with in San Diego. We did several cornea transplants down there. You've seen the pictures of the past. This is the Sahama Volcano. The plane here that we're looking at is actually higher than the peak of the Grand Teton Mountains. Grand Teton is like 13,700 feet. This is 14,000 feet. This is where we're standing in the Sahama Volcano where Mark and I went with Claudia. Could you feel that? Can you feel the elbow? We just walking along the plane, it was okay, but if you go up a flight of stairs, you start to feel it. This is the Institute right here. This was founded in 1975, and this is the Institute where we work, the National Institute of Ophthalmology. These are the founders back in 1975, some of the early Bolivian ophthalmologists that got together and said, we need a place to treat our charity patients, and they founded this Institute, and this is Jose Barraquer came down from Bogota, and was there during the inauguration of the Institute in 1975. These are our post-op cornea transplant patients from June of 2010, and this is my son-in-law who went down with me to take photographs and he's a medical student here now, and this is Dr. Hoa Moya, who's the director, and this is Andrea Lozano, who is an observer here in cornea two years ago, and she's currently doing a cornea fellowship in Mexico City. These are the three profesores. You remember Gene Kim was one of Marc Magie's cornea fellows a couple of years ago, and did a great job. The Institute put on a symposium for cornea transplants and fecos, and we taught these lectures, and I was really proud of Marc and Gene. They taught all their lectures in Spanish. We weren't planning on doing that, but when we got down there, I was impressed with, you know, Marc has lived in South America before, and he speaks really good Spanish. Gene is really bright, he picked it up pretty quickly, but he gave all of these lectures in Spanish. It's one thing to just talk Spanish, it's another thing to speak the medical, you know, talk about crosslinking and refractive surgery and all that. You don't learn that in school, but they did a great job. So this is what we did in the evenings as we did surgeries during the day. And Marc actually did the very first Dalek and the first desec ever done in Bolivia down there during two months ago, did a total of 28 transplants. Most of those corneas came from here, a few from Seattle, a few from San Diego. And we also did some fecos and some SICS extra caps and a few other minor procedures that were done. We saw a fish hook actually inside the anterior chamber that had been there for four days. And one of the, I was really impressed with the local doctors who took that out. This is a collage of some of the pictures of the week. You can see we're busy, a lot of activities going on. Kind of a summary of what we did with 28 cornea transplants. So the goal, when I went down there three years ago, obviously they don't have an eye bank there and they had tried to have one, but it had failed before. And so we started working with Dr. Moya. The director, he came up here last year and he met with the eye bank, met with Marc Mifflin and obtained since last year government approval to establish an eye bank, plus a promise of a million dollars to help fund the construction of the eye bank. So that looks like it'll become a reality next year. This is a sad story of a patient that Claudia knows really well, a patient I operated on, a 38 year old who was fine until about four years ago when she opened a package intended for her husband. It turned out to be a bomb. It blew up in her face, destroyed one eye, severely scarred the other, lost a few fingers, damaged her face, her leg, and unfortunately her husband left her because she was blind. Now she's destitute, had a major fail graph and I replaced the graph. I hope she gets some vision left, but these are the type of cases we had down there. Very, very difficult cases. This is a video I put together kind of showing some of the activities I wanted to show you. The music is actually played by one of Dr. Mifflin's patients. He's a professional guitarist. This is Dr. Pettus Roca, who is the director of the residence at the Horry Scale Surgeon and one of the founders of the institute. This is the waiting room we saw when we walked in there on a Sunday afternoon. We had 65 patients to screen, 25 or 30. I was particularly impressed with how kind and nice these Colombian people are. They're just great. A lot of corneal scars, a lot of care. This is a corneal also. A lot of keratoconus, bulus keratoconus. I thought you'd like to see the OR. It's a very nice operating room. We had two ORs we used and two surgeons. One of them is the Jean and I were in one OR and this is Mark in the other. He is, I think, getting, he was removing a dermoid, a limbo dermoid from a 10-year-old girl. And the dermoid has been excised here. You can see the site and he's preparing the lamellar condition to do the lamellar apache. It's Dr. Kim doing a transplant. This is an old WEC microscope, similar to the one I think that Dr. Olson and I used when we were residents back in, many years ago back at UCLA. Those scopes are pretty good. I think I'm doing a transplant now on a patient with a corneal ulcer scar. He assisted by Dr. Fernandez, who's a corneal surgeon there. So you can see the OR set up. It's not unusual in Latin America to have two, even three surgeons operating in the same room, which is actually a very efficient way to do it with one large back table. The turnaround is very good. Is there a twist in circulating there? You can see this corneal scar here that we're removing, a very dead scar. This is Dr. Andrea Lozano. And this is Dr. Lozano. I remember her from two years ago. She was there. She's one of the things we did. We allowed her and some of the other local doctors to... She came down from Mexico to be with us during that week. But she did one or two of the transplants. So we helped her with that. So the purpose of these trips is not just to go down and do surgeries, but through establishing the eye bank and through training to enhance their ability to do surgeries. One of the things that we learned was that you have to take sutures out a lot sooner down there than we do here. Because of the atopic disease, the solar exposure, and this inflammation, it's not unusual to... I think this is the DALK that Mark was doing. The hard ones are a lot easier to take out. And this is me on that case with the corneal ulcer scar. There's a cataract ulcer. A rather soft cataract doing an IA with an open sky irrigation aspiration with a simple manual technique. A few of our patients had very limited visual progress. It's this particular girl putting in one of the final sutures. Actually, she was very, very happy. She had good prognosis. She was very happy with the outcome. So this is just a picture from the video monitor which they installed since we were there in 2000 for training purposes with the residents and other faculty. So it's very likely that there will be an eye bank down there within about 12 months. They're from the government. The main challenges that's been discussed already is public education. That's going to be the big challenge. It's going to be people. It'll be a slow process, but we're hoping that that will come about. I've done a lot of transplants in South America with... In Chile and... This is our last case, with tissue that's older than 10 days and cell counts around 2,000. And it's amazing how well those patients do. They really do quite well. And we have done... This is one of the last cases we did. Big smile. And for the residents and fellows, those who might want to go to Bolivia or other countries to do some extra caps or SICS surgery, there are some... I have contacts in several countries down there that could help us in training. It's not an easy thing to do, but you're not only learning English, but language, a scope that doesn't work too well. Lint on all the instruments because they don't use disposable grapes. And a lot of other challenges too, but for those who might be interested, there's a good training opportunity. This is the person who's playing the guitar. Mark did a fake on him. He was a very happy patient. This is the residents and program director at his room. He's the one that took the tissue out of the anterior chamber. He also had a... This is the little boy that had a thorn in his morning, who actually almost ended the anterior chamber at his table. The nurse donated some of these idea caps to his table. This is Cloud. This is the patient that I was operating on. She was very happy. He had about 2,100 unrecognized patients. This is the third-year resident, Dr. Tiavis, who would like to come here to be an observer. I'm going to, just in the interest of time, is up newspaper article. Nice coverage by LaPasse. The medical school was very kind and gave us... presented us with diplomas. Honorary professor diplomas. Certainly not necessarily very kind. So plans for the future. In the next year or two, we're hoping to have an iBank established. I'm working with the Humanitarian Department of the LDS Church to get some equipment donated for an optical dispensary in lab and also low vision services in the institute. There are about 35 to 50,000 children, school-aged children, in LaPasse area that need glasses but don't have glasses, don't have the resources to buy glasses. So just in closing, a lot of blind people in the world, solutions, difficult. A lot of work has been done to help the masses, but a lot can be done just with an individual. I'm going to show you a very brief video. About 15 years ago, I was in El Salvador. This is a young girl who was normal until she was three years old. She felt she was very close to Jesus and became bilaterally blind from cataracts. She never went to school. She has an ecstasy misdiagnosis and she's been blind for since age three and she's 10 years old now. So I was asked to remove her cataracts and we did the first one. I didn't know exactly what to do but decided to do it through a small incision and just a manual aspiration through a FACO type incision using a SIMCO irrigation aspiration. A lot of fibrous tissue in the capsule but was able to get the cataract out and place a rigid PMMA lens in the back. And I never saw her smile until after the surgery. She was just a very sad girl, couldn't go to school, couldn't interact with her friends but this is the first day after the surgery and we can see that smile on her face and that type of result makes this very worthwhile. Those of you who have done trips like this even patients like this here in the state you know that feeling. So she says she's very happy that she can see again. It was a very happy moment. It was a very happy moment It was about we didn't actually push her too much. She had very good count fingers vision probably 21. I'm sure she had some amblyopia but at least she was able to see. So just in closing Swedish diplomat Dag Hammershill some of the old timers will remember him he was secretary general of the United Nations back in the 1950s and unfortunately killed in a airplane crash in 1961 peacekeeping mission to Africa but he has a quote that I remember he says it's more noble to give yourself completely to one individual than to labor diligently for the salvation of the masses. This is an individual who was laboring for the masses as secretary general of the United Nations and did a great job but he also recognized the importance and value of just helping one person and I think we are very fortunate to have a profession where we can help one person see better and thank you very much for your attention and thank you Claudia for telling us about Bolivia