Life as an ophthalmologist in Cameroon

In January 36-year-old Cameroonian ophthalmologist Jeanne Mayouego Kouam, MD, received an important and career-changing email. She learned she was a recipient of the ARVO Foundation’s Developing Country Eye Researcher Travel Fellowship. Kouam’s application was also the highest-scored of the 54 applicants and she was one of just nine accepted fellows. This $4,500 grant, supported by the ARVO Foundation’s Women in Eye and Vision Research initiative, allowed her to attend the ARVO 2018 Annual Meeting in Honolulu, Hawaii with the majority of her travel costs subsidized and with the support of senior ARVO members to guide her through the meeting.

Bringing Eye and Vision Care for the Underserved
Kouam’s career in eye and vision research began in 2014 during a residency in France where she learned the latest clinical technology in ophthalmology. Following her residency, she was assigned to Limbe Regional Hospital in South-West Cameroon, where she found it jarring that the facility was missing the most basic clinical equipment or equipment that needed repair. For the past two years, Kouam has worked at Nylon District Hospital, a public hospital in Douala. When she started, the facility did not have an ophthalmology unit. As a result, she has dedicated herself to building the hospital’s eye clinic from scratch.

“As a young ophthalmologist, you think you will go to a big eye unit and just start helping people,” she explains. “You don’t imagine that you will be responsible for building it.”

Kouam recalls arriving in the hospital to find the slit lamp not working and spending time figuring out how to fix it. She is still in need of a tonometer to check interocular pressure and a visual field analyzer so that she doesn’t have to send her patients to other hospitals for basic care. In between patients, she tries to find the right connections she needs to get the necessary equipment to provide basic eye care for the patients she is serving in Cameroon.

Delivering Care to the Community
Kouam currently sees about six patients each day, most of whom walk in without appointments. “I can give appointments after I see a patient initially, but many cannot honor their appointment,” she says. “My patients may not have money that day to travel. Or if it’s the rainy season, transportation may be impossible.”

The most common patient conditions are refractive errors, eye trauma and cataracts. Though Kouam is trained as a surgeon, the lack of infrastructure requires her to refer patients who require surgery to another hospital in Douala or to one of the visiting eye clinics that periodically visit the area — a major inconvenience for patients who may not have transportation.

Sometimes the daily challenges feel unsurmountable, yet Kouam remains optimistic about her work and her desire to help those in her country receive vital access to eye and vision care. Research has played a big role in keeping her focused and motivated. “Research saved me,” she says. “It has kept me busy when the clinical aspect of my practice has been unsatisfying.”

Pediatric ophthalmology has emerged as her primary research interest. Her hospital provides care for children with HIV and she is currently looking at the ocular manifestation of HIV in children. Additionally, Kouam is studying early vision screening of amblyopia and eye disease in children.

Travel Bumps Lead to Learning
Her trip to ARVO 2018 in Honolulu from Douala, Cameroon was not unlike her day-to-day life as an ophthalmologist in a developing country: challenging. After an airline mistake caused her to miss her series of flights, she was able to rebook her 36-hour journey around the world and join the meeting only one day late. Kouam jumped right in to the learning and networking and connected with her meeting mentors: David G. Hunter, MD, PhD, FARVO, of Boston Children’s Hospital and Poonam Mudgil, PhD, of Western Sydney University. Both of these seasoned ARVO attendees and researchers helped her plan her itinerary to make the most of the meeting’s scientific offerings and networking opportunities.

Attending the ARVO meeting was a career-changing opportunity for Kouam allowing her to replace her isolation with connections. “I now belong to an international community of motivated and creative eye and vision researchers,” she says. “I have started building a powerful network for future research and training collaborations. Discussions with some researchers during the meeting helped me reshape some old research projects and imagine new ones that I can conduct in my own setting.” 

“I was hoping to get so much from this unique opportunity. At the end, what I was offered was far beyond all my expectations,” she says. “My self-confidence has been boosted and my resolve for ophthalmology research strengthened.”