The Wall Street Journal commissioned me last November to photograph a story on machine learning (read AI) and its impact on eye care at the grass-roots level in Tamil Nadu (TN).
Armed with a borrowed 14-24mm, a 35mm, a 105mm macro lens, and a D750, plus my own modest camera & lighting gear I set out to Madurai on a rainy night. It was still pouring when I set foot in Madurai the next morning! Although none of my photo gear bore the brunt of the storm, my sneakers got soaking wet and squished with every step I took. Once I checked into the hotel, I spent a good 10-15 minutes trying to get them to dry but in vain. (They eventually gave way that afternoon.)
The two Google representatives, the reporter, and I arrived at the Aravind Eye Hospital around 8.30am. After a rather long interview session with the hospital’s Chief Medical Officer, Dr. Kim, we were given a tour of the facility starting with the one-of-a-kind teleopthalmology unit.
Clockwise from left:
- Four postgraduate students of ophthalmology man the teleophthalmology unit at the hospital.
- Dr. M. Mangaleshwari, teleophthalmologist, counsels a patient after grading her retinal images at Aravind Eye Hospital, Madurai, India, Friday, Nov. 16, 2018. “The joy on the [patient’s] face upon seeing the world anew after undergoing surgery is priceless,” she said.
- The influx of patients was as usual despite the heavy rain.
- Dr. Govindappa Venkataswamy, aka Dr. V iconography is scattered all over the hospital for good measure.
Once our tour was over, we were off to a small town – Thiruppuvanam – about half an hour’s drive from Madurai amid heavy showers to visit one of the first vision centers built by the Aravind Eye Care System to facilitate remote screening for diabetic retinopathy (DR).
- V. P. Eswari, one of the two nurses at the Thiruppuvanam vision center, uses a fundus camera to photograph R. Anusuya Devi’s, 79, retina during a routine eye check-up, Friday, Nov. 16, 2018. Ms. Devi was diagnosed with non-proliferative diagnostic retinopathy (DR) four years back. Ms. Eswari, a high school graduate, has been employed with the Aravind Eye Care System for more than 13 years. She opines that had she been employed elsewhere she would’ve sorely missed the human interaction that she gets to have at the vision center on a daily basis.
- Ms. Eswari has to capture three different useable photographs of the back (fundus) of each of the patient’s eyes for the AI to be able to successfully screen the patient.
- Dr. Mangaleshwari communicates with Ms. Eswari over the internet to assess Ms. Devi’s prognosis.
- The Thiruppuvanam vision center (VC) is one of the 73 vision centres established by the Aravind Eye Care System in rural Tamil Nadu. Around 2,000 patients visit these VCs collectively every day. VCs are open six days a week and charge a consultation fee of Rs. 100 which is good for three months. Incidentally, the Thiruppuvanam VC along with the Alanganallur VC was the very first VC launched by the Aravind Eye Care System back in 2007.
After I had the requisite images (& caption info) in the bag and the reporter was done speaking to the staff and patients, we made our way back to the hospital in Madurai. We stopped on the way and treated ourselves to a hearty meal. With our bellies full and our minds reinvigorated, we were once again back in the hospital around 3pm to see Dr. Kim in action.
- Dr. R. Kim (right), Chief Medical Officer, Aravind Eye Hospital, Madurai, India, performs a peripheral retinal examination on M. Kaliappan’s, 75, left eye using an indirect ophthalmoscope (not pictured) and a 20 diopter viewing lens in the eye examination room, Friday, Nov. 16, 2018. Mr. Kaliappan who had undergone retinal detachment surgery in his left eye 10 years back had come for a routine follow-up. Apart from his regular clinical work, Dr. Kim is involved in driving innovation in the organisation. “People ask me, ‘How can you let a machine screen a patient?’ I tell them, ‘Why not when they can trust a driverless vehicle while travelling?’”
- Dr. Kim sterilizes his hands before attending to his patient, Mr. Kaliappan.
- Dr. Kim examines Mr. Kaliappan’s, 75, eyes using a slit lamp biomicroscope in the eye examination room.
- Mr. Kaliappan is just about done with his consultation with Dr. Kim. The patient was prescribed glasses for presbyopia.
It was a challenging day for all of us and the rain only compounded the problem. Anyway, we decided to call it a day around 6pm. The rain by this time had trickled to a drizzle but there were no signs of it dying down anytime soon.
I was back in my hotel room before 7. After a quick shuteye and shower, I packed my bags and checked out at 10.30. I said, ‘Thank God!’ to myself when a waft of cool breeze greeted me as I made my way out of the hotel and onto the shimmering pothole-strewn street.
P.S. My trusty Pumas held on until I reached home.
P.P.S. Read The Wall Street Journal article here.