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Inside Orbis, the flying hospital that battles blindness

Is it a bird? Is it a plane? Well, yes ... but it's also a world-class medical center and teaching facility.

The latest Orbis flying hospital was unveiled in June 2016. It is the third plane kitted out by the non-profit in its 35-year history, bringing treatment and training to visually impaired people and those who operate on them around the world.
Katie Collins/CNET

This plane brings a whole new perspective to what a hospital can look like.

I'm aboard the Flying Eye Hospital, a one-of-a-kind traveling medical and teaching facility funded by Orbis, a nonprofit organization dedicated to treating vision impairments around the world.

The Orbis Flying Eye Hospital is a heavily customized, three-engine McDonnell Douglass DC-10 aircraft, kitted out with cutting-edge eye surgery equipment. It trots around the globe, serving as teaching hospital as the doctors aboard treat cataracts and glaucoma, the top two causes of blindness and visual impairment.

Given that 90 percent of people suffering visual impairment live in developing nations, the Flying Eye Hospital has a busy schedule flying among 81 countries in Africa, Asia and Latin America. But the plane was briefly in residence at the Stansted Airport near London this week, giving me a rare opportunity to tour the Orbis.

Here's what I saw.

Welcome aboard

Captain Gary Dyson, a FedEx pilot who has volunteered for Orbis for 16 years, welcomed me on board as I slipped into protective blue overshoes. The first compartment of the plane looked much like the economy section of any normal plane, with 46 seats. This is used to transport the Orbis crew, but doubles as a classroom for local doctors and nurses.


Captain Gary Dyson always flies with his guitar, which he uses to entertain patients on screening day.

Katie Collins/CNET

At the front is a 50-inch widescreen television on which students can watch operations taking place in the plane's operating theater. To do so they must don 3D glasses. Seeing an operation in 3D is essential to understanding the surgery, Jonathan Lord, global medical director for Orbis, said in an interview on Tuesday.

A 3D camera donated by TrueVision attaches to the microscope so students can observe the surgery in minute detail. They can also ask the surgeon questions through two-way microphones.

Behind the classroom/passenger compartment is where the real fun begins. Everything past this point counts as cargo, meaning that the Orbis doesn't need to seek permission from the Federal Aviation Administration to customize the rest of the plane.

But it's far from simply storage space. The "cargo" area comprises a series of rooms for AV, patient care, an operating theater, a sterilization area, space for both pre- and postoperative care, and room for its laser.

The plane employs a modular system, with each room and the section of corridor that runs beside it slotting in as separate components. Walking the length of the plane, it's easy to see the breaks in the floor and the walls that divide up the modules. These can be taken in and out, and can be updated and customized, essentially future-proofing the aircraft for years to come.

"We could reconfigure areas so if something dramatic changes in technology, we can incorporate it relatively easily," Lord said.

You don't have to be aboard the plane to watch the procedures. Orbis streams operations to registered medics all over the world through webinars. As long as they have a smartphone and a 3G cellular connection, doctors can watch and even interact live with the surgeon.

The operating theater sits over the wing, which is the most stable part of the plane and which has reinforced floors to keep it steady. This isn't to say surgery is ever performed in the air, but the operating theater must be rock-solid for the surgeons to perform their delicate operations.

In the belly of the beast

I also got a chance to view the plane's hold, which sits directly underneath the hospital sections. This is where all of the biomedical equipment is stored when the plane is in transit, and it also contains the hospital's air conditioning and filtration systems, its modified power generators and its water purification system. When the plane lands, these are pulled out onto the ground and hooked up to the plane to let it run by itself.

Orbis is powered by jet fuel, keeping the entire hospital fully self sufficient. The air filtration system keeps the hospital sterile and appropriately zoned. As such, it's the first non-ground-based hospital to meet US hospital standards and receive full certification, Lord said.

A lesson from the skies

Lord is as passionate about the reach of Orbis and its online training platform as he is about the training equipment on board. This includes virtual reality headsets worn by students so that teachers can see what they see on a second screen as they conduct examinations and can judge whether the procedures are being done correctly.

"Our plane celebrates a marriage between aviation and medicine," said Lord. What aviation has taught medicine is the power of simulation. He pointed to the hours of flight training pilots must complete in simulators before they're allowed to fly a plane. In a simulation, he said, "it doesn't matter if they crash -- no one will be harmed."

Also on board is a state-of-the-art ophthalmic simulator that allows doctors to conduct surgery using real instruments. I watched as a volunteer made an incision into a dummy eyeball, which on the screen by the side looked like a real-life cataract.

"That's what it looks like in real life you look down a microscope, even to the little reflection of the light sources from the microscope," said Lord as he narrated the surgery to me. Training people to have these skills is a crucial part of Orbis' mission to head off blindness with treatment. The organization says of the 39 million blind people worldwide, 32 million cases are avoidable.

"You teach people skills using simulation, and when they're shown to be competent, they then move on to live surgery," said Lord. "It's no longer good enough from a quality and safety side to let people loose on patients when they've never tried and never had demonstrated any skills."

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