Sam Powdrill has never been to medical school, but he has been almost every place else. Now an assistant professor in the Physician Assistant Studies program at the University of Kentucky College of Health Sciences, with the school’s blessing he spends two months a year in Kenya, or aboard the Mercy Ship, or taking some of his students to the Dominican Republic as part of their clinical training. And everywhere he goes, he does eye surgery.
Born and raised in India by his missionary parents, his early education was in a British boarding school in India. (He speaks three of the numerous Indian languages.) He came home to attend Kentucky Mountain Bible College, near Jackson, where he met his wife, Rachel. Both earned R.N. degrees from Indiana Wesleyan University, Marion, IN. They worked as missionary nurses, first in India, then in Honduras. With no physicians in these areas at the time, Powdrill began to read medical texts and shadow visiting doctors. He soon realized he needed more training.
He enrolled at the Institute of Ophthalmology in London in 1988, and found the love of his life: the study and treatment of eye disorders and diseases. Because he did not have an M.D. degree, he was not qualified to practice in London or the United States, so one of his instructors helped him find a job in research in Sierra Leone. After more than two years there, he joined German-based Christian Blind Mission International (CBMI). Their proposal to Tenwek Hospital, a 300-bed mission hospital in Bomet, Kenya, 225 miles northwest of Nairobi, resulted in the hospital creating a place for him. Tenwek had no eye service at the time.
“We set up their eye unit,” said Powdrill. It was the beginning of a 13-year stint.
They started at Tenwek on April Fool’s Day in 1991. His first patient was a man with a lacerated cornea. The patient recovered well. He has since done more than 300 similar repairs.
“I had done the basics in London on animal eyes,” said Powdrill. “I knew the basic concepts of eye surgery. But for the first two or three years we were at Tenwek it was the ophthalmologists who came out [on mission trips] who taught me how to operate.”
Powdrill is transparent about his qualifications. “I am what they call a non-physician cataract surgeon,” he said. “I do wave a red flag, but try to get the blessing of whatever government I’m working under.” He lists Haiti, Uganda, and Kenya as countries that consider him “actually qualified,” as he puts it.
“He never tries to slide in under the radar,” adds Rachel.
“The government in Kenya said they liked what I was doing, to just go ahead,” said Powdrill. “I told the government officials, ‘If the government changes, or if a patient sues, I am in real trouble.’ So they finally said, ‘Go back [to the states] and get your physician’s assistant [degree]. We already recognize your eye training….Come back here and we will get you in a cataract training program.’”
After earning his physician’s assistant degree from the University of North Dakota, he and Rachel returned to Kenya where he spent one year at Kenyatta Hospital Medical Training College in Nairobi, the national hospital. He did his clinical training back at Tenwek, where that year a board-certified American ophthalmologist was in residence. He gave Powdrill one year of intensive training in cataract surgery. Powdrill worked there until 2004 when he and his wife came home to care for his aging parents.
Working outside the United States, Powdrill does not employ the most widely used technique in cataract removal, phacoemulsification, because it requires a special machine and reliable electricity. Instead, he uses a method that he said, not more than half joking, “I can just about do out of the back of my car.” Called the “Manual Small Incision Cataract Surgery,” or MSICS, pronounced “M-6,” it takes about seven to 15 minutes, and is a very simple procedure using all disposable equipment. “It lends itself to this surgery in a rural area. [In countries where we work] we see many very mature cataracts which are hard to cut. You can do M-6 with less damage to the eye.” Ophthalmologists in the United States have asked him about the method, he said, because they would like to go out of the country or to remote parts of the United States to treat cataract among populations who do not have access to larger medical centers. “They cannot take a phaco machine with them,” said Powdrill.
He hopes to spend time in the next year in, among other places, the Dominican Republic and aboard the Mercy Ship. A self-contained hospital ship operated as a Christian mission, the Mercy Ship brings medical care to parts of the world without basic infrastructure, including a clean water supply and a reliable source of electricity.
In the United States, there is one ophthalmologist for every 20,000 people. In Kenya, there is one for every one million people. He expects to treat 100 to 200 people during the month he is there. He counts it a privilege to do so. “There’s just such a need there,” said Powdrill, the eye surgeon.
By Martha Evans Sparks, Staff Writer