Ashley Silva joins Tanzania eye care team

Ashley Silva knew from a young age that she wanted to be an optometrist, and the reason why will tell you a lot about her.

"In sixth grade, we dissected cow eyeballs," Silva said. "It was the coolest thing to me. I wanted to take it home."

She's been fascinated ever since.

In eighth grade, she did a job shadow at the local optometrist's office. She knew she was interested in the medical field, but she saw this as a good way to interact and connect with patients. It was certainly more appealing than drawing blood all the time.

After graduating from Wahkiakum High School in 2012, she moved to Forest Grove, Ore., and began her studies at Pacific University.

During Silva's freshman year, she joined a program called Amigos, which sends students to different countries around the world on service trips to provide eye care. There is a lot of competition in the optometry program for the limited number of spots on each trip, which are led by professors. Students have to earn so many points to be considered for a trip, and they earn them by volunteering for different duties. One way Silva earned points was to visit a room at the college where they kept donated glasses. Students earned points by verifying prescriptions, and cleaning the glasses.

She is now in her second year of the Optometry School at Pacific University, having earned her undergraduate degree in a kind of accelerated program that allowed her to finish her senior year at the same time she completed her first year of graduate school.

Next year, she will step out of the classroom and move into rotation in a clinic, to continue her learning.

Last Christmas, she traveled to Africa with the Amigos program. She was so moved by the experience, she volunteered to go again next Christmas. So respected, she was asked to lead.

Silva and seven other students traveled to Tanzania with one of their professors, a doctor she really respects. They flew from Portland to Amsterdam, and then from Amsterdam to Kilimanjaro. They spent the night in a nice hotel, because their guide, who grew up there, explained that late night travel was not culturally acceptable. The next day, they headed out to the area where they would spend the next few days.

On the first day they provided care, they visited a school. According to Silva, the children were pretty healthy, but there were some elders nearby who stopped in for a check up. Some had cataracts.

"It was very emotional," Silva said. "I got emotional every day in clinic. We worked from 10-4 and it was very fast paced. We saw around 150 patients each day, going to four different clinic sites."

The second day they visited an orphanage and school that got some attention on 60 Minutes. The students were really healthy and the area was more affluent.

The last two days were the hardest. The team traveled to the Ngorongoro Conservation Area. The Maasai tribe used to live in the crater there. According to Silva, the government kicked them out of their homes. They are still allowed to live in the conservation area, but they cannot live in the crater.

"That's where I saw a lot of the stuff that I would have never seen here in the states," Silva said. "Almost every other patient was blind. People were bringing their elders, walking them there, completely blind. They'd been blind since they were young. When your eyes get damaged like that they kind of shrink and shrivel up, they are just destroyed eyes. That was so hard because there was nothing we could do for them."

Despite the terrible things Silva saw, she and her team were able to give some comfort and alleviate some pain. They gave away a lot of artificial tears, reading glasses, and sunglasses. They don't give out a lot of eye glasses, because the Maasai don't have the same visual demands there, Silva said.

"How much can we really do there?" Silva said. "But every time we even did a test, they were so grateful. Even if we couldn't give them anything, they were thankful."

One teenage girl came to them with recent eye trauma. Struggling to communicate through translators, they asked her how it had happened.

The girl disappeared and returned with an acacia thorn. Acacia bushes are everywhere, and the team concluded that was the culprit for a lot of the blindness they had seen that day. The Maasai use the plant to build fences around their villages to protect themselves, their families and their livestock.

"It was incredible the amount of trauma we saw," Silva said. "We had people lining up and waiting for help. When you got to them, you realized they'd been blind forever."

A mother came to Silva with her son on her back.

"I thought I was going to examine her eyes," Silva said, "but she kept pointing at her baby, who was screaming. She turned his head to me and his whole face was gashed open."

It was the most emotional experience she'd had on the trip and she had to step away for a moment to regain her composure.

"She was so helpless," Silva said. "She brought him there for us to help him, but we were eye doctors and we had to turn her away."

Through translators, they convinced her to go to the hospital. At least, Silva hopes so.

She really struggled with the language barrier.

"It tugged on my heart strings," she said. "I couldn't comfort someone as I gave directions, I had to explain through translators, and it always seems to lose something in the process."

The students administered antibiotic eye drops to some. They brought out their loupes to remove foreign bodies from eyes. On two occasions, they were able to treat an entropion. According to Silva, an entropion is caused by too much exposure to the wind or dust, and it causes the eyelid to roll in, bringing eyelashes into contact with the cornea, which they will destroy. The injury is treated by the removal of eyelashes, which allows the eyelid to relax.

"Once that happened, they were completely relieved," Silva said. "We had to put them through all that pain, and they completely trusted us, which is mind blowing to me."

The students also got to go on two safaris. They saw zebras, wildebeest, monkeys, giraffes, elephants, a couple lions and one rhino.

On Christmas Day, they were invited to a village for a welcoming ceremony, which was very moving for Silva.

"They chanted and held our hands," Silva said. "They danced and we got to dance with them. We go to go into their homes.

"It was surreal," Silva said of the whole experience. "We're driving through the bush and they are herding their cows with a stick. Was I in a movie? People live like this every day."

The return to the US was initially disconcerting.

Silva and a friend are leading the team for the next trip to Tanzania in December, and they've already begun planning.

"There's a lot of work to be done there," Silva said. "Our doctor that goes with us is amazingly dedicated and supportive. He works year around for this trip. It's great to be able to go with him."

This year, they may begin to be able to provide cataract surgery for some of their patients in Africa.

Someday, when Silva has a practice of her own, she hopes to travel each year for similar service projects. She discovered eyes when she was in sixth grade. Apparently, she's always had a heart.