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Sight saver

Aircraft interiors have been modified to meet a wide range of specialist requirements. A stand-out example is that of Orbis International – the world’s only flying eye hospital. Ian Harbison reports from London-Stansted

Orbis International is one of the world’s leading eye charities. It uses a Flying Eye Hospital staffed by volunteer flight crew and medical specialists from the Orbis Volunteer Faculty to deliver treatment and training to developing countries, where facilities and skills may be limited. This is important as 80% of visual impairment can be avoided or cured. In addition, the training is a legacy after the aircraft has departed that enables local medical personnel to continue the work. The most common problems dealt with by the team are trachoma, cataracts, glaucoma, retinopathy of prematurity and strabismus. 


In August 2011, Orbis and FedEx (a long-term supporter) announced a new five-year, $5.375 million commitment in the form of cash and in-kind contributions. In addition, FedEx Express donated a McDonnell Douglas MD-10-30 aircraft to be the third Flying Eye Hospital. The aircraft had been built in 1973 as a freighter and was equipped with a large cargo door. It was converted at the Southern California Logistics Airport in Victorville, CA. 


Orbis led a team of aviation experts, FedEx team members, and former FedEx and McDonnell Douglas employees to design the interior. A particular challenge was that the interior needed to meet FAA airworthiness regulations and medical regulations (it is the only non-land-based hospital in the world that is accredited by the American Association for Accreditation of Ambulatory Surgery Facilities International. In addition, it had to be able to be transported as ordinary cargo to eliminate the need to certify medical items for flight, lowering costs and simplifying maintenance. Some of the equipment has been redesigned to be locked in place for flight, rather than removed and stowed. The facility can now be set up and dismantled in just two hours. 


The solution was a modular design, which was produced by Mobile Medical International Corporation of St Johnsbury, VT, with support from FedEx. The modules fit on full-width cargo pallets that can be loaded piece by piece into the aircraft on a custom-designed cargo handling system. Some of the units span more than one cargo pallet. 


Starting at the front of the aircraft, at the L1 door, there is a galley unit and two lavatories. Behind this (sponsored by the Alcon Foundation) is a forward passenger cabin for staff in transit that also acts as a 46-seat classroom. Local medical professionals are able to watch live surgeries taking place in the operating room at the rear of the aircraft. Two-way communication is established with the operating room, allowing participants in the classroom to watch each incision, hear the surgeon’s explanations and ask questions in real time. The surgery is displayed in 3D, allowing participants to view the surgery with full depth perception through 3D glasses.  


Overhead bins have been added on each side but are used to store emergency equipment. Although the aircraft was built as a freighter, windows were installed but then blanked off in normal use. They have now been restored. 


The rear wall of the classroom acts as a rigid 9g cargo barrier, protecting the classroom and cockpit from the medical modules that fill the rest of the aircraft. These are arranged so that a single aisle runs the length of the aircraft on the port side. The modules include: 


  • An administration room (sponsored by the Ho Man Fat Memorial Foundation), which provides an office environment for staff and the Orbis Volunteer Faculty. There is access via a stairway to the forward cargo bay, which houses workspaces for the biomedical section and the maintenance engineers in charge of all onboard diagnostic, surgical, anaesthesia, laser and patient monitoring equipment. Numerous systems required to run the hospital connect through this area while quick disconnect fittings and a smoke barrier floor panel isolate the hospital from the rest of the aircraft and allow it to be flown as cargo 


  • Audiovisual/IT room (sponsored by the Emperor Foundation), where a control panel allows the AV/ IT specialist to monitor activity throughout the aircraft, control all 16 cameras across the Flying Eye Hospital, and display critical training demonstrations in the classroom thanks to Creston-donated integration technology. Following a Flying Eye Hospital programme, DVDs of training surgeries are donated to partner hospitals


  • Laser treatment room (sponsored by L'Occitane Foundation), consists of three modules and is used for training which does not require sterile conditions. Procedures can also be broadcast to the classroom. 


  • Observation room (sponsored by Grace Tsao), part of the laser treatment room that can be screened off to allow visitors to watch procedures. >>

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