MUSC optometrist and team take skills to Belize to help with low-vision rehabilitation

In April of 2025, James Hill, OD, and his medical team journeyed to Belize in collaboration with the Belize Council for the Visually Impaired (BCVI) to support its efforts to improve the quality and availability of eye care for visually impaired citizens.

Belize, a small English-speaking nation in Central America, suffers from poor health infrastructure that makes it difficult for care providers to address and prevent certain eye diseases, such as congenital cataracts and retinal dystrophy. By the end of 2023, Belize recorded 1,476 visually impaired people, the majority being under the age of 16, especially babies.

According to Hill, the Medical University of South Carolina (MUSC) has had a longstanding connection with the BCVI, collaborating long-distance to provide care for nearly 40 years. However, his effort was the first boots-on-the-ground operation to help with in-person, low-vision rehabilitation. After well over a year of logistical planning, they made the trip to Belize this year to provide visual impairment services.

Once they touched down in Belize, Hill and his associates set up a learning workshop to provide modern strategies and technologies to Belizean optometrists, vision teachers and the entire staff at the BCVI organization; then they conducted pediatric low-vision clinics for two days.

Currently, Belize’s most urgent vision-related health care need is the ability to diagnose cases and treat them early, Hill explained.

 

“Early diagnosis of congenital cataracts and retinopathy of prematurity is the key to long-term success in that population, which entails having someone who can dilate and look at babies that are born premature.”

While children in South Carolina born with retinopathy of prematurity end up at MUSC, where they can automatically receive an injection that tamps down the blood vessel growth, the gold standard of treatments, that is not the case in Belize.

“Access to medications isn't nearly as good,” said Hill. “Treatments for diseases such as diabetic retinopathy, glaucoma and macular degeneration exist, but getting access to them due to cost, logistics and infrastructure proves to be difficult in a developing country such as Belize.”

Without experts to screen children for these complex conditions, people suffer. Hill stressed the importance of this factor.

“There is a huge need to appropriately diagnose patients early and once you diagnose, to have a treatment plan in place that can handle that,” he emphasized. “To have an early treatment diagnosis so that families can be educated, get the appropriate medications and ensure their children aren’t left behind in school.”

Hill noted several surprising discoveries while assessing their medical infrastructure. He spoke of the vast rurality in much of the region and how the transportation system makes it difficult for many families to access care.

“We had multiple families travel up to five hours – walking an hour to get to a bus and then relying on public transport to reach us – just how long it would take to get somewhere less than 100 miles away.”

Despite this, he noted the enthusiasm that Belizean care providers had toward his team’s efforts – their dedication to learning and adding new skill sets to take care of their patients gave them pride and motivation.

“They were really eager to learn and be able to apply their teachings. I really did feel like I made lifelong friends on the trip,” said Hill, who continues to communicate with his colleagues there.

It was fulfilling for his team to have provided education to optometrists that would be shared throughout the medical community, helping to build confidence and continue learning that would foster independence. 

 

One of Hill’s takeaways from the trip was the fact that he now has an even greater respect for the necessary resources MUSC Health is able to offer, realizing that not all others are as fortunate to have constant access to advanced technologies. Belizean health care providers, for instance, must rely on donations to procure the resources needed to treat their patients. 

“After leaving America, you come back with a greater appreciation for how people with fewer tools are able to do a lot with a little. I learned that we don’t necessarily have to have all the technology to be good at what we do. What I took back is a sense of how lucky we are, what we are able to do here and how they are so willing to adapt and learn. We should, as stewards of a great education and health care system, definitely strive to help others to get to the level we are.”

He provided advice for other care providers considering international volunteer outreach: keep in mind bias and perspective. 

“It’s easy to lose sight of what’s important sometimes because we’re just in a daily grind, and when you go abroad and you get perspective, I think it makes you a better physician. My advice is this: If you get an opportunity, go. You’ll bring back a better perspective and attitude of what your purpose is that can benefit your patients that we all strive hard to care for.”

In the future, Hill hopes to return to Belize and continue to foster eye-care education and help to build a better medical program through maximizing skill sets that can lead to better eye disease treatments. The work his team did in Belize, he said, can hopefully be continued in other regions, too, such as Tanzania.