What is the ORBIS Flying Eye Hospital?

The ORBIS Flying Eye Hospital is the result of a unique and lasting alliance forged between the medical and aviation industries. This airborne eye hospital makes it possible for ORBIS to relocate an ophthalmic teaching facility to airports throughout the developing world. The ORBIS medical team provides hands-on training to local eye care professionals and conveys the latest medical knowledge to treat patients and restore sight. On the outside, the plane is like most other aircraft. Inside, however, it is like no other aircraft in the world.

Standard Cargo:
Intraocular lenses, microscopes and operating instruments

Standard Interior:
Operating room, 48-seat classroom, audiovisual studio, communications center, and areas for laser surgery, patient recovery and instrument sterilization.

How did the ORBIS Flying Eye Hospital come about?

In the 1970s, Houston ophthalmologist Dr. David Paton had a bold vision – to use aviation to deliver medical education to the eyes of the world. Motivated by the fact that 80% of the world's visual disability can be avoided through treatment or prevention, Dr. Paton recruited a small group of philanthropists, doctors, and aviators – including Betsy Trippe DeVecchi (daughter of Juan Trippe, founder of Pan American Airways) and A L Ueltschi (founder and chairman of FlightSafety International) – and established Project ORBIS in 1973.

In 1980 Eddie Carlson, former chairman of United Airlines, agreed to donate United’s oldest DC-8 aircraft to the Project. With a grant from USAID and funds from private donors, extensive modifications were made to the plane to convert it into a fully functional teaching eye hospital. Staffed by a highly-skilled team of ophthalmologists, anesthesiologists, nurses and biomedical technicians, the ORBIS DC-8 Flying Eye Hospital took off from Houston, Texas for its first program in Panama in the spring of 1982.

By 1992 the DC-8 was more than 30 years old, and replacement parts were becoming more difficult and expensive to obtain. ORBIS programs were also expanding in scope, and it became clear that a newer, larger aircraft was needed to replace the DC-8. In 1992, with donations from three very generous individuals, ORBIS purchased a DC-10, which had more than twice the interior space of the original plane.

ORBIS recently announced that it has begun the process of replacing the DC-10 Flying Eye Hospital with a newer, more efficient aircraft. The new Flying Eye Hospital will be a MD-10 aircraft, donated by FedEx and powered by engines from United Airlines. It is currently undergoing maintenance at Aeronavali in Venice, Italy and interior installation will begin later this year. Once brought into service—anticipated late 2012—it is expected to meet ORBIS’ needs for a full 20 years.

Why was the DC-10 selected rather than another aircraft?

When reviewing potential aircraft replacements for the aging ORBIS DC-8-21, ORBIS staff, mechanics, and members of the volunteer medical team considered several models, including the A-300, DC-10, L-1011, B-767 and 747-SP. The L-1011 and DC-10 were considered the most attractive options, mainly because of the increased space capacity these planes offered. The available floor space of each plane was approximately 2,000 square feet, which represented a 120% gain in floor space compared to the DC-8. 
 

What is the history of the ORBIS DC-10?

1970	The second DC-10-10 rolls off the McDonnell-Douglas assembly line in Long Beach, California and serves as a test aircraft registered N101AA
1977	Freddie Laker of Laker Airways Ltd buys the plane and re-registers it G-BELO
1982	Laker Airways Ltd ceases operations and the plane is stored by WFU
1983	American Trans Air buys the plane and re-registers it N183AT
1985	Omni International Jet Trading Floor acquires the plane
1986	Cal-Air International acquires the plane and re-registers it G-GCAL
1988	Cal-Air changes its name to Novair International
1990	The plane is transferred to Rank Organization and Financing Company and stored in Prestwick, Scotland and later in Waco, Texas
1991	ORBIS receives a total of $14 million in donations in order to purchase the plane. Proceeds come from three major sources: A L Ueltschi, president of FlightSafety International and chairman of the ORBIS International, donates US $6 million; Y C Ho, a Hong Kong businessman, donates $7 million; and an anonymous donor donates the remaining $1 million
1992	ORBIS purchases and registers the plane as N220AU
1994	ORBIS DC-8 is formally retired and the ORBIS DC-10 takes over as the world’s only Flying Eye Hospital and completes its in augural mission to Beijing, China
2008	ORBIS begins planning for next generation Flying Eye Hospital
2010	MD-10 aircraft donated to ORBIS by FedEx to be used as the next generation Flying Eye Hospital powered by engines supplied by United Airlines.

What are the technical details of the ORBIS DC-10?

Manufacturer: McDonnell-Douglas

Model: DC-10-10

Engines: 3 General Electric - CF6-6d1a, 40,000 lbs thrust each

Dimensions: Span - 156 ft / Length - 171 ft / Height - 72 ft

Weight: Maximum takeoff - 455,000 lbs, Maximum landing weight - 363,000 lbs

Performance: Cruise - 475kts or mach 0.83, Range - 6 hours

How was the plane layout developed?

A full-scale mock-up of the interior of the aircraft was constructed in Houston, Texas using foam core material. The ORBIS design team, consisting of medical personnel, architects, and engineers, reviewed and provided input on the human ergonomics of the layout. The medical team, who were then serving on the ORBIS DC-8, even conducted a day of mock surgeries in order to determine the design and architectural modifications of the plane before finalizing floor plans.

Where did the ORBIS DC-10’s renovation take place?

The renovation was carried out by Mobile Aerospace Engineering, Inc in Mobile, Alabama. It took 18 months to convert the DC-10 into a state-of-the-art ophthalmic medical facility. The Mobile Aerospace Engineering team utilized the foam core mock-up of the interior to ensure proper fit and function.

What was the total cost?

The total cost to transform the former DC-10 passenger plane into a fully-equipped eye hospital was $15 million. Including the design phase, the total project took two years to complete.

When did the ORBIS DC-10 first take flight?

On May 7, 1994, the newly refurbished ORBIS DC-10 took off from Brookley Field in Mobile, Alabama on its first flight to check the interior modifications and the general aircraft condition. The test flight took 2.5 hours. The aircraft performed beyond expectations. Celebrations and tours of the aircraft were held in New York, Phoenix, and Hong Kong en route to the plane's first program in Beijing, China, which began on July 23, 1994.

How many hours a year does the ORBIS DC-10 fly?

On average, the ORBIS Flying Eye Hospital logs 100 flight hours per year¾very few compared with a DC-10 commercial aircraft, which typically logs 200-300 hours per month. From 1992, when ORBIS acquired the DC-10 through December 2010, nearly 1,500 hours have been logged. During this same time period, the plane landed 421 times.

Where does ORBIS get its pilots? Pilots from FedEx and United Airlines volunteer to fly the ORBIS DC-10 from program site to program site. Until 2001, when United retired their fleet of DC-10 aircraft, the airline held the lead role in maintaining the ORBIS DC-10 Flying Eye Hospital, with United employees treating the ORBIS plane as though it were part of their own fleet. Over the years, more than 300 United pilots and maintenance crew members have donated their time and expertise to ORBIS.United Airlines is considering the “Founding Airline Sponsor” of ORBIS International.

FedEx, a “Global Sponsor” of ORBIS, has taken over as the primary aviation sponsor. Through the Delivering Sight Worldwide initiative, FedEx DC-10 pilots now volunteer alongside retire United pilots. In addition to providing pilots, recurrent pilot training, and a full-time aircraft maintenance technician, FedEx ships urgently needed medical supplies to ORBIS program sites at no charge, and helps to raise public awareness about avoidable blindness.

In 2006, FedEx and ORBIS launched the global FedEx Fellows program, which designates two ophthalmologists per year to complete one- to three- month fellowships at some of the world’s leading eye institutes. The FedEx Fellows program provides a boost to the developing world’s ophthalmic expertise by enabling doctors to learn from the very best in their field, and then return to the forefront of blindness prevention work in their local communities.

Have there been any changes to the flight deck?

Over the years, the flight deck of the ORBIS DC-10 has undergone several modifications in order to comply with FAA requirements. In 2002, the navigation system was upgraded to a Honeywell HP9100 GPS, courtesy of Honeywell and Goodrich Aviation Services. The DC-10 is TCAS or ACAS equipped, also courtesy of Honeywell. The aircraft is approved for RVSM (Reduced Vertical Separation Minima) and for 8.33 MHz radio channels.

Why is the operating room in the center of the aircraft?

The operating room must be positioned in the most stable area of the plane so that surgery can be performed on the ground in any type of weather. The area between the wings of the aircraft, where the main landing gear is located, is the most stable part of the aircraft. Additional measures were also taken to stabilize the floor of the operating room. During the renovation process, the floor of the operating room was replaced with the same type of floor material that is installed in a cargo plane.

What is the audiovisual system set up?

Seventeen cameras, eight microphones, and 54 video monitors are stationed throughout the plane and are controlled in the audiovisual studio. The system permits viewing of live surgery anywhere on the plane and allows for live interaction between people in the classroom and those in the operating room. Surgeries are also recorded, edited, and duplicated in DVD format on board the ORBIS DC-10, and a record of the procedures taught during each program are donated to the host country’s ophthalmic community.

In 2001, the Flying Eye Hospital’s audiovisual suite was upgraded from an analog to a digital system. The new system’s benefits include enhanced image quality and interactive remote classrooms, which may be located off the aircraft. The upgrade also allows 3-D graphics, video effects, picture-in-picture applications, and the capture of high-resolution still images for telemedicine and record-keeping applications.

Do you bring water with you?

There are onboard water filters, which ensure that the hospital has pure water anywhere in the world. The five-step filtration process is quite unique and ensures that water used for surgery is sterile. It entails eight regular filters, plus two ultraviolet lights to kill certain microbes and two chemical compounds.

Where does the crew sleep?

There are no sleeping accommodations on the ORBIS DC-10. The Flying Eye Hospital team stays in hotels, which usually offer generous

How is the plane powered?

There are three power sources for the aircraft: 1) custom-made ground power units (GPU), provided by Aviation Ground Equipment Incorporated; 2) standard auxiliary power unit (APU), maintained and donated by Honeywell; and 3) uninterruptible power source, which serves as a battery back-up in the event the other two power sources fail.

How do you ensure the cleanliness of the aircraft?

e airflow on the plane is forced through hospital-grade HEPA filters. A positive pressure is maintained in the operating room, which means airflow begins in the OR and then filters out to the rest of the aircraft. To insure air quality, the Flying Eye Hospital carries an air compressor that filters air before it is piped into the aircraft. This compressor meets US hospital standards, and was designed and installed in 2003 through the joint efforts of ORBIS and Aviation Ground Equipment Incorporated.

Do you perform surgery in the air?

Surgeries are conducted only when the aircraft is parked and set up as a hospital. While in flight, fragile ophthalmic equipment is packed into padded cases, which are then secured to the floor or stored in cargo compartments.

What are the benefits of the new MD-10 Flying Eye Hospital compared to the current DC-10 model?

• Two crew members: With the MD-10, we will only need two pilots as opposed to the current three, which includes a flight engineer.
• The aircraft’s range expands from 4,000 miles to 6,000 miles: the MD-10 has better range, enabling us to complete transatlantic flights and avoid exorbitant fuel prices charged at out-of-the way stations.
• The ability to more efficiently customize the hospital configuration: by converting a cargo freighter, rather than a passenger aircraft, to a hospital, we will be able to more efficiently customize the interior and take full advantage of new technologies, including satellite communication systems and networked computers and medical equipment.