Orbis Flying Eye Hospital: Inside One of the World’s Last Two MD-10s

Some of my favorite aircraft are airliners that found a second life that’s as meaningful if not more so than hauling passengers and freight. That includes aircraft like NASA’s now-retired 747SP SOFIA and its still-active DC-8 airborne lab, and firefighting DC-10s and 747s. Another such aircraft is an MD-10 used by Orbis, a non-profit organization fighting avoidable blindness around the world.

Orbis uses the MD-10 as its Flying Eye Hospital – the one and only accredited ophthalmic teaching hospital onboard an airplane. It deploys the aircraft on missions around the world to provide local doctors with training and local residents with an opportunity to undergo eye surgeries.

Recently, I had a chance to tour the aircraft during its visit to Japan where the non-profit’s partners and press could see it up close before it departed to Vietnam for Orbis’s next project. Continue reading to learn more about the Flying Eye Hospital and see what it’s like inside.

1982 to Now: Three Aircraft, One Mission

The vast majority of people with avoidable blindness live in low- and middle-income countries and the cost of bringing doctors from those countries to the United States to study and train is high. In the 1960s, this gave an idea to an American opthalmologist Dr. David Paton to bring the education to those countries instead.

It is out of this idea that Project Orbis was born and officially launched in 1973. That said, it wasn’t until almost a decade later – until 1982 – that the Flying Eye Hospital took off for the first time. Since then, three different aircraft served as the Flying Eye Hospital.

The first one was a Douglas DC-8 made in 1959 and delivered to United Airlines in 1960 as N8003U. It served with the airline until 1980 when it was donated to Orbis. With the support of a USAID grant and private donors, the aircraft underwent conversion into the world’s first teaching ophthalmologic hospital onboard an aircraft.

With the modifications finished and re-registered to N220RB, the DC-8 took off for its first project to Panama in 1982. The DC-8 served with Orbis until 1992 at which point it was over 30 years old. Today, the aircraft is on display in the China Aviation Museum in Datangshan, Beijing.

The DC-8 was succeeded by another Douglas aircraft, a McDonnell Douglas DC-10-10. This aircraft was the second DC-10-10 to come off the production line and was first delivered to Laker Airways in 1977 (reg. G-BELO). It later served with American Trans Air (N183AT), Cal Air International, and Novair (G-GCAL).

In 1991, a group of generous donors came together to purchase the aircraft for Orbis which was in need of not only a newer but also larger aircraft to match the expansion of the non-profit’s activities. The aircraft entered into service with Orbis in 1992 after undergoing extensive modifications. Orbis used the DC-10 registered N220AU until 2016 after which the aircraft met a fate similar to the DC-8 – it was placed in the Pima Air & Space Museum in Tucson, Arizona.

Orbis started using its current, third-generation Flying Eye Hospital in 2016. The aircraft was originally delivered to Trans International Airlines in 1973 as a McDonnell Douglas DC-10-30. While in passenger service, it also flew for Transamerica Airlines, Nigeria Airways, and Air Florida.

In 1984, the aircraft was acquired by FedEx and re-registered to N301FE, starting its cargo-hauling life. The now-50-year-old aircraft was given a new lease of life in 2001 when FedEx had it modernized to a Boeing MD-10-30. It then continued to serve with FedEx until 2010 after which the company donated it to Orbis and the aircraft underwent conversion into the Flying Eye Hospital it is today.

One of the World’s Last Two Boeing MD-10s

Rather than being a distinct aircraft type built from scratch, the MD-10 is a conversion program that was launched by McDonnell Douglas in 1996 with the goal of modernizing aging DC-10s. The first MD-10 conversion was finished in 1999, a couple of years after McDonnell Douglas was acquired by Boeing.

The MD-10’s exterior is identical to that of the DC-10. The aircraft is also powered by the same three GE CF6 engines. What is different on the MD-10, though, is the flight deck. Unlike the DC-10 which is equipped with a three-crew analog flight deck, the MD-10 has an LCD-based “Advanced Common Flightdeck” which eliminates the need for a flight engineer. It also allows for a shared type rating with the newer MD-11.

FedEx was the MD-10 program’s only customer. That said, the airline retired the MD-10 at the end of 2022 leaving the world’s active MD-10 fleet with only two airframes:

• N330AU – delivered as a DC-10-30 to Trans International Airlines, acquired by FedEx in 1984, serving as the Flying Eye Hospital since 2016
• CP-2791 – delivered as a DC-10-30F to FedEx in 1988, acquired by TAB (Transportes Aereos Bolivianos) Cargo in 2013; currently frequently seen on flights within Bolivia and between Bolivia and Miami

It’s also worth noting that the above three operators – FedEx, Orbis, and TAB – are the only three operators to have ever operated the MD-10 making the MD-10 a much rarer aircraft type than the DC-10 it is based on.

Touring the Flying Eye Hospital Nose to Tail

On the outside, the current Flying Eye Hospital wears an eye-catching (no pun intended) blue livery with Orbis’s logo near the nose and on the tail, the organization’s web address on engine number two, and a large “FLYING EYE HOSPITAL” title across the fuselage. On the bottom of the fuselage’s port side, just past the second door, titles thanking FedEx for the donation of the aircraft – and the company’s logo – can be found.

When I toured the aircraft, we got on through regular ANA-branded passenger stairs attached to the port side’s first door. We got off through “rougher” FedEx stairs that were attached to the rear door and offered an excellent view of the MD-10’s tail and number two engine.

Multiple Orbis-branded ground equipment units were placed off the starboard side of the Flying Eye Hospital and connected to the aircraft.

Stepping onboard through the L1 door, one could – at first glance at least – think the Flying Eye Hospital is a regular passenger airliner. On the left side of the door is the cockpit and on the right side is what looks like an economy class cabin.

In reality, however, the cockpit is about the only place on the entire airplane that is the same as it would be on a regular aircraft. Even there, a donation sign on the back of the pilots’ seats reminds people that they aren’t on just any ordinary aircraft but one serving an important mission made possible by people passionate about the cause.

The area to the right of the L1 door does indeed serve as a passenger cabin when the aircraft is on the move. As the “The Classroom” sign next to the entrance to this area indicates, though, it is way more than that. It’s a place where up to 46 eye care professionals can gather to learn by not only listening to Orbis’s volunteer medical experts but also watching surgeries live-streamed on a large screen at the front of the cabin.

Each of the light blue seats features a design based on the Landolt C (the vision test with rings that have gaps facing in different directions) on its backrest and a headrest cover with the Orbis logo. Just like in the cockpit, each seatback sports a sign thanking the organization’s donors.

On the back wall is a panel with the non-profit’s logo and three globes showing the Earth from three different angles that adds a beautiful finishing touch to the cabin.

During my visit to the Flying Eye Hospital, one of the seats in the cabin was occupied by Seymour who is, as one of Orbis’s Facebook posts says, “a volunteer Teddy Bear who travels the world training other Teddy Bears on how to give the best hugs and cuddles.” He could be seen in other parts of the airplane serving as a model doctor and patient too.

Technically, the Orbis MD-10 is a combi aircraft with The Classroom being the passenger section and everything past that being the cargo section. This design in which the facilities in the cargo section are housed in large containers allowed Orbis to equip the hospital part of the aircraft with all the equipment it needs without the equipment having to be certified for use on an aircraft per se. That is, as long as the equipment is properly secured prior to each flight.

On the flip side, because of this configuration, areas past the passenger compartment are inaccessible in-flight. That’s not an issue, though, as while on the ground, it’s possible to walk across the entire aircraft through a hallway running across the port side of the cargo compartment. …and, it wouldn’t be a good idea to try to do eye surgery on a bumpy flight anyways!

Starting at the part of the hallway nearest to The Classroom, there is an administration room where the staff can get their office work done and where meetings can be held if necessary.

Past that is an audiovisual/IT room which looks more like something one would find in a TV studio than something on an aircraft or in a hospital. Here, all the magic related to streaming what is taking place in the operating room and elsewhere onboard the aircraft into The Classroom and even remotely to the rest of the world happens. As such, this small room plays a crucial role in helping achieve Orbis’s mission.

Behind the audiovisual/IT room is a laser treatment room. Throughout the room, various simulators and other pieces of equipment that are used to teach laser treatment can be found. While in this room, Dr. Hunter Cherwek, Orbis’s VP of Clinical Services, briefly talked about the parallels between healthcare and aviation such as the use of simulators for training and checklists to avoid unnecessary errors.

As hinted earlier, all of the equipment used in this room as well as the areas I will talk about below is standard equipment that is used in similar facilities on the ground. One of the Orbis team members that were onboard during my visit noted that more or less the only custom hospital “equipment” on the aircraft is the storage cabinets.

In addition to serving as a laser treatment room, this room also serves as an observation room. It is equipped with large windows providing an unrestricted view of what is happening inside the operating room next door.

The operating room itself is located over the wings – the most stable portion of the fuselage. Its centerpiece is an operating table above which is a set of lights and a 4K camera that can be used for streaming a surgery. Around the operating table are several pieces of equipment and cabinets packed with medical supplies.

During my visit, Seymour the Teddy Bear was at the head of the operating table. In addition to a surgical mask and gown, he was also wearing a headset, demonstrating how an actual surgeon could be providing commentary to those watching a surgery streamed in The Classroom or through Orbis’s online platform.

Outside the operating room are a soiled room, a large sink, and a sterilization room so that strict hygienic measures can be followed before, during, and after operations.

Lastly, at the very back of the aircraft is a recovery room. While the configuration of this room might slightly vary depending on the mission, during my tour, it was equipped with two hospital beds separated by curtains.

One of the beds was occupied by – you guessed it – Seymour, this time serving as a model patient. On the other bed were a couple of training manikins.

While the above concludes the tour of the Orbis MD-10’s main deck, there is one more area of the aircraft that needs to be talked about – the cargo compartment under the main deck.

Normally, this is where an airline would put passengers’ luggage and containers filled with cargo. In the case of the Flying Eye Hospital, though, it serves another purpose too. It serves as a maintenance room that allows the Orbis team to monitor the aircraft’s operations when on the ground. There’s even a tiny set of stairs leading up to the main deck.

Summary

The MD-10 currently used by Orbis is the third aircraft to serve as the Flying Eye Hospital and one of the world’s last two active MD-10s. Prior to the MD-10, the organization used a DC-8 and a DC-10, both of which are currently on display – one in China and one in the United States.

Onboard, aside from its cockpit and a small passenger cabin that doubles as a classroom, the Flying Eye Hospital looks nothing like a regular airliner. Everything from the operating room all the way to the state-of-the-art audiovisual system that allows for the streaming of surgeries not only within the aircraft but globally makes the aircraft one of the most interesting airliners. An airliner that, instead of being turned into Coke cans, has found an extremely meaningful life after its time in airline operation.

Lastly, it also needs to be mentioned that while in the aviation world Orbis is often synonymous with the Flying Eye Hospital, the latter only accounts for about 15% of the overall organization’s budget and the organization runs many other just as impactful programs. Case in point – even in 2021 when the Flying Eye Hospital’s projects were limited due to the COVID-19 pandemic, Orbis did over 3.5 million eye screenings and examinations, prescribed almost 100,000 eyeglasses, and performed nearly 40,000 eye surgeries.

With that, I would like to thank the Orbis team and Daniel from LIFT Aero Design who was helping the Orbis team during their visit to Japan for arranging the opportunity to tour the aircraft. To learn more about Orbis’s activities, make sure to check the organization’s website.