See one of the wonders of the world

The visit by our eye team to the Masai Mara Game Reserve was just in time to enable the locals to see the famous spectacle of the wildebeest migration. Over 300 patients were tested and 111 sight-restoring operations performed.

Above: Patients struggle to the camp in line for help.

Naisenya

Naisenya was one of the patients treated at the camp. She was born blind with cataracts nine years ago. She had never been to school, let alone seen the migration.

She had successful cataract surgery by our team in both eyes and gave all those involved such joy as she exclaimed with delight when she could see for the first time in her life!

She is desperate to see the migration for the first time and to go to school with her brothers and sisters.

Above: Naisenya before surgery with her mum.

Above: Naisenya telling Lillian, our cataract surgeon, what she will do now that she can see.

Myth about eyes disproven

Alfani was an energetic palm tapper who spent most of his working day climbing up to the very top of tall coconut palms to collect their sap. Each tree needs to be climbed three times each day and the fluid collected can be drunk within two days or distilled to make a strong spirit.

But the shadow of darkness fell onto Alfani’s doorstep. He developed blinding cataract. His only wish was to get back to his lofty profession and keep his successful business operational.

He sought help from all angles but none brought back his sight. Many of the people he asked suggested he went to KDEC, but Alfani was suspicious. He had heard that his eyes would be gouged out and a goat’s eye implanted. That was if he survived the surgery.

After 9 months of ‘baby-sitting’ her helpless husband, Alfani’s wife had had enough. She decided that it was better to take the risk of goat’s eyes or death on the operating table than to put up with the frustrated difficult husband Alfani had become. Her persistence saw the couple come to a nearby screening and to KDEC for surgery.

His mature cataracts meant that he had been blind for over a year.

Neither Alfani, nor his wife could believe it when he was able to see to walk on his own.

On their return to the village, they kept phoning the clinic to express their appreciation.

Such is field work in Africa!

Picture right top:
Alfani, blind, at the Centre with his persistent wife.

Picture right bottom:
Alfani, where he likes being most of the time, up a coconut tree.

Heavy downpour and bad terrain would not deny children services

Field work is much easier when the sun is shining and the roads smooth. Our Vision Therapist, Almasi, was all geared up to ensure that children receive our much-needed services; little did he know that the journey on this day would be challenging.

Armed with all his equipment strapped onto his trusty motorbike, he was caught in a heavy downpour which instantly turned the roads muddy and slippery. Determined to continue his mission of improving the life of the visually impaired, he skillfully manoeuvred his bike to get his destination.

He did not think about how he was going to get home as he feels that what he is doing is so important.

Above: Almasi determined to get to his destination.

Kwale District Eye Centre opens satellite clinic in Taita District
160km NW of Kwale

In late May we expanded our horizons by opening a satellite clinic in the small town of Mwatate, west of Voi in Taita District.

This was in response to constant requests from the population and an appeal by the government ophthalmic clinical officer for help in this area.

The clinic provides preventive, curative and rehabilitative services using the comprehensive eye care service model, just as we have been doing at the Coast for seventeen years.

The local community is delighted to have a new eye clinic on their doorstep.

Dr. Roberts, our Medical Director, said;

” The opening of the satellite clinic in Taita is part of a focused growth plan in KDEC’s strategy to expand the Centre’s services to other rural communities.”

Photographs:

Top right shows the new Kwale District Eye Centre – Taita branch

Bottom right shows The first patient at the Taita branch clinic being examined by Ophthalmic Sister Rose Atsiaya.

A few of the recent donations from supporters through Eyes for East Africa UK

We are grateful to The Elizabeth Frankland Moore and Star Foundation for their continuing help with a £ 5000 donation and to the Canning Trust in London for their donation of £ 4000 to fund our work helping glaucoma patients in the coming year.

£1,000 from St. Mary and St. Peter Wilmington Parochial Church Council to our poor patients fund enabled us to carry out cataract operations on 32 eyes. Thefortunate people who can see again have asked us to thank those involved.

London Power Associates continue to support us with a donation of £ 1000.

A big thank you also to the many others not mentioned for your donations.

Challenges of field work – The case of Bekabato, aged 3

Bekabato (Beka to his siblings) was born blind from cataract in a tiny village 180km from KDEC.

Reaching help is one of the biggest challenges, especially if you are poor. But, with a programme strongly enmeshed in the community, we can overcome this sometimes.

Beka’s parents would not believe us when, at a field screening, we explained that their son would not see unless he had surgery... and fast. It took many hours of talking to convince them that we were giving the best advice and, with great trepidation, they agreed to let us do surgery. He did well but then we did not see him again.

Our Community Based Worker for Bekabato’s area begged the mother to bring him back to the main Centre so that we could test his vision, prescribe and fit spectacles, check the eye was recovering, check that he had was not developing complications. Her response was “But it’s 180 kms away..and our son can see. Why did he have to go all that way? “

Our Community Based Workers are endlessly patient. They explained why we needed to monitor their son at base as well as at home. Eventually, the parents agreed to bring him. It was just as well that they did because one eye was becoming lazy. Beka continues to need patching of his good eye in order to develop fine vision in his other eye. The real challenge will begin when he starts school next year.

Above: Bekabato aged 8 months before surgery

Above: Bekabato, aged 3, undergoing vision assessment in the low vision clinic

Life Must Go On

Story complied by Rehabilitation Officer
M Mwachepha

Barka Otieno has become irreversibly blind. A typical mother, her main concern is her ten year old son and how she will educate him.

She was desperate not to be a burden but, when we met her, she depended on him for everything; he even had to help her in the bathroom. He refused to go to school and leave her alone in the house. "It is not dignified" she said; "I am supposed to help my son in this way, not the other way around".

But Barka was a fast learner. It took only a few visits by our rehab officer and the community based worker to teach her how to get around on her own, to visit the bathroom alone, wash clothes, clean the house and even cook.

She is an unusual woman. It was not enough to be independent with her son free to go to school now that she could manage alone. She wanted to do more. She joined the Red Cross as a volunteer. She now counsels people to cope with their lives and gives them hope.

"I survived and am now thriving despite one of the worst afflictions - total blindness, if I can overcome that, then you too can overcome this difficulty if it faces you."

The photograph on the right shows Barka.

Recognition of Rotary Support

The Rotary Club of Diani, a near neighbour of ours, sponsored the original building of Kwale District Eye Centre nearly 18 years ago and many Rotary clubs elsewhere have given a great deal of support over the years. Nobody is quite sure why it took us so long to get round to recognising this important event.

The Centre has grown unrecognisably into a large, Comprehensive Eye Care Centre.
Over 47,000 people have been seen at the Centre and over 14,000 have had sight saving surgery.

The photograph top right shows Dr Helen with some of the Rotarians, who have been with Diani Rotary for more than 18 years, visiting the Centre to unveil a plaque.

The lower photograph shows the plaque in close-up.

Sad News

In August 2009, we told you about Mnyazi who was too weak to have surgery to restore his sight.
Mnyazi died, still blind, 4 months later. Such is poverty in Africa. This month we bring you story of a child with similar challenges.

Abdul's Story - A report by Hassan Mwachimako, Field Supervisor.

Abdul’s twin died a few minutes after birth at Coast Provincial General Hospital. Lucky to have survived, Abdul was blind.

He was a poor feeder and fast became weak and malnourished. His vision worsened and almost all his childhood activities were delayed.

But Abdul’s mother had two other children to care for and no husband. She did not have any money for medical services.

The mother took Abdul to a screening organized by Kwale District Eye Centre where Abdul was diagnosed to have bilateral congenital cataracts.

Small photograph top right: Little Abdul, blind from cataract and malnourished at 4 months old.

Even more important than restoring his sight, Abdul really needed proper nutrition and physiotherapy.

We referred Abdul and his single mother of three to our nearby District Hospital for care where Hassan personally ensured that they received a supply of nourishing porridge for him.

Eventually we decided that Abdul was strong enough. He had surgery and, for the first time in his young life, he could see.

Photograph middle right: Eye Centre Field Supervisor Hassan Mwachimako with Abdul

“This is a true miracle” Abdul’s mother cried when she saw that, at last, her blind child could see.

A few weeks later, Abdul has started crawling, and joyfully playing with other children. Now he needs lifelong follow up.

Photograph bottom right: Abdul attending vision therapy services at the Eye Centre

Hassan commented on seeing how jovial Abdul had become; “Surely the greatest gift is to put a smile on someone’s face”.

Abdul’s smile is a perfect example.

Joint donation ensures safe eye operations

As we mentioned last month, we were awaiting the arrival of a replacement non-vacuum steriliser for Kwale District Eye Centre’s operating theatre.

Now we are pleased to be able to show you what this important piece of equipment looks like.

The equipment was jointly funded by the Rotary Clubs of Fleet and North Wirral in UK, together with Mr Harry Acland.

Microsurgery requires fine, delicate instruments and these need to be absolutely free of anything that may cause infection.

An infection inside the eye acquired at surgery is devastating. The patient rarely regains sight and may be left with a painful blind eye.

Dr Helen Roberts says; ‘This steriliser is vital to ensure that we can continue to offer safe sight restoring surgery’.

Photograph top right: Unpacking the steriliser

Photograph bottom right: The steriliser in use

Having started on a serious note about reduction in funding last month, we thought a more upbeat first item would be good start this month.

Wedding of our visiting orthoptist

Our gorgeous orthoptist married in a traditional church ceremony in Ireland in December.

Geraldine has spent almost three months working at Kwale District Eye Centre, primarily training the staff on the examination and treatment of children with eye problems.

She is a great source of support and encouragement, especially to our low vision team.

It’s never too late to seek treatment

Mary's husband was fed up with having to do everything for his wife. He even had to lead her to the bathroom and help her with her clothes.

He had left her at home alone and was on his way to market to catch up on the local gossip and sell some avocados when he heard a loud hailer announcing that there was to be an eye team in the area later that month. Could they help him he wondered?

He thought it unlikely, after all, going blind was just another burden of old age wasn't it? And goodness knows he had a few burdens, but it was being held just up the road and what did he have to lose really? He already had a blind wife.

Here we see his wife Mary just as she has the eye bandage removed after her cataract surgery.

Within minutes she was berating him for having taken so long to get her to this sort of care.

At last now she could do the cooking again, complaining he always used too much salt!

Above: Mary after surgery

Above: Mary (left) with a friend also recovering from surgery

Patients from a distant part of our area

The photograph on the right shows two ladies resting after surgery at an eye clinic we set up in a remote village in our area.

More funding from Rotarians in UK

Regular contributions from Rotary Clubs in Kenya and UK are always most welcome and display confidence not only in the work of the eye centre but also how their donations are always used for the benefit of the patients.

We are very grateful for another donation from the Rotary Club of North Wirral Cheshire, enabling us to purchase a replacement non vacuum steriliser. It’s been ordered but delivery has been
delayed so we can’t include a photograph in this edition! Other regular supporters not far away in the Rotary Club of Northwich Vale Royal have recently funded a a phacoemulsifier handpiece, a vital and expensive piece of ophthalmic surgical equipment.

The impact of global financial problems – a perspective by our Medical Director

We have all heard of the problems on the global financial scene and the reduction in charity donations around the world which have followed as a consequence. Our news report of August 2009 highlighted our concerns this could have on patient care at the eye centre and in the community. I can now reveal the harsh realities we face in 2010.

Our anticipated income for 2010 compared with 2009 will be reduced by over Ksh8mill, approx USD 100,000, a considerable percentage of the annual running cost of the eye centre.
This means that we have had to focus on our core activities in 2010; that is eye treatment at the centre.

Last year we laid off the lady rehabilitation officer, this year the remaining rehab officer will be laid off at the end of March when he has handed over completely to our community based workers. We have reduced the number of screenings in the field from 4 each week to 3. We have laid off a driver and a nurse and plan to sell a 4x4 Landcruiser and 4 motorbikes. We have postponed all training both in the field and at base until the financial situation improves.

All this will mean that we are able to reach less people. Sadly, it is usually those who need our services most who are the most difficult and expensive to reach. The challenge is to react to this downturn in funding quickly and with as little long term damage as possible.

Thank you for your support.
Dr Helen Roberts MBE, Medical Director.

The following are examples of the kind of marginalised patients we will be unable to treat in 2010 due to lack of funds.

Daniel - deaf and blind

When we found Daniel he was seven. His parents were in despair and Daniel was left in corner, hardly moving, let alone interacting with his family.

Our specialist encouraged his parents to include him in family life and explained how best to communicate with a child who can neither see or hear.

This was what they needed, some expertise, understanding and support . They were delighted to see the changes in Daniel, now they could enjoy their child and instead of his frustration and bewilderment was more like other children.

The family have joined a group of other parents with deaf blind children and have learnt to be receptive to change.

Daniel has been assessed by a teacher from the deaf blind unit who has concluded that he is clever and capable.

He now goes to a special school in Kwale and will be able to learn just like his brothers and sisters.

Above: Daniel, when we found him in a vegetable crate

Above: Daniel’s mother watches in amazement as he opens up after specialist teaching

Shalet- deaf, blind and with cerebral palsy

Shalet has been in and out of hospital since birth. Her parents are primary school teachers living in a nice house and they even have electricity.

Shalet is like a two month old baby. She cannot even hold her head up and needs constant care.

However what her mother struggles with most is the attitude of her relatives, neighbours and people in the community who consider her child to be the result of a curse.They believe that the parent’s success in life and modest wealth has been achieved through witchcraft which damaged the child in the process.

Shalet and her mother feel isolated as some relations seem afraid to come close to either mother or child. Health workers at the hospital were no exception.

We explained to the mother that she was not alone and that such degrading beliefs are common in the community. She was relieved to know that there were people who care.

That’s KDEC !