Sambani is from Kalonga Village in Lilongwe District.  He lives with his parents and four siblings.  He had been blind for two years, and had stopped going to school last year.  He had been doing well at school, and told me “I was an intelligent boy!”  He was in standard 4 but his low vision “made me to be a useless boy” he said.  I couldn’t believe what he was saying.

Sambani in the Clinic

He lives with his father and mother and four siblings, and they were looking after him.

Sambani after his second cataract operation

Sambani told me and nurse Rose, that he is now going to continue his education because he is “still young”.  He wants to be a driver or a teacher.

Sambani

It will be great to take Sambani back home today, so he can be with his whole family again, and then start school again next week when school opens for the new year.  We will try and meet him again in a few months to see how he is doing.

Pieter, the South African missionary living near Monkey Bay phoned me yesterday.  There are many people he has met in the villages who would like to, or need to, come to Nkhoma for their eyes.  Lumbani will be heading down on Sunday with the ambulance to help collect them. We will try and meet with Mary who lives nearby, and see how she is doing, 4 months after her surgery!

Mary with white diabetic cataracts - Photo: Roger Loguarro

With the help of the doctors in the general hospital, she did extremely well.  She felt much better, less tired, but was still blind.   Eventually after 12 days it was her time for surgery.

I felt very sorry for Mary, as she is so young and was doing well at school until relatively quickly her sight was lost.  She can barely move around now, and constantly needs help.  Of course school has been out of the question for her for the past year.

I don’t really see that many people with Diabetes in Malawi.

Meeting Mary on the waiting line

I was a bit scared when operating, as I wan’t sure how far advanced the diabetes in the eye was, but after the first operation all was well.

Half way there, and happy

In the end a small miracle happened.  I was scared that the diabetes had not only resulted in cataracts, but had also affected the retina.  The surgery went very well, the Nkhoma team were awesome in their care, and Mary’s sight was totally restored.  I will try and visit her in her village near the south Lake Malawi lakeshore later this year, and we are helping her with her diabetic medications so she should be back at the hospital in a month or so for a check up as well.

I felt so thankful that Mary had found us, and we’d been able to help.  I really hope that her life carries on in the way she planned.  She was so excited to head home and celebrate.

Mary, ready to take go home to Lake Malawi, 3 hours drive away

I said goodbye to Mary on a Tuesday, and she travelled home with the Nkhoma ambulance early the next morning.  I’ll tell you, and I am so happy for her!

Mr Kambewa, the fantastic Clinical Officer and Cataract Surgeon here at Nkhoma, does a large amount of the work in theatre.  Operating patients cataracts with high quality and high volume!

One of the jobs that falls on me however is operating all glaucoma patients (the surgery is a bit longer… around 30 minutes instead of 8 minutes for cataract surgery, and a bit more tricky with all the small stitches); and also all the patients who need cataract surgery, but have only ‘one eye’, in that the other is blind from a cause that we cannot treat.

A number of patients come to Nkhoma blind.  That is they can perhaps see a finger or two at 3 metres from them.  Sometimes even less, only able to see a hand waving in front of them, or even just able to see light and dark but no detail at all.  A number of these patients are blind in one eye because of something that we can do nothing about.  A large scar on their cornea, very high pressure in the eye and end-stage glaucoma, trauma, previous infection or severe problems at the retina at the back of the eye.  It often happens that then the other eye (which in effect is their only ‘good’ eye) is severely visually impaired because of cataract.

It falls on me to have a chat with them about surgery, and then go ahead and do the operation if they agree and consent.  In the operating theatre, you take a deep breath, relax and go ahead and perform the cataract surgery calmly as you would any eye (trying not to think that this is their ‘only eye’, and that you kind of have only one shot).

Mr Jamison was untreatably blind in his left eye

Mr Jamison is 83 years, and came to Nkhoma from Mchinji, near the Zambian border, with one of our mobile clinics.  He has been blind in his left eye for 50 years from trauma, since a thorn went into the eye.  He can’t even see light from his left eye.  He had over the past 11 years been finding it increasingly difficult to see with his right eye.  In fact he said he has been blind for around 5 years.  He couldn’t see his maize or other food, and some children sometimes would come and take his meat.

I operated his right cataract and thankfully it was a great success, and he was thrilled.  He said he is going to celebrate by buying many fish!

I have operated cataracts on over 60 patients with ‘only one eye’ so far this year, and it fills me with joy and considerable relief to see them happy the next day!

Kuona kwa tsopano, Moyo wa tsopano

Around 80% of blindness is avoidable (as in treatable or preventable); and 90% of blind people live in low income countries.

We are winning the war on blindness!

Looking into the dawn of a new decade towards 2020

But a lot of momentum has to keep building to increase efforts even further in the next 10 years to keep going until the job is done..

Thursday 14th is World Sight Day!  An international day of awareness to focus attention on the global issue of avoidable blindness and visual impairment.

80% of global blindness is avoidable.

4% of the World’s population are blind or severely visually impaired.  That’s four times the population of the UK!  It’s truly staggering, but we are also celebrating.  Yes there is a lot of need indeed, but we are winning the war on blindness.

It is incredible to think that CBM have with 102 years’ of disability and development experience and expertise performed over 10 million cataract operations.  And together with the WHO and the International Agency for the Prevention of Blindness, the burden of avoidable blindness is being tackled.  We need to carry on this work, and increase even more as we count down to 2020.

Mrs Samuel in her village before coming to hospital

Mrs Samuel back at home, a month after cataract surgery

But, it’s numbers.  Numbers that I can’t really get my head around.  What really counts to me, the staff at Nkhoma, and most importantly the patient… is that the 10 minutes, or even 6 minutes it takes for that cataract operation (and £20 donated by a kind supporter of CBM) will change that individuals life.  Forever.

New sight, New Life

Or as we say in Nkhoma…

Kuona kwa tsopano

Moyo wa tsopano

In line, waiting for surgery

Mrs Kadzichi back at home in the village