Tikale just after surgery

We operated and successfully implanted an artificial lens.  Tikale stayed with us in the hospital for nearly two weeks after surgery, so we could get all the drops in his eye, and check his vision regularly.

Already happy after surgery

He enjoyed hanging out at the hospital, and made a lot of friends as he was so full of renewed energy!

Tikale gettings ready to go home after surgery

On the same day a team went out to visit the villages, and drop off Tikale and his family, Sam spotted an elephant youth.

Baby elephant in the village

There used to be families of elephants roaming the Linthipe valley near Nkhoma even as recent as 25 years ago.  They have all moved on now.

We are blessed that there are still one or two around!

From the team at Nkhoma and on behalf of all the patients we serve, I wish you all a very Merry Christmas and all the best for 2011!

My good friend and colleague had cerebral malaria and a stroke nearly a year ago, and is still recovering. Two other work colleagues have had near death experiences on the roads in the past year. We have lost one member of staff to AIDS, very sadly just after I arrived. About once a month a member of staff at the Eye Hospital goes off sick with Malaria, and thank the Lord recovers after treatment. About once a week a member of staff is off for a day to attend a funeral in their village.

I very luckily have only had malaria once, and took the treatment very quickly, and was back at work after 3 days. It was like a bad cold and fever with strange joint pains. But the treatment worked quickly, and unlike a cold it was cured within days, not to linger untreatable for a week or more.

This is the life and reality here. We are not immune to malaria, accidents and other events and conditions that affect the population we serve.

It is times like these that I try to calmly sit and reflect on our blessings. The blessings of health, and the great work we are involved in.

There is a tradition in Africa whereby if a person has had a great tragedy, such as a death in the family or a near-death personal experience; that the whole village will line up outside the house, in a manner, and enter the house in turn. The one who is traumatized, so to speak, is then given the opportunity to recount the events and ordeal to each visitor. Sounds heavy retelling the tale a hundred times, but the community support and comfort lends itself to healing.

This is Africa. Dangerous. Beautiful, and full of love and true community support. Unpredictable. And we are only here at Nkhoma Eye Hospital to help those in need of help for their disabilitating blindness. But, we all live here. With or without electricity. With or without running water. With mosquitoes. With dangerous roads, dodging pedestrians, cyclists, goats, chickens, other vehicles and unreal accidents. When I say running water I am pretty good at my house really. The taps in the house run almost 6 out of 7 days a week.

We are in dry season though, so the water in the big lakes at the top of the mission village drain quickly. You can’t drink the water anyhow. It’s unfiltered from the river, and there is the chance of water-borne diseases. For drinking water I have a 5000 litre tank on the side of my house that collects rainwater. I treat this water chemically, filter it through an Indian ceramic filter, then a Britta filter. Or boil it, and use it for cooking. The last rains were 6 months ago though, so it is nearly empty, and yellow algae tend to grow after a while. So lots of boiling.

We need to give thanks that through all this, there is no war here. There is no violent tribalism. There is nothing to really fight over, no big gold or diamond deposits. There is no political unrest or massive inflation. There are no great floods or droughts or plagues. There is no scourge of violent crime. We are actually very lucky in peaceful and beautiful Malawi.

We can still plan and carry out our work, trying to travel and find blind and vision impaired in villages in Central Malawi, without daily fear or trepidation.

But, we are reminded sometimes that it is a relatively dangerous world we live and work in. I have so much respect and love for all here who partake in this; and we all have so much heartfelt thanks for all who support it.

There are no photos for this update, none needed I feel.

God bless.

I had a busy day on Tuesday getting all the initial surgical supplies together for the modern phaco cataract surgery machine.  I and the staff are very excited about the prospect of introducing this to Nkhoma! Imagine… the country’s first ever permanent modern phaco cataract surgery unit.

On Wednesday I met a wonderful group of CBM supporters from Canada, and we showed them the work here.

On Thursday I saw a boy who had been hit in the eye with a stick some two months ago, accidentally while playing with friends.  The stick had gone into the eye initially, and it took him 6 days to get to the hospital. I cleaned it up and stitched the eye back together.  By now, two months later, his eye had healed well, but he couldn’t see anything as his iris, the coloured part of the eye, was stuck.  So I took him back to theatre to make a new pupil for his eye.  I hope he will be able to see even just a bit now.

I went to Lilongwe for a clinic on Friday morning.  Nearly hit a baby goat 20 seconds after starting on the road, and a huge 10 metre wide tree branch came metres away from falling on me and 4 patients in the hospital in a freak wind.  I then got a call around lunchtime that I may have to go all the way up north to Nkhata Bay on Monday for a cataract session.  There are 100 patients waiting to be operated on Monday and Tuesday, and they didn’t want to cancel.  In the end one of the other 7 eye docs in Malawi, who is a bit closer than here, was happy to go and cover.   Otherwise I would have been starting a 7 hour drive around now.

Finished the week with a long power cut on Friday night, so some candles and an early night as totally exhausted.

5 Speed ECCE

So anyway, the next two months. We really want to end the year on a high note, it’s been a tough year. And the best thing we can do is to go to as many villages, screen as many people, and try and reach as many as we can to offer cataract surgery or other assistance. We have a finite amount of money left till the end of the year, and pretty much will spend it all on diesel for the clinic ambulances and food for the patients. All the medicines and lenses and staff are already here!

And this is what it comes down to for the bulk of the work. I hope that link above ‘5 Speed ECCE’ works. It’s a normal cataract operation, at 5 times speed; which is why it is just under a minute long.

With the help of the staff here at Nkhoma and in the field, and the great team at Malawi Council for the Handicapped (MACOHA), Mr Kambewa and I are going to try our best to perform as many of these surgeries as we possibly can in the next two months. Except at normal, rather than 5 times speed. It’s the Nkhoma team’s real strength… high volume high quality surgery. And it’s our hope that as many individuals as possible, who are now struggling with the burden of blindness, will be able to see by Christmas.

We have done our first few cataract operations.  I also saw a 12 year old boy who had a penetrating  pen injury to his eye.  Managed to sort it out in theatre.

Steve and Kambewa are driving 200 miles to Mangotchi and Machinga, near the lakeshore, tomorrow to meet the district health officer for his permission to work for patients in his area.  It’s actually a very under-served area of Malawi, so a perfect place to start our outreach activities this year.

We have had fantastic rains here in Nkhoma, interspersed with beautiful warm sunshine, so the maize crops in the villages are doing really well.  In fact the rains and storms were so good here at Nkhoma, I had lightning strike my house twice last Friday.

So here we are.  All safe and well; scorpions, spiders, malaria, tame snakes and lizards, and my trusty dogs Ellie and Malu; ready to tackle the house; and with the amazing staff at Nkhoma, the year ahead.

We are all missing Nick.  And we continue to pray daily for him and his family.  The work that he built up here absolutely must continue.

Sadly the gentleman, Mr Efuloni, who came to Nkhoma from Salima last year, having been referred by the Malawi Council for the Handicapped (MACOHA) has died.  He was a wonderful man, a village chief.  The cataract surgery on his first eye was the 25,000th cataract operation at Nkhoma since 2000.  I remember his smile very well after we operated his second eye!

before the cataract operation

Mr Efuloni after surgeries

He had spent the last few months with his family in his Salima village.  But, as a small blessing to his family and Mr Efuloni, he could see his family, his children and grandchildren; and his wife.

Let’s get this year started, trying to help more people like Mr Efuloni who have been robbed of their sight.