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.

Malawi Council for the Handicapped (MACOHA) has a team of field workers in their community based rehabilitation programme.  They have spent weeks and months travelling through the Salima District villages screening people, and then bringing them to Nkhoma Eye Hospital throughout this fortnight.

Over a hundred cataract operations have been performed, and after a day or two for each patient in the hospital, a lot of people have left happy.

A satisfied crowd from Salima, waiting for the car home

MACOHA refer around 30% of all of our patients to us.

We will be heading back into the villages around Salima in a month or so to follow-up a few dozen people.  Usually it’s too far and expensive for people to travel back to the hospital for a check up after surgery, so we are going to travel to them.

It is very cold and windy at Nkhoma right now.  As most of the people in the villages don’t have electricity, there is only open fires to keep warm.  Sadly that also means a lot of burn injuries, and we recently had a 15 year old girl who had an epileptic seizure, and fell into a fire face first.  It was a while before anyone could help her, and unfortunately too late for the third degree burns she sustained over her eyelids, face and neck.

Dr John Sandford-Smith was visiting and luckily could successfully help her with her eyelids.  We are sending an ambulance into her village near Kasina to bring her to hospital for review today.  I hope we can find her.

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.