“In 48 hours his world will become full of light and colour again" - Kirsty’s tales of Tanzania – part 1

Here is my first blog from Tanzania, as I travel to CBM supported Kilimanjaro Christian Medical Centre (KCMC) to witness two children regain their sight following cataract surgery.

Its 8am on a chilly morning in northern Tanzania and Mount Kilimanjaro is still blanketed in cloud as we make our way over the potholed road to KCMC, just outside Moshi town centre.

Monday would normally be a busy day in KCMC’s eye department but because there is the College of Ophthalmology of Eastern Central and Southern Africa (COECSA) annual congress this week, many of the staff will be attending that, so the number of surgeries scheduled has been reduced.

The COESCA congress will take place in Arusha, Tanzania from 25th – 26th August and the theme is “Eye Care Challenges and Opportunities in Developing Countries.” The congress is attended by ophthalmic clinical officers, ophthalmic nurses and optometrist from across east, central and southern Africa.

Still the waiting room is already busy with many booked in for follow up consultations or treatment today, and many others, both adults and children, have arrived unplanned. The eye health team starts each week with a Monday morning meeting to share news, information and discuss challenges. All the talk is of whether the final agenda for the COECSA conference (at which many of them are presenting or chairing sessions) has been published yet.

The doctors and nurses disperse to their clinical duties, and the patients start to move through the system of registration and then allocation to the relevant department. Cataract surgeries don’t happen on Mondays as patients need to be admitted the night before and no-one is admitted on a Sunday. However, the operating list for Tuesday starts to fill up as patients are interviewed by the nurse counsellor and then reviewed by the surgical team.

A child turns up unexpectedly, 14 year old Ezrah from the rural area near to Moshi. Sombre in a black jacket, he hardly speaks, listening to the nurse’s description of what will happen to the clearly visible cloudy lens in his left eye. It is unclear why this cataract has developed as Ezrah cannot identify any trauma that might have caused it but he is lucky that it has been identified after only a few months. 

Meanwhile, in the sunny children’s waiting room upstairs, where cartoons adorn the walls and push-along cars keep small people distracted, a very vocal 2 year old, Sheldon, is carried in by his father Esmond. Over the past 5 or so months, both his eyes have developed a cloudy lens and it is clear that he has very little sight left in either eye. Esmond moves through the stages of triage, until he reaches nurse Jennie, specifically trained in counselling children and their families in ophthalmic cases. She confirms that bilateral cataract surgery is necessary. 

By lunchtime, the waiting room downstairs is heaving. The eye department not only carries out a range of treatment, surgical procedures, and refractive error correction, but also serves as a training hospital and KCMC is currently hosting student doctors, medical officers and nurses from UK, Mozambique, Germany, Kenya, New Zealand and other regions of Tanzania.

As the day wears on, the queues move forward and more and more patients are seen by the respective teams of experts. Ezrah and Sheldon have both moved upstairs to be admitted to the children’s ward, a sparse but bright and clean room of low beds, where they will spend the night before surgery tomorrow morning.

Ezrah’s his cataract has not yet begun to seriously impede his schoolwork and will be corrected early enough to ensure he can regain full sight and functionality. But Sheldon can scarcely make out more than my outline as I play with him and chat to his father. I can’t help but imagine what he will experience in only 48 hours when suddenly his world will become full of light and colour again.

The prospect of his future without this surgery would be very grim – It is estimated that 90% of children living with disabilities in developing countries do not go to school.  Without an education, Sheldon’s chances of employment and of future independence would reduce dramatically.  

I will attend Sheldon’s surgery tomorrow and then be there to witness his bandages being removed where after only an hour or so, the pen which the nurse held right in front of his nose will move from being a non-distinct blur to a clear, distinct object,  Sheldon is lucky that he is receiving surgery young enough to recover full sight and I leave the hospital deeply humbled that the support of  CBM UK’s supporters, who will never meet him and whom he will never know, has made this life-transforming treatment possible. 

I’ll be back tomorrow to let you know how Sheldon’s and Ezrah’s surgery went.

Read part 2 of Kirsty’s tales of Tanzania here (open link in new tab).