|Posted on:||Thursday, 25th August, 2016|
My second day at CBM supported Kilimanjaro Christian Medical Centre (KCMC) starts early. It is cool and cloudy as I head upstairs to the operating floor, where I put on my surgical gown, hat and mask and make my way in to the theatre to join paediatric ophthalmic surgeon Dr Forahini is reviewing his case notes.
Patients are operated on in age order so 2 year old Sheldon, whom I met yesterday, is second on the list. I am glad that he does not have to wait long as he has not been allowed to eat or drink anything since yesterday.
The anaesthetist, who has two trainees in tow, is readying the machinery and I wander out to see how Esmond is doing. A doting father, he is ready in the waiting room, with Sheldon on his knee dressed in a hospital gown. We greet each other warmly and smile about what tomorrow will bring.
First in is baby Elizabeth, who has ingrowing eyelashes which are causing her a lot of pain and risk scarring the cornea. This hospital’s eye department has a good number of ophthalmologists but paediatric surgery requires additional training, and while KCMC has Dr Forahini, he is one of only two fully qualified paediatric ophthalmologists in Tanzania, there is still a huge need for more.
Before long, it is Sheldon’s turn and he is carried in and placed gently on the operating table. Cataract surgery in an adult is relatively simple, takes just 20 minutes and costs as little £24, changing someone’s life forever. But for children it is much more complicated and lengthy costing around £95 because of the need for general anaesthetic.
In seconds, Sheldon is asleep and the first of his cataracts can be removed. As I watch the surgeon skilfully make the tiny incisions, I try to imagine how I would feel if it were my 2 year old lying there, and say a silent prayer not just for the little boy and the surgeon before me, but for his anxious father in the waiting room.
The soothing tones of the anaesthetist who keeps up a continuous stream of coaching to his two trainees accompany me through the careful removal of all the pieces of the cloudy lens, first in one eye and then the next, and the insertion of the intra ocular lens specifically made for children. After almost an hour, Dr Forahini straightens up and announces, “Finished”, and is called away to consult on another case..
Later in the day, it will be the turn of 14 year old Ezrah. He is lucky that he needs surgery only in his left eye, but despite knowing that this operation will restore his sight fully, he still seems very apprehensive about the surgery.
I leave the theatre in order to join the outreach team on a follow up visit. We head out to see 3 year old Faith who received surgery on both eyes in 2015. Faith lives with her parents around 5km from the hospital so KCMC was well known to them before Faith’s operation. Faith’s sight was so poor, but now she is able to see perfectly well and her mother is hugely appreciative of all the staff at KCMC, who have not only restored sight to her daughter, but transformed her life.
The lenses used in child cataract surgery are very powerful and often require the need for glasses in order for the eye to develop properly. I am pleased to see Faith is dutifully wearing the tiny frames she was fitted with. Unlike spectacle frames for adults which are mass produced in China and India, frames for children are difficult to obtain. Unfortunately, during her everyday play, the frames have become bent out of shape. Faith is lucky that she lives so close to the hospital and can return reasonably easily and at little cost. Martha has already made an appointment for next month to get Faith’s spectacles mended.
We head back to KCMC and arrive in time to see Sheldon and Ezrah, both asleep on the ward, their eyes heavily bandaged. Ezrah’s father reports that he is still anxious, but not in pain, so he is glad he is now getting some rest. Esmond moves to sit up and Sheldon stirs. Amazingly, he is cheerful as soon as he wakes, bothered only by the drip needle in his hand. I don’t think I have met a happier 2 year old!
The CBM supported child eye health project not only ensures that these children can access free surgery but also carries out a huge number of awareness raising and screening campaigns which ensure community members and healthcare personnel are aware of the services available to them.
Without this support, Sheldon and Ezrah might have never been treated and would face a very different future, like all the other children living in some of the poorest communities who are yet to be found by the programme. I leave them to their rest and head out through the now almost empty waiting room, this sobering thought uppermost in my mind.Back