Our Specialists Restoring Vision in Africa

24 June

Restoring Sight in Africa

Dr Trevor Gin joined Eyes for Africa as one of two surgeons on a mission to help restore sight to many of the poorest and visually impaired people across Ethiopia. His amazing and heartfelt story tells of the challenging conditions and wonderful people. Treating 200 people with severe cataract was one of his most rewarding experiences.
img1 I have done a number of third world medical camps in the past but this is the first time I have been to Africa and the first time I have taken one of the children. When I was asked by Julie Tyers, the founder of ‘Eyes for Africa’ (www.eyesforafrica.org) to go to Ethiopia the opportunity was too good to refuse. It is a charity organisation that has performed free cataract surgery for the poor and underprivileged in Africa since 2007, and is reliant on donations and self-funded volunteers. Although Max was only going to be 12 and the youngest they had taken on one of these camps, I was keen for him to come to experience an entirely different life and also see the effect of cataract surgery on patients that had been completely disabled by their blindness.Our group of 10 flew by small plane from Addis Ababa to Dire Dawa in the north of Ethiopia, then by road to Harar, where we would do the surgery. It is an ancient walled Muslim city not far from the Somalian border. There were originally plans to go to Afar, near the troubled Eritrean border, but I was keen not to go there after the murder of 5 tourists by terrorists earlier in the year. On the first day we went to the Jugal hospital, a 102 year old dilapidated hospital that would serve as our base, and were met by hundreds of patients in the courtyard. I was overwhelmed by the crowd, and it was confirmed by Dr. Abu, the Ethiopian ophthalmologist I would be operating with, that they were all there for us. Many had travelled by foot for days to get there, guided or carried by relatives.
img2 The logistics of organising the swarming crowd was enormous. Our orthoptists, Jane and Laura, did an amazing job with the local nurses to order the patients, organise identification and files, and to try and establish priority cases. We had to enlist the help of the local police first and then the military, as desperation lead to disorder and fighting.The conditions were hot and uncomfortable. The operating conditions were not ideal, with flies and other insects in the theatre, and a single fan to keep us cool. There were frequent power blackouts that halted surgery, and eventually we sourced a generator that enabled us to press on. On occasion we had to finish surgery by torchlight, something that would inconceivable in Melbourne.I couldn’t have been prouder of Max, who guided the blind patients to their next area, did their preoperative drops and eventually learnt to sterilise the surgical instruments and take them into theatre. He didn’t complain about the conditions, but I could tell it was hard for him.Early in the week Max unfortunately got violently sick with gastroenteritis. He was unable to take fluid and lost a lot of weight quickly. Fortunately I had brought a good range of medicines and within 48 hours he was largely better. In the middle of his illness, however, I was thinking that the decision to bring him was the worst decision I had ever made, and how was I going to get him home safely from the middle of nowhere?
img3 The payback for all our hard work was always doing the first postoperative examination. The big toothless grins you get from the patients when they realise they can see is just priceless and heart-wrenching. Despite having done this for years, Julie would still cry at this point. I’ve always wondered about the experience from the point of view of the patients. They have usually been blind for several years. They are taken to a place where unknown people speaking a foreign language poke and prod them, and then they are led to a room where they lie down and are told to be still. Someone puts a needle through their eyelid and their eye goes numb, then they have to lie still under a drape and trust a stranger they don’t know to operate on them. And the next morning they have the cover taken from their eye and they can see at first vague light, then people, then smiles. And the amazement that comes with going from total darkness to seeing again is encapsulated in a big, spontaneous, toothless grin. And they will never know who did their surgery, where they came from and why they came. It must be quite bizarre.The commonest reaction from the patients apart from the initial smile was a lovely warbling high-pitched song, la-la-la-la-la-la, accompanied by the palms of the hand held skywards, with the arms going up and down quickly. It was lovely to see and hear the whole ward of patients doing that together. However, I quickly found out that there was one village which had a very different reaction when they were happy – they spit! I took the patch off one lady, and she first smiled and then suddenly pursed her lips and made a sound like a spitting cobra, ffft-fft-fft-fft. Spit flew out of her mouth and on to me, including in my mouth. I recoiled in horror, only for the interpreter to explain that that was what she did when she was happy, and she was blessing me. I guess you would call it a blessing in disgust!After 2 weeks, numerous power blackouts and frequent volunteer illnesses, we managed to complete 199 cases between 2 surgeons over 2 weeks, better than I had thought we could do. The city held a small ceremony for us and we met the president of the Harar region, Murad Abdalhadi and were given certificates of gratitude.