Tanzania

Agency
CBM

Comprehensive Community Based Rehabilitation in Tanzania
Dar es Salaam – outreach held in Mwanza

Case Study Details

Victoria is 10 years old and she was blind from bilateral cataract. We first met Victoria in December 2006 when we went to Segerema Mission Hospital in Tanzania as visiting specialists to help the staff at the hospital. Segerema is a 30 minute boat trip and 2 hour bus trip on terrible roads from the nearest town, Mwanza. Mwanza is 2 days bus journey from Dar es Salaam where CCBRT is based. Victoria did not live in Segerema but on a small island on Lake Victoria. Surgery to restore sight for Victoria (requiring specialist team and equipment) was not available in Segerema or Mwanza so we had to help her and her mother to come to CCBRT for surgery. Victoria came for surgery and was doing well when she left hospital but I have not seen her again.

It was Victoria who first gave us the idea of transporting our specialist team and equipment to Mwanza region for a week of outreach cataract surgery for children. We would operate on the children nearer their own community and the return after 4 months or so to do the follow up and operate new cases.

Cataract is not common in children compared to adults (we probably do more cases than anywhere else in Africa but only do 300 children a year compared to about 3600 adults) but can cause a lifetime of unnecessary blindness if not treated promptly by a highly specialized team. So we did not expect large numbers of children. My colleague who has spent his whole career practicing eye surgery in Africa fully supported the idea and thought 10 cases would be a good result. To publicize the week we traveled up to Mwanza 2 months before and invited all the eye workers from around Lake Victoria to explain the mission. About 20 people attended and enthusiastically supported the idea and it was agreed that we would operate in the regional hospital in Mwanza town.

In June 2007, we traveled to Mwanza for the planned week of outreach surgery. We traveled with around 120Kg of excess luggage including anesthetic and surgical machines. Very quickly it became clear that we were meeting a huge need and by the second day we had 70 children’s names on the operating list with more (requiring more complex surgery or with complex medical problems) referred back to our base hospital. Cataract surgery in children takes slightly longer than adults and it also takes time to put the children to sleep, take measurements of the eye under anesthesia and wake them up – so the average total time in an hour before starting the next case. We managed to operate about 10 children a day by working until around 8 in the evening and after staying a week later than planned and working all day Saturday we managed to operate on 85 eyes of 60 children. Another 8 were referred to CCBRT and 5 to Kilimanjaro Christian Medical Centre.

The regional eye co-coordinator and the local hospital staff worked closely with us the whole time staying extra hours each day until we had finished. It was an enormously moving and rewarding experience because of seeing such a huge need and response all triggered by meeting one girl in Sengerema; because of the great team spirit generated among staff from different organizations and also the team spirit among the parents and children as they had the excitement of seeing or watching their children beginning to see, sometimes for the first time.

A baby girl called ‘Happiness’ gives that to her mother as she begins to see and grasp toys for the first time.

I say beginning to see because the cure is not instantaneous, especially if the child was born with cataracts, when the eyes are very lazy and need time and special glasses to recover. That is why follow up of these children is so important and why we plan to return in November. Already we’ve been told that excited parents are spreading the news and have recruited more new patients for our next visit. Let’s hope Victoria also comes and sees the results of her inspiration.

Report by Richard Bowman, Opthalmologist, Tanzania.

Pictures courtesy of CBM.

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