Eye Clinic 2009
Ben Williams an optometerist, and a partner in the Yeovil and Chard practises of Robert Frith, this year travelled to Kenya to work in the AAF Eye Care Clinic, at Tei Wa Yesu in the Mwingi District. Ben spent a week performing sight tests, prescribing spectacles and medications and organising onward referral for those that he could not help, (mostly cataract patients) who received free treatment at the Kikuyu Eye Hospital at Nairobi, paid for by donations to AAF.
"My trip was a life changing experience and I learned a lot in many ways, from a clinical perspective I saw a greater frequency and severity of eye disease that I am used to as an optometrist in the UK . As a rough estimate, I saw the equivalent of a six months worth of pathology in a single week. Why was this? Primarily because I was the only eye-care available.
I was present for only a week and I would be the only optometrist until my colleague Simon Frackiewicz returns in a years time. If the people of the region need eyecare they would have to travel for 2 hours. They could not afford the journey let-alone the cost examination and treatment. So I was, for my short stint, the only source of help; and as such I was presented with every difficulty from the simple need for reading glasses through to injuries, infections, cataracts, eye tumours and children with congenital blindness.
For example I was presented with a six year old girl who had malformed rudimentary eyes ( a condition known as micro-ophthalmos), her parents clearly hoped that I could offer some cure but the finest surgeons in the world would be unable to do anything. It was sad to realise that the parents and child had never had the guidance of a clinician to explain the reality of the situation, all we could do was make sure they were fully informed and that her eyes were comfortable.
Cataracts were very common (made worse by UV exposure, poor diet and periods of dehydration).Although used to this condition I found that my criteria for referral soon changed dramatically. In the UK I will often need to refer when a person's vision drops below driving standard (about halfway down a vision chart), the typical person I referred had only light perception in their worst eye and they were unable to see the largest letter on a standard vision chart in their better eye. Both of these eyes would be classified as blind by western standards.
I identified sixteen patients with the most severe cataracts to be operated on by the doctors in Nairobi. A further sixteen (with lesser but still significant disabling cataracts) were listed to go on a second trip later in the year.
WOULD YOU LIKE TO HELP GIVE SOMEONE GOOD SIGHT
Eye injuries are common and I dealt with a few foreign bodies in the eyes of the people.
One lady had a penetrating injury with the eyeball being internally infected. This would be an admission to hospital in the UK, she had had to cope with this problem for a month before she got to us. It is not surprising to see numerous corneal injuries, when you soon realise that the only plants that successfully grow in the arid conditions are those with the sharpest thorns. Any farmer needs to clear these abundant plants if he is to run his smallholding (no health and safety and certainly no access to safety goggles). Many, many patients will have pre-existing corneal scarring which normally is due to a history of polio or from an injury. Effectively it leaves a lot of people with only one useful eye, and they need a spare when you realise all the disease and problems they have piled against them
Certain eye diseases I witnessed such as vitamin-A deficiency and trachoma would be incredibly rare in the UK, indeed I have never seen a case of either; until seeing several in Kenya. This is primarily due to poor diet and hygiene respectively, both consequences of the climate and poverty.
I have travelled to poor areas of the world before but the poverty was always at arms length and I was a tourist isolated from it. Being immersed in a busy rural clinic far from the beaten track gave me a true insight to what life was really like. Not only did I experience the severity and frequency of the ocular disease but I also could see why the economy, climate and lack of infrastructure makes it so difficult for the people to get the help they need.
I saw the region at a point when there had been no rain for two years; four successive rainy seasons had failed. Times were desperate and the lack of water meant little or no hygiene, no ability to grow spare crops to sell, no money to buy anything but the basic foodstuffs and hence bad nutrition. Everyone I met had lost cattle due to the drought (the single most valuable thing they owned). I was greatly relieved to hear that the rainfall had come recently and I hope it is all it needs to be.
I hope when I return I will see a region not suffering anywhere near so badly. And I will return because now I have witnessed their need and felt their endless gratitude for the little we can do to help.
Thank you if you are a supporter of the Akamba Aid fund ~ you are making a huge difference."
Ben Williams - Nov 2009
