Blind World Magazine

W H O warns half a million could become blind by 2020.

May 29, 2005.
East African Standard, Kenya.

Mr Robert Omutele arrived in hospital on a stretcher last January, blinded by cataracts for nearly four years and his scraggy legs weakened by age and starvation.

Doctors at the Lions Sight First Eye Hospital in Nairobi performed a simple operation that restored his sight in one eye, and he was carried off to his home in Kwesero village in Kakamega District.

National Planning and Economic Development minister Anyang Nyongo talks to eye patients at the Lions Eye Clinic in, Nairobi.

When he returned last week for an operation in the second eye, doctors were amazed at the transformation the 77-year-old man had gone through since they removed cataracts in his eye.

The old man could walk again, and even performed a jig to prove that the doctors had performed a miracle.

"I feel like I've come back from the dead," Omutele said with a wide grin, revealing two neat rows of milk-white teeth. "When I was blind, children would steal my food. Now they don't."

In blindness, he could not work in his maize, millet and groundnuts farm. That means he went without food.

Omutele's experience is one too many blind people in the country go through. Indeed, the World Health Organisation warns that cases of blindness could double by 2020 if governments fail to take measures to reverse the situation.

WHO issued an alert in 1999 asking countries to act fast to control what it said could wreck the livelihoods of millions of people.

Vision 2020: The Right to Sight Global Initiative, was launched to champion this course.

In Kenya as in many other developing countries, poverty, cultural factors, lack of qualified health workers lead to the spread of eye ailments and blindness.

The Ministry of Health estimates that 224,000, Kenyans are blind, while those visually impaired and in need of treatment are more than 670,000.

But more than 80 per cent of the blind could have been prevented if measures were taken early and communities understood how to take care of their eyes.

The commonest cause of blindness is cataracts, which Omutele suffered from, according to Dr Fayaz Khan of Lions Hospital. It mainly affects elderly people.

"Most people belief that the elderly must get blind at a certain point in their lives," he said. "So they never seek treatment."

Like Umutele's case, blindness causes untold suffering because those affected cannot perform simple duties for themselves such as washing, changing clothes, cooking and cleaning their environment. Some lose their employment and become a heavy financial burden.

People who go blind in the later stages of life need to be trained to adjust to their new life, but this seldom happens for a variety of reasons.

Cataracts occur when a thin layer forms in the eyes and blocks light from getting through the pupil. Using modern equipment, an operation to remove this layer is almost painless and takes between 10 and 15 minutes.

However, the Aids crisis has also led to an unprecedented rise in blindness across Africa, where 70 per cent of the world's 36 million infected live in.

Dr Jefitha Karimurio of University of Nairobi's Department of Ophthalmology said Aids patients across the country were going blind due to complications caused by HIV.

Measles, which is avoidable in children through early immunisation, also causes blindness in youngsters. Diabetes is also listed as a cause of defective eyesight.

But some "focal" eye diseases, such as trachoma, are common in specific communities and are caused by poor living conditions and dirty environments.

In its late stages, the eyelids get inverted and eyelashes rub into the eyeball, causing much pain to patients. It spreads faster in areas with swarming flies, which carry the disease-causing organism.

Nomadic communities are the most affected, because they live very close to their cattle, and spilled milk and animal carcasses slaughtered for meat attract huge swarms of flies. Further, due to lack of water in these semi-arid areas, the nomads rarely wash their faces.

In a survey carried out last year in the six districts of Narok, Kajiado, Baringo, West Pokot, Samburu and Meru North, it was discovered that cases of trachoma was above the acceptable "minimum prevalence" in the areas.

About 46,000 people were threatened with blindness unless they immediately underwent surgery. Another 1.4 million people out of a population of 2.1 million, needed antibiotic treatment.

The survey, completed in July, covered 80,000 sq km and examined 2,787 homesteads and 15,027 people.

"It was a bigger problem than earlier thought when we set out for the survey," said Dr Karimurio, who led the research team.

It recommended that a campaign to carry out surgery, provide antibiotics and teach the communities the importance of washing their faces and cleaning their environment be launched.

But Dr Karimurio said it was difficult to change some of the nomadic people's habits.

"In some of these communities, the old men think swarms of flies in their faces are an indication of impending wealth?" he posed.

The Kenya Society for the Blind, created by Parliament in 1956, is one of the organisations working with the Government to address eye problems across the country.

"The need out there is so great, yet only about 5 per cent of the needy cases have been assisted." KSB's manager for rehabilitation services, Mr Peter Muasia said.

He said last year, KSB diagnosed and treated 500,000 cases and 20,000 underwent surgery to restore their sight. A further 2,238 blind pupils attending non-specialised schools in 32 districts were assisted.

Despite the magnitude of the problem, Kenya has only seven such schools.

Muasia said special schools were too expensive to establish and run, and the trend around the world was to enroll blind pupils in normal schools to let them socialize with other children.

KSB also runs special centres where it teaches blind people survival skills to help them adjust to life, and also trains professionals to use special computers to make their work easier.

However, lack of trained health workers to deal with eye ailments has bogged down efforts to improve the well-being of patients.

For instance, Kenya does not have an institution to train opticians and the few working in hospitals have been trained outside the country. Until 2003, Kenya was not training ophthalmic nurses, and only ophthalmic clinical officers were working in hospitals.

The University of Nairobi, however, plans to start training opticians by the end of the year.

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