ORBIS volunteer seeks to end blindness by building eye care capacity in Ethiopia
Irish ophthalmologist Donal Brosnahan, recently spent a week in Addis Ababa. What he left behind was even more valuable than the sight regained by the handful of children he personally treated. Thanks to his efforts, and those of ORBIS, Ethiopia now has two more ophthamologists trained in advanced paediatric surgical techniques.
“The purpose was to teach skills”, says Brosnahan who practices in Dublin, Ireland. “We had two local ophthamologists, one with quite a bit of paediatric experience. The first day we screened 36 patients to find the best cases for teaching. I then spent 5 days instructing and assisting surgeries at Menelik II Hospital in Addis Ababa”.
During his time at the hospital, Brosnahan also helped educate operating room nurses and primary care physicians in techniques as well as instructing public health workers in screening and follow up skills for patients in remote villages and underserved urban areas.
“It was a full, 360-degree training effort, a comprehensive approach that recognises you have to have it all to make surgery possible. Anesthesia, nursing, equipment maintenance, and supplies as well as surgical skills. One element is not enough to make the whole thing work”.
The systematic approach of improving eye care that Dr Brosnahan experienced exemplifies the ORBIS philosophy.
Dr Brosnahan spends a week every year volunteering for ORBIS in Ethiopia. “It gives me an opportunity to give back”. It also deepens his appreciation for the high level of skill of his colleagues in Ireland. “You kind of take it for granted that expert anaesthesia and nursing and equipment maintenance will be there, but they aren’t everywhere”.
Mamite Kagnew lives in Konso in southern Ethiopia. For many years Mamite suffered from the excruciating pain of trachoma and her situation was becoming increasingly desperate as her sight was deteriorating rapidly. With virtually no sight and in constant pain, she was no longer able to work as a farmer and therefore unable to contribute to the family income. Her large family depended solely on her son’s income. In order to not feel like a burden on her family she continued to help around the home with cooking, cleaning and taking care of the children, although as the trachoma infection progressively got worse she became increasingly frail and her ability to help grew less and less.
Like so many women in rural Ethiopia, Mamite was unaware of what was causing the repeated trachoma infection and how to receive treatment. When an ORBIS trained health worker visited her home and examined her, it was clear that she had developed trichiasis – the blinding form of trachoma – and without immediate eye surgery she would eventually go blind. Mamite was naturally reluctant and scared although in her desperation she agreed to visit the Health Centre. So she walked the five kilometers to see Gedensho Gemeda, an ORBIS trained Eye Care Worker, who was conducting eye surgery to reverse the effects of trichiasis. Gedensho explained to Mamite how easy it is to prevent trachoma through good personal hygiene. He also recommended that she visit the Health Centre to take an annual dose of the antibiotic, zithromax (kindly donated by Pfizer), which protects individuals against trachoma. Three days later and Mamite’s bandages had been removed and her sight is restored. Mamite is now working as a farmer again and is able to provide for her family. She cooks, cleans and helps around the house and no longer feels like a burden on her family. She is overjoyed at being able to return to her normal life.
Help to transform lives with ORBIS and give people like Mamite the sight saving surgery they so desperately need.
Abaynesh is an 8 year old girl who has a bright future ahead of her. She is smart, and at the school she attends in Suke she has been promoted to the third grade, according to her father. She was a cheerful, happy girl with healthy eyes until about six months ago. She started to complain of pain in her eyes, a foreign body sensation with redness and tearing of her right eye. She had trouble during class as she was unable to see properly. After seeing the seriousness of his daughter’s eye problem her father brought her to the nearby Health Centre at Suke about 2km away from their home.
On her first visit, Esayas Gensa, the eye care worker diagnosed Abaynesh as having trachomatous trichiasis (blinding stage of trachoma) in the upper eyelid of the right eye. He discussed with her father about her case and reached an agreement that she needed an immediate lid surgery for correction and made an appointment for surgery a couple of days later.
Like any 8 year old girl, Abaynesh was naturally terrified at first at the thought of surgery. She went ahead bravely and came back a week later to have her stitches removed. The surgery was a success and Abaynesh is now back to being her happy, lively self. Her condition had improved greatly- she was no longer in pain and her vision was much clearer. Her father spoke of his happiness:
“My child has got her sight back again and now she is able to play with her friends and attend class in comfort without eye problem”.
Trachoma is a major cause of blindness in the world, found primarily in rural settings like Suke in southern Ethiopia. Children are most susceptible to the infection, with blinding effects of the disease often not known until adulthood. If Abaynesh had not received treatment for her triachiasis, it is highly likely that she would have become blind due to scarring of the cornea.
Trachoma is commonly found in persons over 15 years of age after they have suffered infections of the disease several times during their life time. Therefore, finding trachoma in children below the age of 15 is considered an indicator of the severity of trachoma in the specific community. In the poorest areas of southern Ethiopia, families simply cannot afford treatment and trachoma spreads rapidly.
Girumo is a six year old boy, living in southern Ethiopia, with his whole life ahead of him. His father described him as a funny and alert child until a year ago when Girumo developed a severe eye disease in both of his eyes.
Girumo started to complain of severe pain in his eyes and he suffered with redness with profuse discharge.
His father brought young Girumo to Azo Health Centre for treatment. Alebachew Hunie, the ORBIS Eye Care Worker examined the child and discovered he had trachoma trichiasis in both of his upper eye lids. Trachoma is a major cause of blindness in the world, found primarily in rural settings in developing countries. Children are most susceptible to the infection, with blinding effects of the disease often not known until adulthood. If not treated properly, trachoma may worsen and cause blindness, due to scarring of the cornea.
Girumo’s condition was so developed that he desperately required corrective surgery, but at only six years old he was too young to conduct surgery under local anesthetic. The family was therefore advised to take him to Arba Minch Hospital where they would conduct the same surgery under general anesthetic. The family left the Health Centre, but unfortunately the cost of taking Girumo on the long journey to Arba Minch was more than the family could afford.
Girumo’s discomfort continued until he could barely open his eyes and the pain of moving his eyelids was excruciating. His family had no option but to bring little Girumo back to the Health Centre in Azo.
Yet again, the family was told of the severity of Girumo’s condition and told if he was not treated immediately he would be completely blind within a few months. The family explained their desperate situation as they simply did not have the money to take Girumo to Arba Minch Hospital.
There was only one option… to conduct the surgery under local anesthetic at the Azo Health Centre. Alebachew spoke with the family explaining that it was perfectly safe and straightforward procedure, but for a child so young it is preferable that they are placed under general anesthetic.
Girumo and the family agreed to go ahead with the surgery.
For a six year old boy it was very upsetting especially when the local anesthetic was injected into his eye lids, but Girumo was extremely brave and the surgery was conducted on both eyes successfully.
Alebachew followed up with Girumo the following day and then yet again after 10 days when the sutures were removed.
Girumo is now back to being a happy, bright boy who is no longer in any pain or suffering and… he can see again!
To reduce the episodes of trachoma ORBIS are desperately trying to transform this region. Not only through surgeries which cure the disease, but also through distributing the antibiotic zithromax (kindly donated by Pfizer), educating locals on the importance of personal hygiene and improving sanitation by providing clean water and building latrines.
Pfizer has pledged to donate the antibiotic zithromax for the life of the campaign and to date ORBIS has received $68m worth of the drug. ORBIS is currently distributing over one million doses of the antibiotic per year in southern Ethiopia.
With your support we can continue to work towards completely transforming this region so the next generation can grow up free of the threat of blindness.
Before ORBIS’s intervention into regions of southern Ethiopia, blind or visually impaired children like Abush Gudeta had little hope of regaining their sight.
Suffering from trichiasis, a blinding complication of trachoma in which the eyelids turn inward and eyelashes rake across the eye’s surface, Abush endured horrific pain and discomfort for almost two years. He ultimately struggled at school and was unable to assist with simple household chores.
His parents met a neighbour who had recently received trichiasis surgery as part of an ORBIS program. They recommended that they take Abush to see the eye care workers that were scheduled to return to their local health centre in the coming weeks.
When the time came, Abush and his mother walked several miles to the health centre, where an ORBIS-trained eye care worker performed the simple 20 minute procedure on Abush. Thanks to this straightforward procedure, Abush’s pain was relieved and his vision preserved.
In this remote part of Ethiopia, where primary care service is almost non-existent, ORBIS is bringing hope to thousands of children like Abush. With your support we can continue to conduct numerous outreach programmes to conduct these simple surgeries.
ORBIS is implementing the World Health Organisation’s “SAFE” strategy, which is designed to prevent and control trachoma through conducting sight saving Surgeries, distributing Antibiotics, educating locals on the importance of Face washing and improving the Environment.
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