Restore eye sight & worth of rural poor in Uganda

Never had I associated low hemoglobin, as in anaemia, to eyesight. Well, medical professionals confirm that one’s “retina may become damaged due to a lack of oxygen and leaking blood vessels,” due to low hemoglobin. And, furthermore, empirical researchers, among them Alicia Traveset et al, advise that among people afflicted with diabetes. there is an association between anaemia and the eye condition, retinopathy – the leading cause of preventable blindness.

“There are several studies showing the role of anemia as an independent risk factor for diabetic retinopathy, particularly in population-based studies. Among them, Davis et al., demonstrated that, in Early Treatment Diabetic Retinopathy Study, low hemoglobin and hematocrit levels were independent baseline risk factors for the development of high-risk proliferative diabetic retinopathy and severe vision loss over a 5-year follow-up.”

It is important to note, upfront, that diabetes is taking root in Uganda. The number of those it afflicts is increasing as the proportion of Ugandans who are obese and overweight is on the increase. The proportion of Ugandans obese increased nearly eight times from 1.2 percent in 2016 to 9.3 percent in 2023; and those overweight doubled from 7.2 percent to 14.6 percent.

The association between low hemoglobin and eyesight was on my mind on Tuesday, 23^rd June 2024, when I visited Uganda Police Force Headquarters. And until I got to the main entrance and I saw the banner, I was unaware of Africa Public Service Day, commemorated on 23^rd June.

“Africa Public Service Day, which reflects on the virtue of public and community service, originates from the first Pan African Conference of Ministers of Public and Civil Service held in Tangier, Morocco in 1994,” I have learnt from Africa Reach.

The atmosphere at the Police Headquarters moved me to want to participate in the on-going Africa Public Service Day commemoration activities, among them “a blood donation exercise,” as the banner at the main entrance informed that “the Chief blood donor is the IGP (Inspector General of Police.” And indeed, “IGP and other senior officers led by example” and did donate blood.

When I was done with what had taken me to Police Headquarters, I found my way to the medical tent and offered to donate blood. I was warmly welcomed. The preliminary test was done to establish my hemoglobin level, at 12.8 it was within the range of normal for women, I was told. Honestly, I did not know what that meant at the time. but now I understand from the Cleveland Clinic:

Hemoglobin is a protein in your red blood cells. Your red blood cells carry oxygen throughout your body. Oxygen powers your cells and gives you energy … For men, a normal level ranges between 14.0 grams per deciliter (gm/dL) and 17.5 gm/dL. For women, a normal level ranges between 12.3 gm/dL and 15.3 gm/dL.

Then the nurse who was doing the preliminary check, asked for my birthdate. When I told it to her, she stopped her pen. Apparently, even though I had okay hemoglobin to donate blood, at 56 years of age in August 2024, I am too old.

“In Uganda to donate blood, for women, you have to be at least 17 years of age and a maximum of 55 years; the latter if you have been donating regularly. Otherwise, if a woman has not been regularly donating blood, the maximum age for her to be allowed to donate blood is 50 years. This is because, within this age bracket, the body is still functioning well manufacturing blood.

When one ages, above 55, their bodies capacity for manufacturing blood reduces. So, we do not accept blood donations from women above 55 years of age, because they need their blood for their elderly years – 60s, 80s, plus,” explained the Blood Bank Senior Nursing Officer.

Crushing disappointment for me. This is because I suffered anaemia in the 1990s and 2000s. I had a fibroid which caused me to loose loads of blood during menstruation. Until the fibroid was surgically removed and I got better. During that time. at least on two occasions, I received blood transfusions, the blood that others had prior donated saved my life.

In the longer-term, diet related solutions for boosting and maintaining hemoglobin are advised. For example, for me, post my fibroid surgery I got to learn of hibiscus sabdariffa. I became a producer and a consumer of it to this day; because of it, from being one chronically anaemic I now have loads of blood, some of which I could afford to donate.

The last time I donated blood, was during a blood donation drive organised at my alma mater, Lake Victoria Primary School, on 2nd December 2023, when I was four months older than 55 years. An exception was made for me and I was allowed to donate. According to World Health Organisation recommendations, I had hoped I still had a decade during which, age-wise, I qualify to donate blood.

Sadly, that is not the case, I am no longer among the few Ugandan women able to donate blood.

“Many women come to blood donation drives wishing to donate, but they find themselves with low blood. They can’t donate. We are the mothers of the nation. We loose blood on a monthly basis, you know our periods. That means we have to take care of ourselves by eating a balanced diet – eating food rich in iron, most especially greens,” explained the Senior Nursing Officer.

Which got me thinking about the big picture of prevalence of anaemia among women in Uganda and the fact that the majority, 60 percent of Ugandans that are obese, overweight and diabetic, are women. Millions at risk to loose their eyesight if not made aware of preventable causes and they receive eyecare services.

More medical events/camps, such as the one organised by the Ministry of Public Service, in commemoration of Africa Public Service Day and held at Police Headquarters, are urgently need. And so, I express our gratitude to our donors who have made a contribution to our project to champion the fight against preventable blindness among the poor and marginalized communities of Uganda, including organising medical camps.

Please help us to share the word and invite others to make a contribution in support of restoring eyesight and worth of poor people in rural Uganda. Thank you.  

Links:

• Article - Understanding Impact of Anaemia on Eyes and Vision
• Lower Hemoglobin associated with retina ischemia
• Public Service Ministry to offer medical services to slums

Before I became involved in our project that is focused on the wellbeing of our eyes, I would have simply celebrated the testimony of a young welder. In response to a conversation on social media, “suggest businesses that require little capital but yield high profits,” the young welder wrote:

“I am a welder and I deal in welding metals. In a day I can go into work with 2k (2,000 shillings) in the morning and I can come back home in the evening with 20k (20,000 shillings) through welding boda bodas (motorbikes) and doors.”

Indeed, my colleague, an innovator, confirmed how lucrative welding can be. He shared:

“This makes me reflect back during my welding apprentice, my trainer would tell us that we are permitted to earn our pocket money from daily customers. So, we used to buy our own welding rod (each could cost 500 shillings), this was to help work on daily customers who bring broken hoes, motorcycles, wheel barrows, bicycles and cars.

Welding each of these could cost around 2,000 shillings to 5,000 shillings. It could cost more depending on the damage on the tool or machine the customers had brought at the workshop. On a daily basis a welding trainee would go back home with 20,000 shillings or even more depending on the location of your workshop and the good relationships you have with your customers.”

Wow! A business which multiplies your investment ten-fold or more within a day is worth celebrating and promoting. Be that as it may, my newly gained ‘eye-wellbeing-consciousness’ reminded me to ask, at what cost to the welders’ eyes?

I was reminded of photo on social media in which government officials were celebrating a skilling programme and the photo accompanying the story was of a young female welder, welding without any protective gear covering her eyes.

“Long-term exposure to UV light can produce cataracts in some persons. Exposure to infrared light can heat the lens of the eye and produce cataracts over the long term.

Visible light from welding processes is very bright and can overwhelm the ability of the iris of the eye to close sufficiently and rapidly enough to limit the brightness of the light reaching the retina. The result is that the light is temporarily blinding and fatiguing to the eye.” This is according to the Canadian Centre for Occupational Health and Safety.

I am yet to know of a blind welder. Reality is that we need good eyes to earn a living from welding. Which makes it vital that a welder should earn while protecting the wellbeing of eyes by wearing the necessary protective gear. I am excited that through our project, we will encourage the culture of being consciously concerned about the wellbeing of our eyes in whatever we do.

We are grateful for the support of our donors, without which we are not able to be among those addressing a significant eye problem in Uganda. According to a cross-sectional study on prevalence and risk factors for visual impairment, for example, cataract, is the leading cause of blindness among the elderly. And yet it is preventable.

Through our project, we believe we can contribute to reversing this trend through community outreaches and health promotion campaigns that make people consciously aware of preventable blindness and to want to do something about it. With your support, yes, we can. Please consider making a donation. Thank you.