Restoring Sight: My Work With the Himalayan Cataract Project in Ethiopia

by |September 7, 2010

The following is a guest blog by Dr. Matt Oliva, an MD with the Himalayan Cataract Project. Dr. Oliva also practices with the Division of International Ophthalmology at Oregon Health Sciences University and serves as the Associate Medical Director at Sightlife.

Disclaimer: The views expressed by the author in this blog do not represent the opinion of the Millennium Cities Initiative, the Earth Institute at Columbia University or any of its professional consultants.

Blindness exerts an incredible toll in the Tigray region of Ethiopia, in terms of both human suffering and adverse economic impact. Due to environmental conditions, malnutrition and vitamin deficiency, ocular infections, trauma and lack of access to care, some of the world’s highest rates of blindness exist in this arid and mountainous area, with a 1.5% estimated prevalence rate. The majority of this blindness is caused by cataract and corneal opacification, both of which are treatable conditions, often for as little as $20 per surgery.

The Himalayan Cataract Project (HCP) is working to eradicate preventable and treatable blindness in the developing world. Beginning in 2007, in partnership with the Millennium Cities Initiative, we joined forces with the Quiha Zonal Hospital in Mekelle, Ethiopia, and the Tigray Regional Health Bureau to dramatically expand access to high volume, high quality, modern cataract and corneal surgery in northern Ethiopia.

HCP and Ethiopian physicians perform sight-restoring surgeries.

The results have been stunning. Over the last two years, Quiha has provided more than 1,000 sight-restoring surgeries per month – both at the hospital in Mekelle, as well as through extensive outreach work at community health centers staffed by ophthalmic nurses. A particular highlight has been five high-volume cataract programs over the last two years. Most recently, in July 2010, a staggering 973 surgeries – cataract, corneal transplant and glaucoma – were performed over the course of one week. Patients were screened throughout the region over the preceding three-week period, with ophthalmic nurses traveling to remote villages and finding bilateral blind patients, who were then transported to Quiha. Patients from as far as Eritrea traveled over 600km to seek care. In seven long days of surgery, I worked side-by-side to restore sight with Ethiopian surgeons Dr. Tilahun Kiros, Dr. Zerihun and Dr. Yewubnesh, and American surgeon Dr. Paul Jorizzo. Careful follow-up care was provided by the network of ophthalmic nurses.

Examining a patient.

HCP has made significant investments in training and infrastructure at Quiha as we strive to make it a model center of excellence for eye care and training in Africa. Medical Director Dr. Tilahun Kiros was an HCP Fellow in 2009, studying cornea in the United States, with follow-up training provided in Mekelle by visiting faculty. Staff surgeons Dr. Zerihun and Dr. Yewubnesh recently returned in June 2010 from a six-week training course in Nepal, where they honed their high-volume/high-quality cataract skills at the Tilganga Institute of Ophthalmology in Kathmandu. A continuous stream of U.S. eye surgeons and support staff instructors from Tilganga have visited Mekelle to help Quiha reach its goal of replicating the high-efficiency comprehensive eye care delivery systems that have been so successful in reducing blindness in Asia.

Patients recover post-surgery.

As we look to the future, a modern state-of-the-art eye teaching hospital is being built next to the existing Quiha structure, slated to open in 2011. The ophthalmic nursing program, which graduates 12 nurses per year to serve Ethiopia and East Africa, is expanding, in collaboration with Mekelle University and HCP. Additional doctors will join Quiha as permitted, with subspecialty training in pediatrics and retinal disease.

The new hospital under construction.

The quality of care and surgical outcomes at Quiha is as good as I have seen anywhere in Africa. This past July, when we removed each morning the eye bandages of more than 150 patients from the previous days’ surgeries, a chorus of ululating patients would give thanks to the Quiha team who helped restore their sight. As these patients return home to their villages or towns with their new sight and broadened horizons, we expect the demand for eye care services in Tigray to continue to expand.

Please visit the Himalayan Cataract Project website (www.cureblindness.org) for further photos and videos of HCP’s work in Ethiopia.

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Lisa

I think that this is a wonderful program that you do. I would like to see a documentary on this someday.