KWALE EYE CENTER (Kenya)

 

For many years now we are spending our winter holidays in Kenya. Since several years we stay always in the same hotel named Leisure Lodge Beach and Golf Resort. It is located on the Diani Beach of South Coast to Mombasa some 50km north. City of Mombasa is on an island and one has to pass the wide Kilindini Creek on a ferryboat. The traffic is rather intensive to and fro the large Kilindini Port of Mombasa so it intersects the ferryboat’s route often. Once the ferryboat has crossed over the creek it lands on the mainland again. From there one passes through the large settlement of Likoni first. From here the traffic follows on a tarmac road leading southward a few kilometers away of the South Coast shore line to end at the border with Tanzania.

The almost straight road passes between patches of forest and palms woods as well as a few scattered settlements. There are some police blocks along the road and any vehicle has to slow down slaloming between boards holding  long spikes on. About halfway there is a right turn for a road leading to Kwale a larger settlement that is located at the foot of Shimba Hills Reserve about 3km far only. A while later another narrow earthen road at left leads toward the Kwale District Eye Center about that I would like to report later.

 

Since several years Ljiljana collects summer dresses, shirts and underwear for grownups and children as well as school utensils and toys. As members of the LTU Charter Carrier we are entitled to 30kg luggage each and Ljiljana uses her part mostly for her “collection”. She has a long list with names of Resort’s lower level staff members including the number and age of their children too. Once we have settled in our room Ljiljana sorts the goodies by placing the selected pieces to plastic bags each with a paper slip listing the items that she would sign adding recipient’s name later. The signed list has to be produced at Resort's checkpoint when a recipient leaves it with any parcel. Although the staff changes from year to year there are still many who know Ljiljana well from our several visits. They are waiting for Ljiljana’s to open her “boutique” to start handing out goodies in bags with the list of items and receiver’s name. The staff members like to talk to her in Swahili (East Africa’s lingua franca) as she learned it through the years of our living in Kenya and by improving during our many visits there.

During our vacations at Leisure Lodge in January 2002 Ljiljana met a gardener aka “shamba boy” named Nicolas. Unfortunately Nicolas lost his right eyesight after an infection at an age of 4-year. He could not’t any better job in spite of his fluent German and English he learned in a Mission school. He was a handsome young fellow but his misfortune made his face looking somehow distorted. Ljiljana seeing his bad luck wanted to help him to seek an eye clinic for a diagnosis at least. We’re supporting “CHRISTOFFEL” (CBM) that is an Austrian Mission for Blind People through many years. So prior to our next travel to Kenya we contacted CBM Head Office in Vienna (http://www.cbm.at) and we were informed that the KWALE DISTRICT EYE CENTER (clinic) does exist not too far away from our favorite holidaying place.

 

In January 2003 our holidaying procedure went on the usual way on visiting Leisure Lodge again. Though Ljiljana’s protégé Nicolas wasn't’t working as hotel’s gardener anymore but through “bush drums” Nicolas appeared few days after. It was agreed that Nicolas would guide Ljiljana on a journey to the Kwale District Eye Center (KDEC) by using the “matatu” transportation service. Matatus are minibuses that stop at any place along a road to pick up passengers but tour along a certain road stretch only. The matatu’s fares are inexpensive and natives mostly use this way of transportation mainly for short distances. On the agreed day Nicolas came to the hotel and accompanied Ljiljana on the trek to KDEC. This was the first time Ljiljana traveled by this simple transportation means. They had to change several matatus to reach the Center after an hour ride in heat at last. After a while Nicolas was directed to the outpatient ambulance for a checkup. Ljiljana went to the Center’s administration to obtain official prospectuses and address including bank account etc. She met there an elderly German lady who brought some 40 spectacles as her donation to the Center. She was in company of Mr. Salim Rahamtula who turned out to be a nephew of our late friends in Bamburi Portland Cement Works.

When Salim recognized Ljiljana’s surname he offered help as being a member on the Board of KDEC. He introduced both ladies to Dr. Helen Roberts, a British ophthalmologist, who was in charge of KDEC directing it since its start in 1993. Dr. Helen Roberts was a good looking and vigorous lady of early 40s and when learning about Nicolas’ problem went to see him in the ambulance soon. Unfortunately for Nicolas his one eye was lost for ever. Dr. Helen suggested place over the eyeball an artificial eye white that incorporated a bogus lens. The artificial eye would make Nicola’s facial feature look more pleasant but he would not’t hear of it at first. Then a Kenyan nurse suggested Nicolas to take a mirror to see for himself how a “new eye” would look like on him. She sneakily suggesting that he would catch more girls’ attention looking into his face with two eyes. Ljiljana offered to pay for Nicolas “new eye” some EUR 8 so the nurse showed Nicolas how to he has place in the “new eye”. After instructing Nicolas about the necessary care and regular controls she gave also him a liquid against eye’s irritation. Obviously Nicolas was too happy with his new appearance and  left KDEC in the best spirit on returning home alone. Ljiljana made a contribution of EUR 30 needed for a cataract surgery to help another child in need. After several obligatory “kwaheris” (goodbyes) Salim drove in his car both visiting ladies to their respective hotels on Diani Beach of Mombasa’s South Coast.

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INTERLUDE

 

Patricia Hughes-Scott wrote in the article published in COAST WEEK newspaper, January 09 – 15, 2004 that worldwide one person becomes blind every five seconds. Of the estimated 50 million people completely blind some 90 percent live in countries of the developing world. In this article titled KWALE DISTRICT EYE CENTER - Serving the Community with Affordable Eye Care – she mentions that in Kenya the rate of blindness is 10 times that of Europe. In other words in Kenya one person in every 100 is totally blind of whom the blindness in some 80 percent could be preventable. More than half of the visual problems are caused by cataracts in the eyes.

 

About a decade ago Dr. Helen E. Roberts, a British ophthalmologist, settled with her family at the South Coast of Mombasa in Kwale District and close to Diani Beach. She was appealed by people’s blindness plague determinable started the task to provide affordable and accessible eye care to the community. Helen’s husband, an industrials and plant manager, helped building a humble single room 8m by 6m without any plumbing and water supply but it had to serve every need at first. With Rotary Club of Diani funds and donations of most the equipment some 850 patients were treated and 50 operations were carried in that first year 1993.

 
Ten years later and after four phases of development the Eye Center comprises now: an air-conditioned op-theater with adding new equipment continually, a de-humidified store for instruments and pharmaceutical medicine, an in-patient hostel with male and female wards, laundry and kitchen facilities, a day care room for private patients and new offices for the administration. A new standby generator and own water-well including plumbing and sewage provide the main necessities of the Eye Center. Through funding one could purchase a Landrover and a motorbike for the field work to visit scattered hamlets and small villages. The statistics show a constant rise of Center’s services to patients from all over Kwale District. In 2002 a total of 7748 patients were seen in the field and another 9051 ones came to the Center for control. Some 1383 eye operations were performed and another 1235 cataract surgery carried out in the same period.

KDEC is different from a regular clinic as it provides accessible and affordable eye care in the 2nd poorest province of Kenya. Kwale District stretches over 8,5sq km on the southern Kenyan Coast. The population of around 600.000 people mainly subsides on farming and sea fishing with some employment in the tourist trade. According to WHO study in 1999 in average one employed person supports 16 dependents thus few people have money to spend on any kind of health care. Therefore KDEC is a charitable institution and patients pay only an affordable contribution for their care. A special charity fund pays for those who cannot make any contribution like single mothers with a lot of children. The service quality of the Center is given by its International associations and its Medical Director Dr. Helen E. Roberts MBE MBChB MRCOphth FRCOphth.

From the begin KDEC recruited Community Based Workers as trusted and respected persons who were taught to identify eye problems and counsel people where to go for treatment. Initially folks were afraid through ignorance and did not’t know that cataracts are treatable but also afraid that someone would take to their eyes. Village Health Committees were formed to identify and address the populace regarding the needless blindness. Also KDEC trains District Health Medical Teams and even traditional birth attendants are taught to recognize the eye diseases in their working areas and to advice individuals on help and curing. According to Dr. Helen it is the lack or deficiency of Vitamin A in children’s diet that causes the blindness. This happens too often if a child gets an infection like measles and if it survives an illness the meager source of Vitamin A in child’s liver is burned out followed by the blindness. Cataracts are mostly curable and the only treatment is by 20 minute surgery done at the Eye Center. The most rewarding moment comes for the surgeon when the eye pad is removed and the patient who could see nothing and after less of an hour sees everything. Dr. Helen told about her most rewarding moment to be when a child could see a toy in splendid colors after all.

   A left males' ward room and visitors talk to Dr. Helen Roberts at the courtyard

Dr. Helen feels truly humble and rewarded when looking on the patient who sees a child’s face for the first time or just look at the sky or trees. There was one man who was wanted to hang himself because he could not bear his blindness and dependence on others. After the treatment he said “You gave me back my life!”. That makes the Center’s staff feel really good and proud of their work too. Dr. Helen has many favorite success stories but she likes the one most. There was an old man who was led to the Clinic by a child what’s common here. The child becomes the carer for an old person who cannot more move around alone. After the operation and when the pad was removed from old man's eyes he realized soon that he can see again. He chased the toto (child) away telling him to go to the school as he was not’t needed anymore. Dr. Helen tells on: “He threw his stick in the bushes and we saw him dancing a jig outside and in that way he went off down the road he came in blind”.

The KDEC has a partnership agreement with Christian Blind Mission International and with Sight Savers International too. KDEC are in constant need of funding and any donations are gratefully received. Center welcomes visitors and to get in contact please make use of E-mail: eyeskwale@africaonline.co.ke or search the website at URL: http://www.eyesforeastafrica.org.

 

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Many months before our next journey to Kenya Ljiljana started collecting spectacles and eye glasses with emphasis on dark ones. She aimed to beat the 40 spectacles that of an elderly lady donated to the Center in 2003. As the time of our departure came closer the number of spectacles rose well over 100 but their weight became a concern because of the luggage weight limitation. Our LTU CARD allows 30kg baggage weight per person but Ljiljana already had “her” 30kg packed up with goodies for her “rafikis” (friends - in Swahili). The weight situation became even more critical by December by the influx of additional many sets of spectacles cum frames as well as paired eye glasses from donors like opticians and some stores of “lost items”. Soon Ljiljana had a large travel bag carefully packed with spectacle's donations weighing well over 12kg. Therefore I had to wrote a letter to LTU CHARTER asking for an excess luggage of 15kg as for donations. Shortly we got that luggage excess weight approved and the bag was specially marked and stored to the bulky container on check-in at Munich airport.

Salim Rahamtula met us at the Mombasa airport as we could expect some problems with the customs there. However the bag passed the custom officer just saying "hakuna matata” (no problems) and we got out of the  Mombasa International Airport fast. Thus over 200 spectacles that Ljiljana did not’t have time to count reached their destination without any damage or breakage. Several days later Salim took us to KDEC where my best of wife handed her “spectacles' collection” to Mrs. Rosemillia ONYANGO, Project Manager of KDEC. Everybody was too happy and most satisfied with the great donation. Later we have toured the whole compound and were shown to every room including male and female wards where patients greeted us smiling and in good spirits. Dr. Helen took me to the day care room for private patients to check a small wart on my right lower eyelid with the advice to check regularly (what I do anyway) in case in starts to disturb me.

 

After a short chit-chat our visit had ended when Dr. Helen was called in for another check of a private patient waiting on that rather humid afternoon. We have promised to come next year “Shauria Mungo” (God’s Will) and try to make public this extraordinary task started by a single but determinate ophthalmologist in this rather poor part of Kenya.

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