Rural Zambia presents challenges for eye health care
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I recently spent three days in the Solwezi region of Zambia’s North-Western province (that’s its name, like Alberta), in the very pleasant company of Operation Eyesight ophthalmologist Dr. Edith Pola.

On March 10, I accompanied Edith and her team to an eye screening clinic at Meheba Refugee Camp, one of the longest-standing refugee camps in Zambia.

Meheba and other camps like it are supported by UNHCR (the United Nations refugee agency). It occupies about 50 square kilometres, and was once home to almost a quarter-million refugees from African countries like Rwanda, Burundi, Uganda, Sudan and the Democratic Republic of Congo. Fleeing brutal regimes, men, women and children walked thousands of kilometres through the jungle to get to the safety of Zambia.

Over the years, more than half of the camp’s residents have been repatriated to their home countries, although many people refuse to return because they don’t trust their own governments. Some refugees have lived at Meheba over 20 years, and children have spent their whole lives there.

Living conditions in the camp are harsh, and health care facilities are limited. As the only ophthalmologist working in the province, Dr. Pola and her team of four ophthalmic clinical officers and two ophthalmic nurses find themselves stretched to keep up with the need for eye care.

Splitting into two groups to work long hours out of the camp’s small health clinics, the teams individually screen hundreds of refugees for cataracts, glaucoma and other eye diseases, as well as low vision. Mothers with babies and young children, classes of uniformed school children, and the elderly make up most of the long queues.

Many patients suffer from infections and/or mild acid burns in their eyes, due to treatment with traditional eye medications – often urine, cow dung or herbal concoctions. Edith tells me such “remedies” are still common in rural Africa. She and the ophthalmic clinical officers must prescribe anti-inflammatory medications and antibiotics for these people before any other eye health issues can be accurately identified.

Yet while this Operation Eyesight-sponsored team works under challenging conditions, they are obtaining significant results in Meheba and places like it, where residents have no other means of obtaining eye care.

Without them, people like Emmanuel would remain in their worlds of darkness. Emmanuel, a 66-year old Rwandan refugee who has lived at Meheba since 1998, is completely blind in his left eye, and has only limited vision in his right eye because of cataract. He was recovering from malaria when I met him, and still a bit shaky from fever; yet had made his way to the clinic to have his eyes examined.

“The doctor is going to try to help me,” he says hopefully.

At the end of the long day, Edith takes a stretch break while her team starts to pack up their equipment. When I remark that everyone has worked extremely hard today, she smiles.

“This province is very large so human resources are an ongoing challenge for us,” she says. “We need to train many more doctors and nurses to meet the needs of our population.”

Because the eye care staff complement is so limited in this area, the team travels within a 100-km radius from Solwezi over heavily rutted dirt roads that are often impassable in the rainy season.

“We really need jungle cruisers [heavy-duty 4×4 vehicles] to go over these roads,” she says ruefully. “Right now we only have one such vehicle. The need is great.”