Bringing eye health to the Isoka district, Zambia

George Sichamba lives in Kalungu village in the Isoka district of the Muchinga province in Zambia. George explained that before he lost his sight everything was going well for him; “Before I lost my sight I had a very nice family. We lived together with no problems”. However, when he discovered that his sight was slowly deteriorating, his life began to be affected. George’s main source of income is farming but working became increasingly difficult due to his visual impairment and he was unable to bring in as much money. “Staying in the village without good sight is a very big challenge. Working in my field became a problem. This is because I was losing my sight in both eyes at the same time unfortunately”, he explained. His inability to support the family became a source of conflict between George and his wife. The situation affected his marriage and eventually his wife decided to leave him which meant he had no one to help him find food. Life became miserable for him.

Eye care services before and after the Seeing is Believing (SIB) project: Zambia is classified as a lower-middle income country and has a population of 15.02 million.  It is Africa’s biggest copper producer however this growth has not been felt by two-thirds of Zambians (63%) who continue to live in poverty.  Life expectancy is among the lowest in the world at 57 years old .

The SIB project, which began in April 2016, aims to provide sustainable eye care services at the district level for people in four districts of Zambia, including the Isoka district where George lives. The project area is sparsely populated compared to urban areas of Zambia and the combined population is 1.4 million, with more than 75% residing in rural areas .

The economy is heavily dependent on agriculture and levels of extreme poverty remain high.  Access to health services is a challenge as often the nearest rural health centre is far away making it difficult for vulnerable groups such as the elderly and persons with disabilities to access health services.

The Isoka district is particularly underserved.  Eye health services are not routinely available here due to a severe shortage of trained eye health personnel and a lack of equipment. There are no other eye health non-governmental organisations operating here.  Before the SIB project began, eye care services in the Isoka district were limited to the treatment of trachomatous trichiasis (TT), bacterial conjunctivitis and refractive errors. Since 2010, there had been no eye camps to carry out cataract operations in the district and if health staff suspected a patient had cataracts they would be referred for screening at hospitals in Kasama or Kitwe over 200km away.  Screening equipment at the hospital was extremely limited therefore it was difficult for patients to be treated adequately.

Thanks to the project, the hospital in the district is now equipped with all the tools necessary to carry out accurate screenings. Eye camps are now running regularly which means that patients can be diagnosed and treated within the district, without having to travel hundreds of kilometres for treatment. One of these patients was George…

One day he was listening to his radio and heard that there was a team of eye health personnel from the Isoka district carrying out eye examinations at the Kalungu health centre just 2kms away from his home. One of his brothers took him for an eye examination there and he was diagnosed with an operable cataract.  Staff reassured him that his sight could be restored with eye surgery and he was immediately booked in. However, George’s decision to undergo surgery was met with discouragement from his peers who told him that if he goes in for an operation, it would be “the end of his eyes and that he would never be able to see again”. However, despite this, George took the brave step to go to Isoka district Hospital for a cataract surgical operation. He had a successful operation, and said the restoration of his sight was ‘a miracle’. Thanks to this, George is able to move around on his own and has been able to begin farming again. He is now hoping to concentrate on the future.

By the end of the project in December 2018, we aim to carry out over 3,686 cataract operations, treat over 24, 402 other ocular morbidities, screen over 50,000 people at the community level and to dispense over 8000 spectacles. Another large focus of the project is the training of ophthalmic nurses, and community health workers.