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Chapter 9 Lomo Kikuyu: The Kikuyu Eye Unit – How an Eye Clinic Works

Back to Kikuyu. You know now what this is about, and you can imagine why it is so extremely important to dedicate so much attention and financial resources to combating eye diseases and blindness. The Kikuyu Eye Unit plays a key role for the whole of Kenya! That it costs money, even though considerably less than it would here in the industrialised countries, is clear. As is the fact that there is still not enough money for it in these countries, either.

So donations are needed. Get the drift? But of course you would like to know what really happens with the donations, how the money is used and how efficiently and effectively it is used.

This is probably best explained when we see the teamwork behind the eye surgery and the effects of such an operation in the Kikuyu Eye Unit in context. To make such surgery possible there are certain basic prerequisites: First of all it is important that sufferers actually know that their illnesses can be treated and cured at the Kikuyu Eye Clinic. This information can be spread by word-of-mouth, the telephone, the Outreach Programme (which we will introduce in more detail later on) or by other methods of communication if it is to reach the ears of those people with eye problems. Once patients know that help is actually available, they have to decide how to reach the Kikuyu Eye Unit. This is situated, as you already know from your close reading of this text, near Nairobi, which could be a long way away from a patient’s home. If a patient cannot see at all anymore they will be dependent on an escort to accompany them on their way to Kikuyu. This trip can, as mentioned, involve quite a long distance as Kenya is a fairly large country. Reliable transportation is very seldom, which is why many patients come all the way to the clinic on foot. This might seem an almost incredibly arduous undertaking for us inhabitants of post-industrialised cities, but for the Kenyans it is not such a big deal. From an early age on they have been used to covering long distances using their own two feet.

Our ‘model patient’, let’s call him Abdi, finds himself in front of the gates of the Kikuyu Eye Unit after a march of two hours, 2 days or 2 weeks. His details are recorded and he is asked to wait patiently for the initial diagnosis and to take a seat. This could take a long time. There are not just a small number of patients waiting to receive treatment at the clinic. Take a look at the statistics at Lomography.com and check out the exact figures. Tens of thousands of people are examined on location in the eye clinic every year, so it’s not difficult to calculate how many patients visit the Kikuyu per day. A considerable number, huh!

Later Abdi finds himself in an examination room at the eye clinic and is seen by a doctor, who makes a diagnosis. Trained ophthalmologists aren’t the ones necessarily doing the standard examinations because they are working practically night and day, performing surgery. It is the job of the eye nurses and assistants to carry out these routine check-ups. Many of these assistants are trained here every year – but more about that later.

Abdi is already somewhat older and blind in both eyes. He’ll probably be diagnosed as having a cataract. That’s the way it goes. You have already read about it, so you know that surgery is called for. The two cloudy lenses Abdi was born with have to be replaced by artificial lenses made of plastic. However this does not happen all that quickly as the demand is so great and there are so many other patients also waiting for surgery. This means that Abdi will most likely spend the night in one of the 75 beds at the eye clinic and will only be operated on the next day.

The operation is scheduled for the next morning. Today there have been even more surgical operations carried out than usual, mainly cataracts corrected, and people infected with Trachoma have had surgery on their eyelids. Cataract surgery doesn’t usually take any longer than 15 to 20 minutes on average. Abdi will also see the light of the world again in less than half an hour – like so many thousands before him. This sounds pathos-laden, but this is exactly the way it is!

The most astounding thing about the surgery is that the success is immediately visible – in every sense of the word. Abdi can see the colours and shapes of the outside world again, for the first time in ages, while still on the operating table – he can see the lenses of the microscope and the strained face of the surgeon. A sensation, that often leads to emotional outbreaks by the people being operated on, crying, screaming, a state of shock. These are not only profoundly moving experiences for the patients but also for the doctors – touching, positive, genuinely moving moments!

Basically, in Africa this surgery is not very unlike similar small operations performed in modern developed countries, except that the biometry is usually left out to spare on expense. ‘Biometry’ is what the preliminary examination is called where the required strength of the so-called intraocular artificial lens is determined.This is then inserted into the patient’s eye in place of their own clouded
lens. This preliminary examination is compulsory here. In the poor regions of the world the same standard lens is always used, one with between 21 and 22 dioptres. This is the normal strength of eyesight. Eyesight with one of these standard lenses might not satisfy Western demands but it suffices in Africa entirely. Somebody’s vision can also always be improved afterwards with glasses.

Another literally minute difference between cataract surgery in the poor regions of Africa compared to the same surgery in the industrialised parts of the world is that in Africa a millimetre small insertion is made for the folding lens, whereas here they just make a tiny hole using a laser. This little difference means that the operated eye in Kenya is red for a few weeks after the surgery because, logically, the scar needs more time to heal. It stands to reason that Abdi has to wear a bandage for quite some time yet. It also stands to reason that he has to smear his eyes with ointment. But he can see again – so this is a comparatively small price to pay. Speaking of price, what does the whole thing cost him? Of course medical treatment can’t just be for free. The surgery isn’t prohibitively expensive by Kenyan standards, and those who have the money do pay. But sometimes the patients simply do not have the means to pay because the minimal profit from their smallholdings has already been spent on the most important of basic staples within a few days. They try to pay with what they have, with wheat, goats or chickens. But some people do not even have that much.

Should the helpers in the eye clinic send the people away who have nothing, not even anything to trade? Nobody who has experienced how relatively easily people can be helped could bring themselves to deny anybody treatment. The aim of the Kikuyu Eye Unit is to help all blinded and visually handicapped people, even if they have no money, no land, no livestock, simply nothing. The opportunity to live a much more fruitful life should not be denied somebody because of money.

This is where the donations come in. These are made by people that can afford to give up a part of their income, by us, by you. You can contribute to showing and giving these people in Africa the world of sight. Not only do you finance one, two, ten or many more surgical operations with your money (depending on how much you can spare), part of the money also helps to secure the future of the Kikuyu Eye Unit. For in order to increase the capacity and to maintain medical standards new equipment, lasers, microscopes and other wonders of technology have to be purchased. And these flawless instruments are not only used in the clinic in Kikuyu, some of them are also transported over long distances. In the next chapter you will find out why many trained teams with loads of equipment travel hundreds of kilometres in Africa, how the whole thing works and why it is an important aspect of the work done by the Kikuyu Eye Unit.

Lomo Kikuyu It’s good to see (again). Every Lomographer along with their friends and acquaintances worldwide is being appealed to donate 30 Euros/30 American dollars to save a person’s eyesight. Get the chance to do this by getting your own Lomo Kikuyu Book now.

written by ungrumpy

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This is the original article written in: English. It is also available in: 日本語 & Deutsch.