Eye Camp in Offinso

Hello!

It has been a week since I've written because I left Accra, and have been very busy working in another town since then!

I am currently writing from Offinso, which is a small town about 30 minutes from Kumasi, which is the second biggest city in Ghana. I came here with another Unite for Sight volunteer, Ian, and a Unite for Sight ophthalmic nurse, Dennis, and we are working in partnership with an ophthalmic team from Bawku (which is way up in the north, about 7 hours from Kumasi, very close to the Northern Border of Ghana). The 12 person team was assembled by Dr. Gyasi, who is a fun-loving and knowledgeable ophthalmologist who is the only other person I have met here who wears glasses! He used to work in Bawku with the team he invited to work with us in Offinso, but moved to Accra 3 months ago with his family because his wife found employment there.

The purpose of our trip was to provide eye care to people surrounding Offinso. The team from Bawku and Dr. Gyasi brought over all of the materials needed to perform cataract and pterygium surgeries (the only ones being performed in this eye camp), and they set up an eye camp in the local hospital, St Patrick's Hospital in Maase, in the Offinso district. We were originally supposed to be here for two weeks (the first week is now over), but at the looks of how many patients are coming in, we may need to close the eye camp early, because there are not enough cases. Since Monday, Dr Gyasi, and an ophthalmic nurse who has been trained to do cataract surgeries, Mr. Baba, have been doing about 40-50 surgeries a day, restoring sight to a total of over 200 people, generally aged 60-90, and with vision of Counting Fingers at 3 meters or worse (Counting fingers means that they cannot read any of the letters on the letter chart, which you normally do at the optometrist's office, and you can accurately tell how many fingers someone is holding up when they are at most 3 meters away from you).

I learned that actually, many people here have health insurance, perhaps about 65%. National health insurance costs are determined individually by the 230 districts in Ghana (each district elects a representative in parliament). In Accra, health insurance costs about 20 Ghana cedis, while in the Bawku, it is only 10 cedis (approximately $10 CDN), and this covers all procedures and health visits for the entire year - including your children who are under 18. Unite for Sight is important here because it is covers the cost of those who cannot afford health insurance. In total, we have sponsored 78 surgeries, here in Offinso.

Blindness in developing countries is a significant burden to families. In Canada or the US -someone who is blind could probably fair alright because the resources and manpower are there to take care of them. In Offinso, it is a relative who is usually the main caregiver for the person who is blind. I was testing the visual acuity of one elderly woman who was virtually blind - she could not even see the chair I needed her to sit on in order to take the test - and when I thanked her and told her she could now line up to see the doctor, a young woman came to her side to help her. As she turned around, I saw that she had an infant strapped to her back. She would likely spend the greater part of her day assisting her mother or grandmother to get eye surgery before she could return home, which is probably quite a ways away from the hospital).

Providing free eye surgery to people in need, however, is a tricky matter. The doctors here explained to me that providing completely free eye surgery can get patients "addicted" to getting free surgeries. That is why Unite for Sight actually charges patients fees for the medicine, which they sell at a reduced price. They believe that it is important for patients to put in a decent amount of effort to pay for their eye health or they will not cherish it. Contrary to what I had thought, too, Unite for Sight does not pay for their patients to transport themselves to the hospital. They have volunteers who take care of all the logistics (arranging for a driver and van, and paying for overnight lodging, if the patients have come from far away, so that the doctors can follow up on them the following morning), but the patients must pay to board the van. The cost of a ride depends on the village's distance from the hospital or Eye clinic where they will receive surgery. I'm sure that some of you may disagree with how they do things here, and I myself am not sure where I stand yet. But a significant and ongoing challenge here is trying to figure out how to improve access to and education about eye health, and yet not doing it in a way that will have negative repercussions among the patients we are trying to help.

Since coming to Offinso, I have an increased appreciation for the work that the doctors here in Ghana do. Although this is an eyecamp, and therefore not the regular clinic that Dr. Gyasi runs, we have been working practically non-stop since Monday (Sunday was our only rest-day). Yesterday, we were in the operating theatre until 7:30pm, having eaten nothing since that morning at around 8am. Nonetheless, there is the urgency to keep going when you have patients coming in who need help. I assisted with the surgeries yesterday, by passing instruments to Dr. Gyasi. It was incredibly confusing trying to anticipate what instruments he would need next, but by the end of the day, I had gotten the hang of it. It may seem a scary idea to some of you that I did this, but there were two ophthalmic nurses present in the room to assist me, and because of the nature of cataract surgery - it is not as time-sensitive or as prone to complications as other surgeries like cesarean sections or open-heart for example - I felt comfortable taking up that role.

Other than that, while helping to test the visual acuity of many patients, my Twi has improved - but only to the extent that I can tell you to cover your left and right eye, and to go line up to see the doctor! Another important, yet not very challenging, job that Ian and I must do as Unite for Sight volunteers is keep a record of the patients that we are sponsoring, and making sure that the right people get the right care that your generous donations were intended for.

Unfortunately, I forgot to bring the cord I need to transfer the pictures that I have taken, but I assure you that they are good! And that I will upload them as soon as I return to Accra.

On a side note, it is getting hotter and hotter here in Offinso, and only now has it begun to rain a few times since I have arrived in Ghana. As a result the electricity has been off and on (even in the operating room, usually only for a few seconds, but when it rains heavily - it can last for several minutes - actually right now, I am writing in the dark...cannot see anything around me at all!

Ahh...it has turned back on again.

Until next time, and with more photos,

Christine