LOFA COUNTY CATARACT CAMP REPORT
DECEMBER 1- 9, 2006
The usual understanding of the outreach concept is that a team travels from a base clinic or tertiary hospital to offer services either at another health facility or in a community, in order to increase access to services for underserved populations.
Sometimes, teams travel from one City (usually developed) to another (usually far away) for the same purpose. The success of the Cataract Camp Outreach Program depends largely on adequate awareness and planning. Five (5) local community health workers were used to carryout mobilization of people with various eye diseases to seek medical services at the Cataract Camp set up at Kolahun Transit Center.
Now that the war is over, and with a new government securely in place, peace and stability has finally returned to Liberia. Through the efforts of the United Nations High Commission for Refugees (UNHCR), Liberian refugees are finally returning from neighboring countries of Sierra Leone and Guinea.
These families seek to re-establish their lives in villages that were devastated by the war. They are returning to broken homes and many challenges. As most people from Lofa are subsistence farmers, with rice as the staple food, the first priority for most returnees is to plant a rice farm to enable them provide food and income for their family within a few months time. Second priority is to build some type of structure to provide shelter for their family. Until their rice grows and is harvested, daily subsistence is a continuous, tedious, struggle.
Throughout the civil war years (1989-2004), many rebel training camps were located close to the Guinea and Sierra Leone borders Lofa natives are returning with a multitude of medical problems. Even before the war, it was one of the least developed counties in the nation.
Remember that in Liberia's National Eye Care Plan- 2007 - 2012, the prevalence of blindness in Liberia is estimated at 1% (WHO, 2002), giving an estimated total of 35,000 blind.
Cataract is the major cause of blindness in Liberia, contributing 50% of cases. There is an estimated backlog of 17,500 persons with age-related blinding cataracts who require surgery. Besides, there is also an estimated 105,000 persons with visual impairment that needs attention.
Moreover, for the majority of the population, with extreme limited access to medical care the only opportunities they have is the use of harmful Traditional Eye Medicine (herbal remedies). For the most part, these herbal remedies are toxic and causes more harm than good.
Regular Outreach activities and large Awareness are essential in discouraging the use of harmful traditional remedies. The Ministry of Health and Social Welfare, selected Lofa County as the site for the second Cataract Camp (the first and only one was held in 1987 by the Israeli Eye Specialist Prof. Joseph Perry Frucht) aimed at diagnosing and treating vision problems for poor. This initiative is in support of Liberia's National Eye Plan.
Christoffel Blindenmission International (CBMI), Sight Savers International (SSI), and the Greater Monrovia Lions Club, MSF France The Speaker of the Honorable House of Representatives Hon. Edwin M Snowe, and The World Lebanese Culture Union assisted the government in providing financial, personnel, equipment and material support. The Ministry of Health and Social Welfare provided financial, personnel and logistical support as well as oversight supervision for the entire camp's activities.
Aggressive outreach and awareness were held one month prior to and throughout the duration of the one week Camp. The Camp was staffed by six Liberian Ophthalmologist/Surgeons, several Ophthalmic Nurses and other Ophthalmic Medical Assistants and Community Health Workers twelve (12 Community Health Workers were trained through this effort). The Camp was held at two sites: a UN sponsored transit camp in Kolahun and Curran Lutheran Hospital Eye Unit in Zorzor.
The Curran Hospital (Zorzor) site consisted of a self contained eye hospital, complete with Out Patient Dept., operating room, and wards. The Kolahun site consisted of a large building that was minimally renovated by the UN to house incoming Liberians returning from Guinea and Sierra Leone refugee camps. A small generator was brought in to provide minimal lighting as well as means to power the ophthalmic microscopes and charge electronic equipment (lap tops, digital cameras, etc). Sparse furniture (tables, chairs) were provided by the community.
Within a six day period of time, a total of 700 patients were screened and treated (including outreach and at bases all Kolahum village and Foyah District). Of this number, 190 surgical procedures were performed; including 102 cataract surgeries, and 18 other (cosmetic, Pterygium removal, staphyloma, secondary glaucoma, Optical Iridectomy etc.). Patients treated ranged from ages 2 to 92. As the news of the Eye Camp spread by word of mouth to mouth and through local radio stations, for those who were not reached through the efforts of the outreach vehicle and the shortage of limited gas and fuel from Monrovia , people walked for many hours and days to reach the two sites.
Restoration of sight elevates one's quantity and quality of life. The person becomes able to earn a livelihood and lead an independent life. The un-sighted person has been dependent upon.
In post-war Liberia, the Lofa County Eye Camp is the pilot for many future eye camps in Liberia.
Even though the Cataract Camp was a success , there were multiple problems that hindered the outreach awareness activities and they are as follows:
The ignorance of the realities of the terrain compared to our limited number of vehicles to transport the underserved population from their villages to the Cataract Eye Camp in Kolahum;
The poor sanitation facilitates and the incomplete renovation of Kolahum Hospital to host the Cataract Camp;
The limited number of the operating beds (2 for 3 Ophthalmic Surgeons;
The insufficiency operating microscope and Cataract set, each Ophthalmologist was asked to come along with limited surgical set;
The inaccessibility of some villages as a result of poor road conditions. And limited quantity of gasoline and fuel to transport the outreach team and some patients to their villages;
There were insufficient patient gowns and mattresses for personnel and patients beddings;
The poor servicing and the regular breakdown of the only Onchocerciasis pick- up NECP had to her disposal while en route from Zorzor to Kolahun and on return from Kolahum to Zorzor.
These foregoing constraints served as great impediment and as such, the Cataract Camp Outreach Team was not able to reach its entire target groups.
This report clearly shows that there is important need to have a National Eye Care Program by the Ministry of Health and Social Welfare for working partnership with all Eye NGOs to eliminate the avoidable Blindness in Liberia.
1. Dr. Edward Guizie, National Coordinator, National Eye Care Program and Chairman, JFK Hospital Eye Department, Monrovia;
2. Dr. Momo Sonii, Director, SDA Cooper Hospital Eye Unit;
3. Dr. Joseph Kerkula, Director, Ganta United Methodist Eye Unit;
Dr. Fred Amagashie, Ophthalmologist assigned to Harper City, Maryland County;
Dr. Jemmeh Larabelee, Director, Curran Lutheran Hospital Eye Unit)
The usual understanding of the outreach concept is that a team travels from a base clinic or tertiary hospital to offer services either at another health facility or in a community, in order to increase access to services for underserved populations. Sometimes, teams travel from one country (usually developed) to another (usually far away) for the same purpose. As we were limited in gas and fuel and vehicle, motorbike or bicycle we walked for miles to go to the villages.