High-flying eye care touches down in Zambia

Nine-year-old Lucy Mwika is one of about 30,000 visually impaired children in Zambia.

Like her two sisters, the youngster has cataracts in both eyes and the impairment caused to her sight means she is now falling behind at school. But Lucy is one of the lucky ones.

After a 16-hour bus journey with her mother, she is set to receive life-changing surgery with the help of a doctor from the ORBIS Flying Eye Hospital.

The charity’s converted aircraft contains an operating theatre along with recovery, sterilisation, and laser treatment rooms. A 48-seat classroom rounds out the flight service.

Since its inception in 1982, the Flying Eye Hospital has visited 78 different countries, including Bangladesh, China, Ethiopia and Vietnam, and more than 23 million treatments have been carried out on board.

“Since ORBIS came to Kitwe, they provided us with what we needed to actually set up the only paediatric eye centre in the country.“ – Dr Chileshe Mboni

According to ORBIS, Zambia has one of the highest rates of childhood blindness and is home to nearly 10 percent of Africa’s blind children.

The charity’s medics have been working in the country since 2010 and with the government have developed child eye health services at Kitwe Central Hospital, based in the country’s second-largest city.

Dr Chileshe Mboni is a paediatric ophthalmologist at the hospital and one of dozens of local physicians to receive training from the charity.

“In Zambia we have over 30,000 children with visual impairment. Since ORBIS came to Kitwe, they provided us with what we needed to actually set up the only paediatric eye centre in the country,” Mboni told Al Jazeera.

High-flying health care

According to the World Health Organization, 285 million people are blind or visually impaired across the globe. Yet it estimates with the correct eye care, 80 percent of visual impairments could be prevented or cured.

Although the causes of eye conditions are wide-ranging, the charity focuses on six ailments including cataracts such as Lucy’s. Cataracts are the most common cause of adult blindness in the developing world, and are caused when the eye’s normally transparent lens becomes cloudy.

With mild cataracts vision is dull and blurry, but in advanced cataracts, common in developing countries, vision is extremely poor. Treatment involves a simple operation to replace the diseased lens with a new artificial one and the procedure can take as little as 15 minutes.

Glaucoma, caused by increased pressure in the eye, is also targeted by ORBIS medics who treat patients either with eye drops or surgery.

In one form of the disease, the condition creeps up slowly and painlessly, gradually stealing people’s peripheral vision, until all sight disappears.

The other form is characterised by a sudden, painful rise in eye pressure and without prompt treatment, vision loss occurs.

“Medics need training, but once they receive it, they take huge pride in their work and can teach others.“ – Dr Ian Murdoch

As well as treatment, ORBIS medics have helped countries set up screening programmes so those most at risk of glaucoma or those in the early stages can be treated before vision deteriorates dramatically.

Similar screening programmes have been set up to identify people at risk of diabetic retinopathy, a condition caused in diabetics when blood vessels in the retina are damaged.

Squints, a congenital condition leading to double vision and caused when the eyes do not work in unison, are also targeted on board and a procedure to straighten the eyes carried out.

Trachoma, a highly contagious infectious disease which if left untreated causes the eyelid to turn inwards, and damaged retinas in premature babies known as retinopathy of prematurity, also forms part of ORBIS medical staff’s treatment.

Training local doctors

But it is not just direct patient treatment ORBIS provides. A key part of its work is training local doctors and nurses to better treat visual impairments when the aircraft departs.

The plane has 18 cameras so surgical procedures can be broadcast to both the plane’s classroom and to a hospital nearby.

To date, more than 262,000 eye care clinicians have received training from the ORBIS team either on board or in local hospitals.

The charity also funds fellowships and in 2010 sent Dr Mboni on a paediatric fellowship to Tanzania’s Kilimanjaro Christian Medical Centre to shadow paediatric ophthalmologist Dr Lee Woodward.

Consultant ophthalmologist Dr Ian Murdoch from  Moorfields Eye Hospital in London, England, has been training eye doctors in Ghana’s Korle Bu Teaching Hospital as part of a separate initiative for about six years.

“Better training has a huge ripple effect,” Murdoch told Al Jazeera. “Increased success rates boosts confidence among villagers. If things go wrong, patients will tell their neighbours who will be deterred from seeking medical help. But get it right and they will tell that to their neighbours, too.

“Medics need training, but once they receive it, they take huge pride in their work and can teach others.”

ORBIS staff also work with governments to promote strategies for improving eye care and have worked with more than 90 countries.

ORBIS’ DC-10 has been used for 20 years [Paul McKelvey/ORBIS]

The charity is part of a consortium that includes the UK government, human rights organisation The Carter Center, and charity Sightsavers.

Airplane upgrade

From early 2014 ORBIS’ aircraft, a DC-10 that has been used for two decades, will be replaced with a more modern MD-10 model donated by logistics company FedEx.

The former cargo plane is being refurbished in the US state of California.

The upgraded aircraft includes a digitalised cockpit compared to the existing plane’s analog system, while its larger fuel tanks, more efficient engines and more advanced landing gear should reduce expensive and time-consuming fuel stops.

The upgraded flying system means the 107 tonne plane requires only two pilots compared to three on the existing plane. The improved landing gear means the new plane will be able to touch down at more airports compared to the current aircraft, and will require less maintenance.

After the operation, Lucy has an eye test that shows her vision has dramatically improved. And medics say it won’t be long before her improved sight helps her do better at school.