Seva Canada: A Solution in Sight

Cataract, the clouding of the lens of the eye, occurs with age. Blindness due to cataract occurs with poverty.

In Canada, almost no one becomes blind from cataract. Cataract is diagnosed early when impairment is minimal, and treated surgically, almost always restoring near-normal sight.

In low-income countries, almost everyone with cataract becomes blind. Cataract is diagnosed late when impairment is severe. When possible, cataract surgery occurs, almost always restoring near normal vision.

This teenage girl from Nepal is blind from mature bilateral cataracts. Photo from Seva Canada.

The difference between cataract in high and low income countries is not the condition or its treatment. All populations develop cataract with age. All countries offer similar high quality cataract surgery. Therefore, the difference is timing.

In Canada, cataract surgical services catch people up-stream as they age, before they become blind. In low-income countries, cataract surgical services work down-stream in the deep accumulated pool of older cataract blind.

The problem in most low-income countries is that they developed their cataract surgical service after their population aged beyond 50 years, and 5-10% of them became blind. Their cataract surgical services face this accumulated mass of cases. Meanwhile, the population ages and more and more cases pour in.

In most low income countries, there are five times as many in the pool of blind people needing surgery as the number of people who become blind every year. Even with a large investment in cataract surgical services it takes a decade or more to deal with the backlog, while meeting annual incoming needs.

Seva programs are situated where the backlog is greatest and services are least. As a result, their cataract surgical services require substantial expansion, far beyond those expected by people living in a high income country such as Canada, where cataract blindness is seldom, if ever, found.

Ken Bassett MD PhD is the Program Director for Seva Canada and Director of the BC Centre for Epidemiologic and International Ophthalmology.

This young Indian woman is blind from cataracts. Photo by Dr. Martin Spencer for Seva Canada

Here is the same Indian woman after having her sight restored in one eye through cataract surgery. Photo by Dr. Martin Spencer for Seva Canada

Cataract scare opened Burnaby woman’s eyes to world

Burnaby woman, 28, realized how lucky she was to have access to good treatment

By Elaine O’Connor, The Province January 21, 2010

After a series of medical treatments, Burnaby’s Karin DuBois was shocked to be diagnosed with cataracts.

She was only in her 20s.

Thankfully, doctors assured her that the risk of losing her sight was small.

“They told me it’s such a simple surgery and that the chances of success are so high that it’s not even a concern — the chances of me going blind are very slim,” the 28-year-old recalled.

That’s far from the case for millions in the developing world.

Ninety per cent of the world’s 45 million blind live in impoverished countries; two-thirds are female.

Most of these cases are preventable. The most common cause of blindness is cataracts, which could be removed with a simple 15-minute, $50 surgery. But women and girls are only half as likely as men to get treated.

That’s one of the surprising statistics DuBois learned while creating an awareness video recently for SEVA Canada.

The Vancouver-based registered charity funds eye-care clinics and trains doctors to perform cataract surgeries in seven developing countries: Tanzania, India, Guatemala, Cambodia, Nepal and Tibet.

DuBois’ video earned her second place in SEVA’s national Her Sight Is Worth It video contest. The winners were announced Wednesday.

The B.C. Institute of Technology grad and Global B.C. assistant director said she wanted to create the video as a way of giving back.

“I’m lucky enough to live in Canada, where medical access is available. If I was in India or elsewhere, my chances of being permanently blind would be so much greater,” she said.

First-place winner Derick Groves of Victoria admitted he had little knowledge of the issue before entering the contest.

“It’s one of the things you don’t really think about,” said the 33-year-old film-school grad.

“It is a little surprising to see the percentage of women that make up the total number of blind and how little care they get.”

Third place went to Ontario-native Rhonda Kara Hanah, who temporarily lost sight in one eye after contracting an infection in Mexico.

SEVA launched the contest last fall, calling on Canadians 13 and older to submit three-minute movies about blindness in women and girls in the developing world.

The contest, sponsored by GAP Adventures and the Planterra Foundation, came with a unique reward: The group is restoring the sight of one woman and girl in the names of each of the three winners.

Penny Lyons, SEVA Canada’s executive director, said the entries served to highlight the “direct link between poverty and blindness.”

“As soon as you restore someone’s sight,” Lyons explained, “they can go to school or work, so by treating blindness in women, you are reducing poverty effectively and inexpensively, especially as it’s been very clearly documented that women are the key to sustainability in their families, communities and nations.”

The films, online at www.seva.ca/contest.htm, will be screened in 12 Canadian cities as part of the World Community Film Festival, which comes to Vancouver on Jan. 31.

eoconnor@theprovince.com
© Copyright (c) The Province

By Penny Lyons, Executive Director, Seva Canada
November 16, 2009

Madagascar, where do I even start? Stunningly beautiful, heartbreakingly poor, rich in culture, language and traditions and complex in its politics.

I travelled here from Tanzania with Dr. Paul Courtright, co-director of the Kilimanjaro Centre for Community Ophthalmology (KCCO) based in Moshi, Tanzania. KCCO has been working with Madagascar eye care programs since 2007 – at first helping create national eye care programs and now also funding training, outreach programs and a pediatric program.

Our task here is to follow up and expand on the work that KCCO has done, as well as evaluate the programs that have been funded by Seva donors. The Canadian International Development Agency (CIDA) has funded outreach in the Vakinankaratra region, as has the May and Stanley Smith Charitable Trust.

Each of these two organizations have helped fund the creation and implementation of community outreach programs in this populous region in the highlands of Madagascar centered around the city of Antsirabe, just 3 hours drive south of the capital city of Antananarivo. In addition, Alcon Canada generously donated an enormous amount of ophthalmological supplies, including intraocular lenses.

Seva programs that I have visited previously have all been well established. National blindness plans were in place, outreach was active and well organized, a comprehensive training program was in place and all programs were working toward both financial sustainability and ensuring services were available to the most vulnerable – particularly children and women.

It has been both enlightening and rewarding to witness the birth of a new program here in Madagascar and to fully comprehend the partnerships at all levels of government, healthcare and community that have to be created in order for eye care programs to succeed. In fact, given the complexities, it is a wonder it happens at all. But here in Madagascar, as in our other programs, there are individuals, hospitals and local governments that have dedicated themselves to making it happen and are committed not only to creating eye care programs but are also committed to creating excellent ones.

Today I visited an outreach program in Mendoto, a small centre about 150km west of Antsirabe. When the team from Fitsaboana Hospital in Antsirabe arrived at about 8am, there were over 300 people in the courtyard of the local hospital. We assumed they were patients waiting to be seen at ALL the hospital departments, but as we started to set up we realized they were all there to have their eyes screened and treated.

The team quickly organized the room we were given. A visual acuity chart and registration desk was set up; there were 2 examination areas for the ophthalmologists; the counselors, who provide information to those requiring more care like cataract surgery or low-vision services, had a small table; and a makeshift pharmacy was created. Patients were divided into two lines, one for children and one for adults, and each ophthalmologist took one line. Periodically someone was sent to scout the lines to make sure those who required the most complex care or who were very elderly were brought to the front of the line.

It was hot, both outside and inside the makeshift clinic. No one complained and no one took a break. Bottles of water were brought to the team, but they barely stopped to take a drink. Everyone knew how many patients were waiting and how far they might have travelled to get there. They could drink later.

In the first two hours, 4 children were diagnosed with congenital or developmental cataract in both eyes and appointments for surgery were made.  Many more children were seen but who could not be helped – children blind because of damage to their corneas – many of whose sight could have been restored if they lived in a developed country. Children with birth defects or severe low vision were referred to the counselors so their families could learn where to find help. Twenty-four adults were scheduled for cataract surgery and, once again, there were many more who simply could not be helped.

The ophthalmologists were unbelievably kind and gentle with all who came and, even after very long waits in the brutal sun, not one patient complained. The last patient was seen at 6:30 pm. All were grateful to be treated and I was grateful to be there.

Our gratitude to the Canadian International Development Agency, the May and Stanley Smith Charitable Trust and Alcon Canada for their generous support in bringing eye care to the people of Madagascar.

World Sight Day is around the corner and here at Seva Canada we have a host of local and national events aimed at raising awareness of blindness among girls and women. Our national video contest, Her Sight Is Worth It (www.hersight.ca), has been featured in Canadian Teacher magazine and the BC Teacher’s Federation newsletter.

The idea is simple: create a 3-minute video on the topic of gender and blindness. Winners will be featured in the World Community Film Festival in 8 locations across Canada starting in January 2010.  First prize is a MacBook computer, second prize is a Flip video camera and all three winners will have the sight restored to a woman and a girl in their names.

On World Sight Day itself, Seva Canada is having a party. Two hundred people will be attending Seva’s Eye Opener Benefit in Vancouver, featuring a 9-piece R&B dance band, a silent auction, door prizes and our special guest, Dr. Paul Courtright, the world expert on gender and blindness. Dr. Courtright arrives this evening in Vancouver and will be in Canada until October 11, where he’ll be meeting with government representatives in Ottawa and Vancouver and doing media interviews about his work in Africa with the Kilimanjaro Centre for Community Ophthalmology and the barriers that women and girls face in accessing eye care.

Seva Canada is using World Sight Day as a launching pad for a year-long campaign to raise awareness about the 30 million women and girls who are blind. That is a staggering number… almost the population of Canada. It’s been said before that people don’t go blind by the millions, but one personal tragedy at a time. Here’s a story we just got from the amazing team at Seva Tibet about one of those 30 million tragedies…

Chime Dolkar, blind from bilateral cataracts, has spent the last two years barely surviving by begging on the streets of Nakchu, nomadic town at an elevation of 4500 meters in northern Tibet. Since the age of 4, her little daughter Tashi has led her blind mother by the right hand through the streets, trying to get enough food to keep them both from starving. At night, they would crawl into a small and nearly worn-out tent stationed near a bridge in the upper town.

Chime and her daughter Tashi after one eye surgery Seva Tibet

There were times Tashi, now 6, begged by herself, telling her mother to rest in the tent. Several weeks ago, Tashi was begging on the street where the Civil Affairs office was located when an official, who was aware Chime’s blindness, told the little girl that a Seva medical team from Lhasa would be doing free surgeries for the blind and would be arriving in one week. He encouraged Tashi to talk her mother for treatment.

Tashi ran back to the tent with the great news. Chime reacted rather indifferently from hearing it and responded, “Surgery? Why would I want that? I am destined to become blind. It’s better for me to comply with my fate.” Poor Tashi didn’t really understand that much about destiny, fate and all that complicated hypothesis, and disagreed with her mom by saying, “Nothing is fixed. If you keep trying to change things for the better, what you call ‘fate’ will be different. Why don’t you try the surgery? It’s free. Please give it try, mom, please!”

Chime agreed, counting off the days until the Seva-funded medical team’s arrival. As each day passed, their excitement escalated. When the medical team arrived they diagnosed Chime with bilateral cataracts and on the first day of the camp Chime’s had cataract surgery on her left eye. Later, on the third day, she had surgery on her right eye.

Nothing in her 48 years of life had so transformed Chime’s life as listening to her daughter’s advice and regaining her sight through surgeries. Until then, Chime said that her life was “totally meaningless and a failure”. The sight-restoration surgery has given Chime new hope and confidence. She is anxious to re-plan both her and Tashi’s life. No longer forced to beg, Chime is planning on asking the local government for a job at the Nakchu train station. Smiling, she says, “I will be very happy if I can work at the railway station…I can work as a garbage cleaner or security guard.” She gazes at Tashi and continues, “Tashi should be going to first grade of elementary school. Wow, life is not that bad after all!”

Her sight IS worth it.

It’s eye camp season again in Tibet. Each day hundreds of blind Tibetans are being screened by Seva for eye problems and scores of people blinded by cataracts are receiving sight-restoring surgery.

Tibetan patients queuing at a Seva cataract surgical eye camp

Seva Canada has been working for over 27 years to restore sight and prevent blindness in the developing world. We’ve been working in Tibet since 1995, where we are the dominant eye-care provider, doing two-thirds of all cataract surgeries.

Worldwide 45 million people are blind, but people don’t go blind by the millions. They go blind one personal tragedy at a time. Here is one story about someone who was blind and had her sight restored by Seva thanks to the generosity of Seva’s donors.

Patients at the Seva eye camp in Chamdo, Tibet

Last autumn in Chamdo, Tibet, a little 7-year-old boy led his blind mother by the hand to a Seva surgical eye camp. Dekyi is a 48-year-old single mother with 6 children depending on her.

Dekyi told Sonam from Seva’s Tibet office, “I never had a husband, but I have two children. Dorjee is the younger one and he brought me here. The older one, my daughter, is at home herding the animals. I became an orphan when I was just 5. My only surviving family member was my older brother and he died 3 years ago.”

She groaned, but continued with a trembling voice. “I lost my sight two years ago and since then I have been depending on Dorjee and my 12-year-old daughter for living. I hope that my sight will be restored from this operation. There is a huge amount of debt mounted from my brother’s illness and death that I need to paid off and I need to free Dorjee for schooling and to raise my brother’s four children. Their mother died five years ago and left all the kids for my brother to raise. His death left no choice for the kids than to depend on me.”

Dekyi's son Dorjee at the Seva eye camp in Tibet

She continued. “I am Dekyi. You know my that name means ‘happiness’ in Tibetan, but I’ve never been happy once in my life. My life has been all about death, loneliness, debts and now blindness. Often, I think I must have been a bad person in my previous life and that my bad karma is causing all this pain.”

Dekyi before her cataract surgery in Tibet

When called to the examination room, Dekyi quickly pulled herself together, stood up with the support of her stick and called for Dorjee who was outside playing with other children. All of the sudden, Dekyi looked pale and restless. She fumbled with her hair and pressed it down at the back and said, “This is it. The only chance I have got. What if my blindness is diagnosed as untreatable?”

Dorjee led her by the hand to the examination room. With Dorjee’s help, she placed herself on a chair in front of the slit lamp. A few minutes later, she was diagnosed with bilateral cataracts and scheduled for a surgery in the afternoon on the same day. Dorjee rushed to her and held her from her behind and buried his head into her coat and cried for a long time. He shed tears for the joy of a new hope and for all the pain borne all the years by her mother and himself. Dekyi thanked and prayed for the Buddha, drawing her palms together at her chest, and then spoke with a tearful face, “I am now feeling happy and happy for the first time in my life.” She wiped her tears with her right-hand sleeve and then followed Dorjee for lunch. Dekyi was operated in that afternoon.

Dekyi getting her eyes tested after cataract surgery

The next day, Dekyi had her vision tested and it was 6/9. She and Dorjee came to thank the Seva staff and to say goodbye. She looked much more tidy on that day than she did when she arrived at the camp. Her black hair was neat, she was smiling and she walked without the aid of her stick.

Dekyi feeling happy after cataract surgery by Seva

Carefully taking off her new sunglasses, she expressed her deep appreciation to Seva and asked that a particular message be conveyed to Seva’s donors. “Please tell all the people in your organization. They are the ones who have helped me end my bad karma and bring a glimpse of light to my life!” Tears of happiness were rolling down her cheeks as she said it.

Please consider supporting Seva Canada’s sight programs by becoming a monthly donor or giving the gift of sight. Call 604-713-6622 or visit our website at www.seva.ca.

Group photo of eye patients at Seva surgical camp Chamdo, Tibet. You can just see Dekyi in her red jacket at the top right-hand corner of the photo.

Imagine if you were blind from cataracts and lived in a village deep in the Himalayan region of Tibet. The world has gone dark. You can no longer see faces of loved ones. You have no way to cook or feed yourself. There are no seeing eye dogs, beeping crosswalks, or eye surgeons to help you.

Tibetan landscape. Photo courtesy of Gary Hahn

In Tibet’s under-served mountainous region, seeing an eye doctor would have likely meant a multi-day trek to Lhasa. It would cost you many months salary pay to have cataracts removed. For too many, this means a mother, father, grandparent, or even child could not have cataracts removed and would remain blind.

Since the beginning, Seva has already tried to help the most vulnerable and has reached out to remote areas where there is no care. Now, in Tibet, people needing eye care but who have no way to travel to get it, can take Seva’s new bus on the Roof of the World!

Seva's new bus in Tibet which transports blind people to and from hospital

This bus will travel to remote mountain villages, picking up blind patients and transporting them, free of charge, to a hospital in the city of Lhasa staffed by local Seva trained eye surgeons. There they will have cataracts removed and their vision restored! And after they have had their sight checked and all their post-operative care, they will be transported back to their villages. A magic bus!

Thanks to Seva’s generous donors like you, this bus will help us better reach the underserved and restore sight.

Seva Canada Board Member, Susan Erdmann, writes:

Prior to my leaving for Nepal in March, I gave my presentation on the Tibetan surgical eye camps to a class of 11 year olds (5th graders) at Mitchell Elementary in Richmond, BC. It was wonderful how well they responded to the visuals and story around eye camps and what it is like to lose sight from cataracts. The students asked lots of questions and were very engaged. When I left, I gave them each a Seva Gift of Sight catalogue and told them that everyone can make a difference and help restore sight.

I left quite pleased that they had responded so well. But what surprised and thrilled me far more was an email from the teacher, Miss Anita Lau, on my return from Nepal, telling me that the children had some money to give to Seva and asking me to return to the school to receive it. On Friday May 22nd, I returned to Mitchell Elementary and in front of the entire school, students from the class presented me with a cheque for $361.83.

Students from Mitchell Elementary School present Susan Erdmann of Seva Canada with a cheque for $361.83

How did they do it? They told me that, having decided to raise some money for Seva and under the teacher’s guidance, they brainstormed what they wanted to do and how they would do it. With their Seva brochures, they visited each classroom and told the other students about Seva and that what they were going to do raise some money to give people their sight back. They were going to hold a bake sale. They made posters to advertise, baked the goodies themselves and held the sale. They sold out and raised enough money to help restore the sight of 7 people.

But much more happened than being able to give Seva some money for the sight programs. These children learned many life lessons about what individuals can collectively achieve – how to work as a group for a common and worthwhile cause, the payoff of working towards a goal through personal effort, the satisfaction of giving to a wonderful cause and helping others in need, and the sheer joy of giving. They were so proud of themselves – as they should be.

The teacher, Miss Lau empowered and guided these young students, allowing them to discover for themselves what might be possible. I applaud Miss Lau and her students for a job well done. These students will have this experience for the rest of their lives, growing up with an expanded view of the world and how they can effect positive change in it.

Susan presents the cheque to the Seva Canada Executive

A huge thank you from Seva!

Blog by Justine Spencer

Earlier this year, I had the privilege of accompanying my father, Dr. Martin Spencer, on his trip to Nepal and Cambodia. In Nepal we visited many cities where Seva supports eye care hospitals and centers: Kathmandu, Tansen, Baratpur, Butwal, Parosi, and Lumbini Eye Institute in Bhairahawa, to name a few.

As a 20-year-old university student, I don’t have any expertise to offer the program and I didn’t come in with much knowledge of how an NGO is run. After attending many meetings and seeing with my own eyes how the programs work, I began to understand. Along with the understanding, came a deep respect and admiration for Seva and its mission. I always knew Seva was doing good work, but its one thing to know and quite another to feel.

At every hospital we visited, my father was greeted not simply as an ophthalmologist who had worked with them 12 years previous, but as a friend. Although it was more than that — they revered him! He was offered not only hugs and handshakes, but gifts and garlands of fragrant magnolias that were placed around his neck with a beaming smile. The training he had offered the local hospital staff so many years ago have had profound effects on the program, and they were understandably appreciative.

Sometimes it’s hard to look past the big picture of Seva’s amazing projects and undertakings. But I think it’s important to remember that it all comes down to the patients. Every patient has a story. The stories are unique, but there are trends I observed among patients that are hard to miss: many arrive blind and, as a result, expressionless. Their interactions are cold. The next day they can see and it’s the closest thing I’ve witnessed to a miracle. They are suddenly glowing with warmth and overflowing with emotion: joy, gratitude, relief, and all areas in between. I can’t imagine what that would feel like, but I feel very fortunate to have been able to see this happen, to feel it.

I also feel fortunate to have been able to interview some patients and hear their stories. It is the best way I can communicate to the rest of the world how it feels to witness this miracle.

Justine Spencer with Mr. RP Kandel of Seva Nepal, interviewing a cataract patient prior to her surgery

A huge thank you to Shelagh Smith, Rob McClure and all the people in Whitehorse who made last night’s fundraiser for Seva Canada (www.seva.ca) a big success. About 80 people attended and raised $1,000 for the Kham Eye Centre in Dartsedo.

Tibet has the highest rate of blindness in the world. Cataract is the leading cause of blindness in the Kham region, as it is in other Tibetan regions. Cataracts can be removed, and sight restored, with a relatively simple and highly cost-effective operation costing about $50, yet the cataract surgical coverage in the area is just 40%; 60% of patients remain untreated. Seva is trying to change this.

A 50-bed eye hospital, the Kham Eye Center, is currently being built in Dartsedo and will open in 2009. The Kham Eye Center will be a non-profit eye care institution specializing in clinical services, research, teaching and prevention and treatment of eye disease. Seva is funding human resource development, technical and managerial mentorship, and provision of ophthalmic equipment, instruments and supplies. The Kham Eye Care Center will have a multitiered pricing system to make the eye care more affordable and accessible to all patients in the community. The ultimate goal of the Kham Eye Center is to build a high-quality, sustainable, accessible, affordable eye care system.

It’s pretty amazing to think that for the price of a condo in Vancouver (even after the slump), you can equip an entire hospital, train the staff, help set up 10 vision centers and provide medical materials and surgical supplies for 4 years. Cost: $825,000. Gifts of sight for thousands of Tibetans for generations to come: priceless!

The goals are:
- to conduct a minimum of 14,000 cataract sight restoring surgeries over the next 5 years;
- to establish 10 vision centers by 2010;
- to train 10 eye doctors and 10 county level nurses;
- to establish the Center as a standard national eye hospital, using state-of-the-art technology;
- to become the model eye care program in the Kham region;
- to become an eye care training center;
- and to develop as a community ophthalmology center.

Thanks again to all the folks in Whitehorse for your generosity and compassion.

Grateful Tibetan patients at a Seva eye camp in 2008

Yesterday we received this very moving story from Guatemala:

Fidelia Silverste Fajardo, age 84, began to lose her vision 20 years ago, making it nearly impossible for her to do her daily activities at home like cooking for her five family members and cleaning the house. Fidelia lives with her family in the town of San Jose which is a few miles from the Mercado Municipal. One of the consequences of her vision loss was a bad fall that caused her to fracture both hips. With little sight and the inability to walk, she was limited to a wheelchair. Fidelia thought that her life was over being bound to a wheelchair and unable to see. She felt useless because she could no longer contribute to her family. In Guatemala, the working poor work and contribute to their families till the day they die. Without a purpose Fidelia was starting to lose hope. Also, Fidelia’s family was beginning to struggle to care for her. Someone had to stay home from work to take care of her. This meant a loss in one person’s wages. This was a loss that the family, which was already struggling, could not afford. Then a member of her family found out about Seva’s partner, Visualiza, where Fidelia was diagnosed with cataracts resulting in light perception visual acuity in both eyes.

She had surgery on her right eye first on February 12, 2009 and she received an operation to her left eye on February 26, 2009. After the second surgery she told the doctors, “I am so happy that I can see again and little by little I am able to walk. I am able to cook and serve my family. I thank you so much and do not know how to pay you. May God bless you for helping me!”

Fidelia Silverste Fajardo, age 84, after both cataract surgeries

Carrying on the photography theme, we want to spread the word about the work of Dr. Larry Louie.

Dr. Louie is an international award-winning photographer and Edmonton optometrist who, like Marco Antonio Cruz, is using his powerful images to raise awareness of the issue of global blindness.

The 20 Dioptor Lens: A local doctor doing an examination. Copyright Larry Louie

In September 2008, Larry and his wife Joanna Wong, travelled to Tanzania to see the work being done by Seva Canada’s partner, the Kilimanjaro Centre for Community Ophthalmology headed by Drs. Paul Courtright and Susan Lewallen.

To view a slideshow of Larry’s eye care images from Tanzania, click http://www.socialdocumentary.net//LarryLouie or visit Larry’s website at http://www.larrylouie.com/

Yesterday I saw this amazing photograph in The Globe and Mail of a poor Mexican woman farmer, blind from cataracts. If this woman had access to a 15-minute cataract surgery costing about $50, she could see again. This cost is based on the 7 countries where Seva Canada works to prevent blindness and restore sight.

Andrea Islas Garcia, farmer, blind from cataracts, Beunavista 1998. Copyright Marco A. Cruz

This photograph was taken by Mexican photographer, Marco Antonio Cruz, and is one of a series he has taken of blind people.

Marco A. Cruz’s work is on the short list for the Grange Prize, a $50,000 award given by the Art Gallery of Ontario, with Aeroplan as a partner. Of the 4 finalists, the winner will be chosen through online voting on the website.

Click here to see this stunning series.

There are 45 million blind people in the world, but it doesn’t have to be this way. Eighty per cent of this blindness is either preventable or treatable. In a word of seemingly unsolvable problems, there is a quick fix and cataract surgery is it.

Looking at these images, I feel intensely grateful for my own eyesight and for my work at Seva Canada helping the blind see again.

I was pleasantly surprised to be greeted at the Kathmandu airport by Parami Dhakhwa, Seva Nepal Program Coordinator, who whisked me away to the Seva office to meet Shravan Kumar Chaudhari, Finance Manager.  Due to some logistical constraints, Shravan had arranged for me to travel south by Lumbini Eye Institute (LEI) vehicle from Kathmandu in order to meet up with Ram Prasad Kandel, Seva’s Program Manager.

Kandel has proved to be a consummate host, and I am greeted warmly wherever we go.  En route to meeting Kandel, I briefly toured Bharatpur Eye Hospital the evening I arrived in Chitwan District.  The next day proved to be rather interesting.  Due to a bandh (strike) because of student elections, the LEI vehicle could not take me to Butwal.  Instead, I took a rather crowded public bus (I was lucky to have a seat!) to Butwal.

From there, Kandel and I went to Tansen, where the Palpa Lions Lacoul Eye Hospital was conducting a three-day surgical and screening camp.  With the exception of a minimal registration fee, all services were provided free of cost to the blind and visually impaired patients who filled the rooms and lined the hallways.

I met Dr. Salma KC, the eye hospital’s resident ophthalmologist, in the operating room, where she was performing one of many cataract surgeries that she would do that day.  Dr. Salma will be going to Vancouver soon for a pediatric ophthalmology fellowship.  Her specialized skills are much needed in a country of 29 million, where there are currently only three pediatric opthalmologists.

Dr Salma, one of 3 pediatric ophthalmologists in Nepal

The following day, we took a rather bumpy and hair-raising ride northwest to Gulmi District to observe a school screening.  All students with anything less than normal vision will be fitted and provided with eyeglasses.  Refractive error is especially prevalent in Asian countries such as Nepal, and by identifying children in schools, the Primary Eye Care Centre (PECC) in Gulmi is reaching children who may not otherwise come to the center for glasses.  They are also detecting eye conditions that can be prevented or treated before the affected children go blind. At the same time, this outreach will result in increased awareness among the community about the eye care services available. The children will go home and tell their families about the eye screening at school and the whole community will benefit.

The Primary Eye Care Centre itself is very well run under the capable and inspired leadership of Chairman Bharat Bahadur Chand, who proved to be an incredibly generous host: he invited us to his home for dinner and provided me with a very comfortable room to sleep for the night.  We also managed to squeeze in a quick trip to the Hindu temple of Yagyashala at the top of Resunga Peak.

On our return ride to Bhairawa, home of Lumbini Eye Institute (LEI), I got to hear one of Seva’s radio messages advertising free cataract surgery for children at LEI.  Although I do not understand Nepali, my ears perked up with I heard mention of Seva.  We also stopped by Butwal Lions Eye Care Hospital, which is quite an impressive facility with much space to expand.

I look forward to seeing the services at LEI today and tomorrow.  I have already met Sanjeeb Adhikari, Seva’s Child Blindness Coordinator, and hope to meet Dr. Karthikeyan, one of LEI’s two resident pediatric opthalmologists, soon.

I am both inspired and humbled by the dedicated staff and partners I have met.  Seva really is carrying out its mission of serving those most in need with high quality, affordable, and accessible eye care and truly embodies compassion in action.

Amanda Marr

Susan Erdmann writes from Nepal:

With all the thoughts and anticipation, nothing prepared us for the reception at the eye camp in Gulmi.

Behind the gates to the school where they has set up the eye camp, a crowd was waiting. Being one of the first through the gates, I was presented with one flower garland after another, most of them made out of local flowers or greens. One old woman placed a garland over my head that she had carefully made from little bits of evergreen. It was one of the most touching moments I have ever had, save the gratitude expressed by the Tibetans.

The entry into the eye camp for everyone was so moving that anything that happened after after paled in comparison.  The townspeople
were so happy, deeply grateful  and excited that we would even make the long journey (if they had any perception of what that meant) for what was happening for them;  the only way for them to express it was through their handmade garlands , ‘Namastes’ and smiles.  I was crying by the end of the line to the door as was Maureen and I am sure everyone else.  It was so moving and so worth the long arduous journey to get there.

Just the greeting, the welcoming had such a impact that the rest of what happened couldn’t come close to the impact of  the entry.  We were shown where the people were screened , eyes tested for glasses and those checked for cataract. They would continue the eye camp until everyone was looked after, and it was projected to last for 3 days.

Dr. Salma was doing all the surgery and a few of the group went in to the room designated for operating to  view her at work.  As we anticipated, going to Lumbini and we didn’t have a lot of time, not everyone who wanted to see surgery got to, but those that did were overwhelmed, not only by her deft skills but the speed at which she removed the cataracts.

Outside the building where the checking and operations took place was a area where people were being checked for general eye sight with a
chart at one end and a little stool at the other. One by one, people would sit down and a woman from the eye team would stand behind and hold one hand over the person’s one eye and then the other while her colleague pointed to the eye chart. Those who passed moved on, while those who did not went to have further tests and perhaps receive eye glasses.

One young woman we came upon as I was walking to the camp said she had an eye that weeped all the time and was instructed to return the next day to have it checked and hopefully fixed.  I am sure that everyone in the village and surrounding area was there. What a thrill.  I said to Kandel…this is really remote and he replied that despite the difficult journey in, this was not nearly remote as some eye camps.  I can’t imagine.

The following video of a Seva eye camp in Pyuthan, Nepal will give you a sense of what a Seva eye camp is like.

[youtube=http://www.youtube.com/watch?v=mz0yREq0N4M&hl=en&fs=1]

Seva Foundation’s Sight Program Director is Dr. Chundak Tenzing, a Tibetan ophthalmologist from Nepal, who lives and breathes Seva’s mission of restoring sight and preventing blindness. Anyone who has ever met Chundak cannot help but be impressed by his caring nature and his deep compassion.

Chundak is also a poet. He sent the following message and poem for Seva Canada’s blog:

I am sharing with you
Voices from the field
Where the blind
Receive sight restoration
And walk unassisted
To live a life
With  dignity

When a heart opens its petals
Like a blooming flower
And hands deliver
A gift of sight

The expression of gratitude
Rolls down a cheek
Like dewdrops
Glistening in the sunshine

To wonder and say
What a journey
It is to be giving
And receiving
Happiness
In its purest form
With no strings attached

grateful Seva patients young and old