He is wearing a black worn suit with missing buttons and loose thread hanging from the seams. Like most patients in the clinic he is wearing his best clothes. He is 93 and is clearly struggling to navigate and with some help we get him sat in position to be examined. As I peer down at the magnified view of his eyes I witness a familiar sight. His pupils are not clear and black but a cream white. No light can penetrate through them for me to see the back of his eyes. No light penetrates through them for him to see. He is blind.
I always feel a mix of sadness and excitement when I see patients like this who are blind from cataract – a curable condition. Sad that he has suffered unnecessarily but excited in the knowledge that something can be done and what’s more something will be done.
We explain his condition to him and offer him free surgery, including transport to and from the hospital.
I turn to the next patient but out of the corner of my eye see the on-going conversation with the patient and he is shaking his head. I soon get a tap on the shoulder; the cataract-blind man has decided he doesn’t want surgery. I ask the nurse to probe deeper. It turns out this man’s brother had eye surgery from which he was left permanently blind 20 years ago. The fear of seeing what had happened to his brother was enough to keep him blind.
Unfortunately I’m seeing this situation too often. Poor quality surgery not only blinds the individual but also can blind their community by preventing others from accessing care. Greater pride in surgical quality and outcome is needed, we take for granted the level of care we have in the UK and are soon to react if care is not to our high level of expectation. For this we should be grateful, here in rural Kenya, patients do not question their doctors and do not complain.
We have plans to implement the Eye Phone as a way of making sure all patients are followed up after their surgery and this information will be feed back to surgeons, donors and health ministers. The hope is pride will be taken in doing good surgery not just lots of surgery.
Madeleine: The matatu (a small mini bus with big tyres and open roof) drives through the gates of Nakuru National Park. We (Ailsa, Lucas and I) are on safari only 10 minutes from our home. It’s been on our door step but it is not till Ailsa’s arrival that we’ve made it down and through the gates. Ailsa is taking a snooze in the heat as we drive to an area more dense with trees, Lucas is busy sticking trucks and cars all over his sticker book. I am scanning, scanning in anticipation of seeing a giraffe. I almost jump out of my skin, nearly throwing Lucas to the floor and giving Ailsa quite a fright! “Stop stop giraffe, giraffe!’ And there they are, six giraffes, barely ten meters from us gracefully munching from the trees. The engine stops and we poke our heads up into this beautiful alive stillness as I take in the magnificent sight and Lucas munches as if he is a giraffe too.
Half an hour later we again poke our heads into stillness as Lucas practises his little roars and we spot the snoozing lions right by our vehicle. Thanks to Ailsa staying we have begun to experience the incredible wildlife of Kenya.
I look up, right by me is an ostrich, bald, kinda small head towering above me, I feel Lucas’ little hands gripping on to me, unsure of what is front of us. The ostrich is stood on his two legs looking directly at us, I want to smile, take his hand and welcome him into the park lodge but he has no hands to shake and I’m not quite sure what he is going to do with his mouth so Lucas and I step back and admire from a distance.
It is a wonderful time catching up with Ailsa and aside from breaking down in two different cars, two days in a row in the heat we have been able to admire the astounding birds, even whilst the car is being repaired.
A Pied Kingfisher swoops down on the lake, he comes up with a fish in his mouth, the grey neck Crowned Crane is just spectacular, the Greater Flamingos with their perfect necks are hardly real and there are many many more we would only normally dream about.
In honour of Ailsa (Irish) our dear friend who I have known for a good nine years now, we met studying medicine, I had to make her yummy recipe for Irish soda bread…it’s really tasty and very easy so a definite to try!
Ailsa’s Irish Soda Bread Recipe
450g wholemeal flour
275ml of butter milk (actually I used half milk, half yogurt with some extra milk to compensate for altitude).
1tsp baking powder
1tsp bicarbonate soda
1. Pre-heat the oven to 200ºC and line a loaf tin with vegetable oil.
2. Mix all the ingredients together into a dough and lightly knead.
3. Put the dough into the tin and press down, so flat, then with your fore finger and thumb roughly pinch the top of the dough randomly all over.
4. Place in the oven for 30mins, if it browns too much place tin foil over the top and continue cooking.
5. Cool on a wire rack.
Some pictures from our safari: