Eye care in Biombo

by Audrey Fernandez. 

The busy clinic at Biombo in Guinea Bissau, West Africa, acts as a centre for primary health care work in the surrounding areas. A group of eye specialists from Christoffel-Blindenmission (CBM) visited Biombo in January this year. We were greatly encouraged by their work and were amazed by the number of people in need. Dr Adrian Hopkins and his team made us aware of how simple hygiene, nutrition and early treatment of eye conditions can prevent blindness which may be caused by Vitamin A deficiency, trachoma, glaucoma and onchocerciasis. 

This brief visit was enough to encourage us into action! We have now started doing eye care at the clinic. Dr Hopkins trained two of our workers to do the ‘entropion’ operation to correct the problem resulting from trachoma, when in-growing eye lashes scratch the cornea, leading to blindness (see page 3). Other members of our team were taught how to use the eye-charts for sight assessment and to promote good hygiene.

Albertina, who will lead this programme, was given extra teaching on diagnosis and treatment of various problems. To gain further experience, she works with a Guinean ophthalmologist for two weeks every three months.

Christoffel-Blindenmission are hoping to send a nurse out for a two year period to work alongside Albertina. This will help her to set up a Community Eye Programme, while carrying on with entropion operations and treatments in the clinic. Complicated cases will be sent to the city hospital. 

To become really effective, an eye programme needs to become a separate programme, with its own team and supplies. Treating simple infections in a general clinic is a start, but will not meet the needs of many people who need more specialised help.
Anyone starting up such a programme will need to decide what their priorities are. Do they have enough staff, medicines and equipment to start up a full eye programme - or should they concentrate on health education and treatment for simple eye infections?  

We have found it very helpful having CBM’s support in training us and providing us with equipment, drugs and advice. Their address, if anyone is interested is: Christoffel-Blindenmission Nibelungenstrasse 124 D-6140 Bensheim 4 Germany.

Case stories

A thirteen year old girl came with severe pain and redness in one eye. Trachoma had resulted in in-growing eye-lashes. She arrived before any permanent damage was done to the eye. An entropion operation was performed. She was given antibiotic eye medicine for a week, then the sutures were removed and she went home free of pain with sight in both eyes. In the past she would have been left untreated and would have eventually lost the sight in that eye after a great deal of pain.

Adjedji, a five year old girl was brought to us in an advanced stage of measles; both eyes were badly affected, she was badly malnourished and had severe pneumonia. With prayer, food, antibiotics, Vitamin A and loving care, she recovered. Once she was able to open her eyes, we discovered that one eye was permanently damaged, but she fortunately has sight in the other eye. Other children are not so fortunate. By the time they are taken to various witch doctors, their eyes are damaged beyond repair, and though we may sometimes bring them through the measles, they are totally blind.

• WHO recommend giving Vitamin A capsules to all children as soon as measles is diagnosed to reduce the risk of death and blindness.