by Penny Lyons
Photo: Corrine and her father
Seva Canada, an international development organization based in Vancouver, restores sight and prevents blindness in the developing world. Since 1982, Seva donors have given the power of sight to over 3.5 million people. Seva works with local partners to create sustainable eye care programs that achieve long-term change, are culturally sensitive and reach those most in need – women, children and people living in extreme poverty and isolation. Seva Canada works in 13 of the poorest places in the world: Nepal, Tibetan areas of China, India, Malawi, Madagascar, Zambia, Rwanda, Burundi, Ethiopia, Tanzania, Guatemala, Cambodia and Egypt. www.seva.ca
Madagascar is a remote, exotic island that conjures up images of lemurs and animated Hollywood movies. In reality, the majority of Malagasy people are poor and marginalized, struggling to survive on two dollars per day.
In Madagascar, over 400 children are born with or develop blindness due to cataracts each year. Children under five years of age are at the greatest risk as most blind children are either born blind or become blind before their first birthday. Early intervention is critical to ensure good vision for life, but in Madagascar, fewer than 20% of children receive the treatment they require.
Corinne was born in rural Madagascar. Her family are banana farmers who work hard to provide for their six children so they can attend school, ultimately lead productive lives and help lift their family out of poverty. This was their dream for their daughter Corinne, who had been a bright and playful baby who loved to explore.
When things suddenly began to change, her parents didn’t know what was wrong. Corrine had become withdrawn, timid and accident prone. It turned out she was losing her sight and by the time she was five-years-old, Corinne was severely visually impaired due to cataracts in both eyes. Once happy, she was now depressed and isolated and required someone to accompany her wherever she went.
Challenges included the inaccessability of the village – it was only reachable by foot – and the lack of medical services and personnel to provide medical advice or care. Unfortunately, this is a common story in Madagascar, a country with only one pediatric ophthalmologist for its 9.5 million children under the age of 14. Her name is Dr. Hobilalaina Randrianarisoa (Dr. Hoby) and she works in the capital city, Antananarivo. As a point of comparison, BC, with 680,000 children under the age of 14, has seven pediatric ophthalmologists.
A child born in a low-income country such as Madagascar is significantly more likely than a Canadian child to be born with – or to develop – cataracts before the age of 16. Cataracts are the leading cause of childhood blindness in the world.
In almost all settings, eye care programs establish pediatric services last because adult blindness, primarily due to cataract, is relatively simple to diagnose and inexpensive to treat. Pediatric problems are far more difficult to diagnose and treatment almost always requires general anesthesia, very expensive equipment and long-term follow-up care.
Luckily for Corinne and her family, her uncle had heard about a childhood blindness program supported by Seva Canada that would be offering free eye screenings in his rural village. Corinne, now 11-years-old, and her father travelled to the village full of hope. Maybe her darkness could be lifted and her independence regained? Maybe she could even go to school?
At the screening, Corinne and her father met Rasoanaivo Delphine, one of a network of village woman who had been trained by Seva to identify children in need of eye care in remote and rural areas. She immediately recognized that Corinne had a serious visual impairment and would need to travel to Antananarivo to see Dr. Hoby. Rasoanaivo used her training to counsel and educate Corinne and her father about cataracts and their treatment.
The notion of travelling to the capital city – a two to three-day bus ride – is not only incomprehensible, but also unaffordable for most Malagasy families. The expense and time away from the farm, compounded by the cost of surgery, including anesthesia and a pediatric lens implant, was far beyond the reach of Corinne’s parents. Rasoananivo explained that, thanks to Seva donors, all transportation, surgery and follow-up care would be free-of-charge.
In Antananarivo, Dr. Hoby confirmed that Corinne had operable congenital cataracts and referred her for sight-restoring surgery at the Child Eye Health Tertiary Facility. After her cataract surgery, Corinne’s vision was vastly improved and her bright bubbly personality began to reappear. “I am so happy! Now I can study and I won’t need anyone to be with me wherever I go. I will never forget everyone who gave me my sight back,” said Corinne. Her father, relieved and full of gratitude, was excited for his daughter’s future and thanked Seva for taking such good care of Corinne.
Corinne, like all kids who have their vision restored, is given an average of 50 years of sight. She can play with friends, succeed in school and pursue her dreams.