Italian association gives (and seeks) help for eye care center in

The center serves a fairly large population where blindness and visual impairments could be prevented with proper treatment in 80% of cases.

Young Italian surgeons work on a patient in the M’Bour eye center.

NAPLES — An Italian association of young ophthalmic surgeons (AMOA) is making an ongoing, valuable contribution to alleviate one of Africa’s main health emergencies: blindness and visual impairment. The AMOA team members are linked to a small but increasingly efficient hospital structure in M’Bour, a small town of 35,000 people 83 km from Dakar, Senegal. The M’Bour eye care center caters to the fairly large population of villages located within a 200 km radius, and for the numerous leprosariums of the area, giving medical care and social assistance to the blind and visually impaired.

“About 80% of eye conditions that lead to blindness there are curable. Their devastating effects could easily be contrasted with some preventive treatment and periodic checkups. Among them are cataract, ocular traumas, glaucoma and untreated refractive errors in children,” said Carlo Sprovieri, MD, winner of this year’s SIFI award for humanitarian medical projects at the Italian Ophthalmologic Society here. “Also, moderate visual impairments are a considerable burden for the local population, which mainly lives on craftwork and manufactured goods. A trivial problem like presbyopia can be heavily disabling for people who need to husk rice, grind manioc and sew their own clothes,” he added.

One-man initiative

The M’Bour eye care center was created in 1993 by Babacar Robert Cissé, MD, a young African medical doctor who had come to Europe to specialize.

“We met at the Medical School of Geneva (Switzerland), where he was studying with the dream of one day building a hospital for his people. Faith and determination made his dream come true: a Swiss lady, who had experienced the tragedy of blindness in her family, made a donation, so he went back to Africa. He had not yet finished his course, but couldn’t wait. He set up a small ambulatory structure, counting on just the basic equipment, his very limited experience and the help of some willing locals,” Dr. Sprovieri recalled.

Along with trying to treat the large population of villages within a 200 km radius of M’Boor, the eye care center also treats patients at a number of leprosariums in the area.

Meanwhile, his Italian friends were gathering support in all directions. They formed an association, raised funds and provided Dr. Cissé’s new hospital with some more equipment, medicines and eyeglasses. Gradually, the hospital grew: an operating theater was set up in 1994, with 6 beds for short hospitalization.

“In the first years, our friend had no surgical experience. We took it in turn to go there and help him. The first technique we taught him was extracapsular extraction for cataract, which is so widespread as a consequence of leprosy. We also sent him books and didactic videos, and organized short training courses for the local nursing staff. We taught them some basic surgical techniques for first aid, minor traumas and wounds. We also provided them with the technical equipment and basic knowledge to make spectacle lenses, while the frames began to be supplied by various European countries,” said Dr. Sprovieri. “We still go there regularly, so that our friend is never alone in his work. He is the only resident doctor, working very hard with the help of three nurses.”

Earning people’s trust

Currently about 100 people a day are seen at the M’Bour hospital, and about 1,000 operations are performed annually. The most frequent conditions in adults are hypermature cataract, glaucoma with vision loss in one or both eyes, maculopathy due to chloroquine treatment, trachoma, invasive cicatricial pterygium, keratitis and leukoma. Ocular traumas with untreated bulb perforation, mainly due to accidents at work, are also fairly common. Presbyopia, hyperopia and astigmatism prevail among uncorrected refractive errors. In children, common problems are congenital cataract and glaucoma, ocular trauma, strabismic amblyopia and uncorrected refractive errors.

Medical treatment and eyeglasses are given free to poor people, who are about 70% of patients. Those who can pay are charged a small fee. Special eye care services are addressed to lepers.

“Dr. Cissé has been working hard in all these years to make himself and his hospital known in the area. He’s now very popular here, and some of the prejudice our practices inevitably encountered has been defeated. Yet, a large number of people regard us with some suspicion and more easily seek help from sorcery and religion. Also, those who become our patients are often uncooperative when it comes to taking medications regularly and coming to us for periodic checkups,” Dr. Sprovieri said.

For these reasons, the AMOA is financing and organizing an educational campaign to increase awareness of preventable causes of blindness and provide full information on the eye care services that the M’Bour center can offer. First targets of this campaign are the headmen and other local authorities, schools and catholic missions.

“This is just one of our goals. In the near future, we want to involve schools, dispensaries and missions in a capillary prevention campaign for the early detection of visual deficiencies and eye diseases. School operators will be trained to measure eyesight, and all local health operators to recognize and treat simple pathologies. We also want to be able to offer grants for aspiring medical students, optometrists and specialized nurses, so that our presence there becomes less and less necessary. For the time being, we need all the help we can get, from volunteers who can take part to our monthly missions, from manufacturers and pharmaceutical firms and from anybody who can give whatever small financial contribution to support our cause,” Dr. Sprovieri concluded.

For Your Information:

Carlo Sprovieri, MD, can be reached at AMOA, Via Molise 5, 60015 Falconara Marittima (AN), Italy; +(39) 071 911066; e-mail: virnadoc@hotmail.com.

Babacar Robert Cissé, MD, can be reached at B.P. 321, M’Bour, Senegal; +(221) 3572017.