"It’s not complicated, but completely transformative”
How one MSF project is helping thousands of people at a time regain both their sight and their independence
Since 2018, Médecins Sans Frontières / Doctors Without Borders (MSF) has been supporting a series of ‘eye camps’ in Somalia, providing treatment and surgery for debilitating eye conditions.
Ranging from cataract surgery to care for eye diseases and prescribing glasses, the camps provide a one-stop shop for essential eye healthcare.
“Eye problems, like many other health issues in Somalia, often go untreated,” says Dr Fuad, MSF medical coordinator for Somalia.
“Common conditions such as cataracts all too often lead to blindness if left untreated. Losing one’s sight – which often leads to losing one’s livelihood – can be devastating, especially in a country where many people face a daily struggle to survive due to internal conflict and chronic poverty.
“Which is why this relatively simple surgery has a huge impact on patients’ lives, improving their chances of living a dignified and healthy life.”
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The eye camps are held at local hospitals and clinics and include screening, surgery, treatment, health education and counselling. Since commencing the camps, the teams of eye specialists have reached thousands of people living with eye diseases, in many cases helping them to regain their sight.
“There is a lot of organisation and preparation for each camp,” says Dr Fuad.
“Especially as we have to manage the camps remotely and work with local partners due to security reasons.
“In the weeks before a camp, we will spread the word that an eye camp is going to occur and, in the days leading up to it, will hold a range of clinics where people are screened to ascertain if they need surgery, glasses, further examination or medical treatment.”
“You can’t see your grandchildren, and then all of a sudden you can. It’s very special.”
In Burhakaba, where MSF is currently conducting a new eye camp, Dr Said, an ophthalmologist for the local eye care service that MSF supports, explains the initial outreach work.
“Last month, we’ve been doing outreach activities in the area. We’ve been talking to community leaders, running radio ads, getting the word out on social media about the eye camps, and encouraging people to come and benefit from the free screening services on offer.
“Nobody has offered services like these here for almost 20 years.”
“Because of insecurity, we’ve had to come into the area discreetly and unnoticed.
“We’re about two hours’ drive from Baidoa and there are some difficult zones to traverse between there and here because of the security situation. We have to be very careful when we’re driving.
“When we finish the eye camp, we will pack up and be just as discreet when we leave.
“So far, we have done about 4,000 screenings at the clinic. Of those, almost 2,000 were adults screened for cataracts and other ocular diseases such as glaucoma.
“Our team includes two ophthalmologists, two optometrists and a number of opticians, and we’ve now started the surgeries. We have done about 500 so far, and we’ll work here for another two weeks. It’s going very well.”
“What we’re doing here is not complicated, even the surgery, but it’s completely transformative for the people treated”
Weeks of outreach work, screening and preparation are needed so that, by the time the surgeons arrive, everything is in place. Cataract surgery is done under local anaesthetic and is a relatively short procedure, lasting five to ten minutes.
On average, about 4,000 people are treated during each camp.
“Many of our patients have bilateral cataracts,” says Dr Said.
“Most days, many of them just sit in their houses, unable to be productive, because they can’t see.
“After we operate, they’re shocked that they simply can see again. It’s amazing for all of us to witness those moments. Every time it happens, it is very moving to see the patient’s reaction.
“Most of our cataract patients are elderly. Some have told us that for a decade or more they haven’t been able to see. You can’t see your children, you can’t see your grandchildren and then, all of a sudden, you can. It’s very special.”
1 | Screening clinic
In the weeks and days before a camp, information is spread about when and where it will occur.
At the same time, screening clinics are held to identify medical needs.
2 | Eye tests
Eye tests help confirm individual cases and encourage trust in the process.
Medical teams often struggle to reach elderly men in some areas of Somalia, but gaining their acceptance can open doors to reaching more people.
3 | Surgery
By the time the surgical team arrives, everything and everyone is ready.
Cataract surgery in particular is done under local anaesthetic and can last less than 10 minutes.
4 | Fitting glasses
Many school-age children have never had their eyes tested and thousands might need to be seen at each camp.
If glasses are then required, inexpensive plastic-framed ones – costing around £19.30 per child – can be life-changing.
The condition causes cloudy patches to form in the lens of the eye, scattering light and causing blurred vision. Without surgical intervention, patients can go blind.
However, a simple operation can replace the damaged lens with a new one, allowing light to focus correctly on the retina.
“What we’re doing here is not complicated, even the surgery,” says Dr Fuad.
“But it’s completely transformative for the people treated. Overnight, people can have their vision and their independence restored to them.
“The results are immediate and tangible. One man we operated on had been blind for five years but was suddenly able to see.”
MSF also supports providing school-age children with free eye services, many of whom have never had an eye test before.
In one eye camp run by MSF in the Hudur region of Somalia, more than 4,000 schoolchildren had their eyes tested. Every child who needed glasses was provided with prescription lenses and standard plastic frames.
“Many children have been struggling to see the lessons at school,” says Dr Fuad.
“Then they come to the eye camp, they are provided with a prescription and free glasses, and their performance, their ability to learn, their quality of life and their options for the future are all improved.
“The standard plastic frames that we provide are simple and inexpensive but, like so much else about this project, they are completely life changing.”
MSF in Somalia
Over the past five years, MSF has supported eye camps in various regional cities across Somalia, as well as in neighbouring Somaliland.
Last year, we supported two eye camps carrying out 4,022 consultations, 656 cataract surgeries, and prescribed 506 children with glasses. In 2022, MSF supported a total of five eye camps with two currently underway.
MSF medical teams in Somalia also focus on maternal, paediatric, and emergency care, nutritional support, and diagnosis and treatment of tuberculosis (TB). MSF also run mobile clinics to deliver care to people living in displacement camps and the surrounding communities. In 2021, we provided 154,814 medical consultations, treated 12,509 children with malnutrition, delivered nearly 8,805 babies, and treated 74 patients with multidrug-resistant TB.
MSF’s work in Somalia, including the MSF Eye Camps Project which aims to restore the sight of hundreds of Somalis, and Mudug Secondary Healthcare Project, which provides vital medical care for malnourished children, is generously supported by the legacy of Tony Welsh.