Groundbreaking research to impact childhood blindness in Africa

Some 35 000 people in KwaZulu-Natal are blind due to treatable cataracts, and 1 270 of them are children.

Dr Susan Levine's paper The Miracle Workers: Obstacles and opportunities for restoring sight to children in KwaZulu-Natal plots the challenges facing children at risk of blindness in the province and the multiple socioeconomic and cultural obstacles that need to be overcome to prevent blindness due to cataracts. The paper will be published in the next edition of the Journal of Anthropology Southern Africa.

The early detection of childhood cataracts '“ lens opacity that develops in children either from birth, or due to systemic conditions or trauma '“ is critical for preventing childhood blindness. With cataracts being the leading cause of surgically treatable blindness in children in poor settings, the timing of surgery for cataract removal is critical; vision never develops normally if surgery is delayed for an extended period.

Levine, a senior lecturer at UCT's School of African and Gender Studies, Anthropology and Linguistics, found that a lack of attention to eye care at the primary health level, the lack of information about cataracts, and a deep fear of biomedical interventions were among the reasons this treatable eye condition goes untreated.

"I tread lightly on the thorny issue of culture in medical anthropology by placing greater emphasis on the political economy of healthcare, but not so lightly that I erase the presence of the ancestors, the weight of generational hierarchy and power, and the structural forces of history that sustain uneven access to medical care," explained Levine.

"There are approximately 383 920 known blind people in South Africa, with a ratio of six ophthalmologists per million people. Although eye disease is considered a 'low-impact' affliction in this country, for the afflicted who cannot see, it is a significant gateway to the world, which remains closed."

Support net must be widened

Orbis Africa spearheaded the research, which was funded by a US$50 000 (R563 000) grant from the Paediatric Cataract Initiative, a partnership between Bausch + Lomb and the Lions Clubs International Foundation. Orbis Africa, a non-profit organisation that works in sub-Saharan Africa to reduce preventable and treatable blindness and visual impairment, is using the research findings to draft new policy for the organisation's work, as well as to produce new media for raising awareness of eye disease in KwaZulu-Natal and the rest of the continent.

According to Lene Øverland, CEO of Orbis Africa, the data generated from this research significantly enhanced the organisation's programme design. "A critical component of child eye health is access to services. The research finding pointed out very clearly that in order to eliminate avoidable blindness on the continent, eye health needs to be supported by partnerships outside of the formal healthcare system. This has resulted in Orbis Africa aiming to form a partnership with structures such as the Traditional Healers' Forums."

Levine also found that delays in cataract treatment in children can be dramatically reduced if immunisation nurses are trained to recognise the early visible signs of the condition.

Image by Michael Hammond.