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This morning I had the pleasure of meeting a 61-year-old man named Michael. Michael has been blind in both eyes to the level of being only able to tell light from dark. He first drew my attention because of a bad smell radiating from his direction. My nurses told me that he has been suffering from urinary incontinence (unable to hold his urine), and when I talked to the patient about it, he told me this story....
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Eleven years ago, he had an accident that left him incontinent and made it difficult for him to walk - his legs are emaciated and weak, but can briefly support some of his weight. Michael comes from a village in the far north of Gabon, in a corner of the country that is near Equatorial Guinea and Cameroon. Because of his physical isolation, he had no way to get to medical care. He said that most Africans are fatalists and don't believe anything can be done about their problems - but he believes in God, believes Jesus died for his sins, and held on to the hope that he would be healed someday.
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Two years ago, Michael had finally collected the money to travel the two days to come to the eye clinic at Bongolo for the first time. Unfortunately, he came in late 2008 when there was no eye surgeon here. That day, he could have at least begun a medical evaluation to see if something could help his incontinence or help him to walk, but he told me matter-of-factly, "I thought that it would be pointless to treat the urine problem before getting my eyes fixed, so I left and planned to come back later. First things first. First the eyes, then the urine problem, then I'll work on walking."
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Michael has now been bilaterally blind for six years. Again he made the long two-day journey to come to Bongolo, his son helping him during the trip. We did cataract surgery on his right eye this morning, and tomorrow we will take the patch off and see how well he sees. The picture above was taken just before surgery. Before taking the picture, I told him to smile and think about Jesus and about hopefully being able to see tomorrow.
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Update on Michael the day after surgery:
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After removing the eye patch, Michael opened his eyes and saw again for the first time in 6 years! He was delighted to be able to see the exam chair he was trying to get to, and had a big smile on his face with much thanksgiving.
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He saw down to the level of the third line on the eye chart (about 20/100) the day after surgery. He will see even better after we do a laser procedure for him in a month to remove some scar tissue left behind by the very mature cataract he had.
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Because the cataract was so advanced, some of the support structures for the lens had naturally begun to disintegrate and so a small amount of gel from the back of the eye also came forward into the front part of the eye. Often this does not impede clear vision and can be left in place, but sometimes it needs to be removed - we'll watch him to see how this goes over the next few days and weeks.
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Meanwhile, we will look at our packed schedule and see if there is any way we can remove the cataract from his other eye before he has to head home in a month! When patients here come from as far away as he does, often they cannot come back for a followup appointment in a month because of the travel expense, so instead they have to stay at the hospital or nearby as they wait for their one-month appointment.
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