The first year of activities of our VISION 2020 link between the Western trust, N.Ireland and ECWA Eye Hospital, Kano, Nigeria is complete.  In June, seven people came here from Nigeria.  Five stayed for a week and two for three weeks. Specific goals had been set for their time with us.  In September, six people went from here to Kano for a week.  Again a detailed activity plan had been devised in order that our targets for the first year were reached.  Following the week in Nigeria Dr Abuh and Rosie Brennan went to Kenya to learn from the Kenyan National Retinoblastoma Strategy group there.

The main outcomes of our first year of activities are as follows:

• Three received biometry training in Altnagelvin.   This enables the correct strength of lens to be chosen to insert into the eye during cataract surgery.  As a result Dr Abuh has been noting a marked improvement in visual acuity outcomes following cataract surgery.   Two were trained in assessing young childrens visual acuity allowing better planning of treatments.
• Thomas the “orthoptic nurse” had 3 weeks training in basic orthoptic assessments to enable patients with squints to be evaluated.  In Altnagelvin surgical squint planning was discussed and squint surgery performed.  In Kano Dr Abuh had arranged for children with squints to attend and these children were assessed by Thomas and then operated on by Dr Abuh under supervision.
• Improving  Theatre safety procedures: the Kano team spent some time learning how to safely run a post-operative recovery room in Altnagelvin.  A new theatre suite has been built in Kano, which for the first time incorporates a post op recovery unit.  This new unit was equipped with monitors that had become obsolete in Altnagelvin.  Several nurses were taught how to properly monitor patients in recovery.  The anaesthetist was trained in the use of a laryngeal mask.  The nurses also spent time in Altnagelvin learning about infection control, environmental audit and the efficient use of personnel.  A modified version of the WHO surgical safety guidelines has been implemented in Kano now.  The theatre has been decluttered and a new streamlined equipment trolley has been installed.
• The second hand equipment we brought out was checked that it was fit for purpose by Graham McFarlane.  He had a very busy week in Kano repairing equipment alongside their engineer.   Some donated equipment from Birmingham including an argon laser machine was serviced and made functional.  We were able to choose patients suitable for laser and Dr Abuh was taught how to use this laser.

It was a busy week of clinics, theatres and lectures.  Dr Abuh and Rosie went briefly to the Ophthalmological Society of Nigeria’s annual meeting in Abuja where Rosie gave a presentation on ptosis management to the paediatric ophthalmologists.  They were envious of Kano’s VISION 2020 link and some are trying to establish their own. Then Dr Abuh and Rosie flew to Nairobi to attend the Kenyan National Retinoblastoma Strategy group’s third annual meeting.  Retinoblastoma is an eye cancer that affects babies and small children.  In developed countries children present early and with treatment their life expectancy is 97%.  In Africa children often present with metastasis and mortality rates are about 90%.  ECWA Eye hospital sees about 20 new cases a year and their outcome is poor.  We were eager to see what improvements the Kenyans had achieved.  Our main take home message was the need to establish a far reaching awareness campaign, educating community health workers and getting posters showing children with a white eye reflex up in the health clinics throughout the local northern states.  If children present early and have their eye is removed before the cancer spreads the mortality rates will come down.  As a result of that meeting, some changes in the clinical management of cases presenting will also be made.

We were delighted to be awarded a £30,000 grant this year from the British Council’s International Health Links Funding scheme.  We’re also grateful for all the local support we’ve been given for this project and look forwards to returning to Kano again in January for year two of our activity plan.