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Journey
An uneventful journey made effortless by Marcia’s contacts and ‘fixers’. Luckily the in-flight food was satisfactory as Yvonne was not overly keen on purchasing the goat’s head soup or peppered snails at Lagos Airport. Rosie’s attempts at sleeping included a variety of yoga like seating positions which caused much amusement.
Accommodation
Basic but pleasant guest house accommodation. We were woken one morning by the half hour severe flogging of the next door neighbours dog who apparently had consumed its owner’s rather plump turkey – an important economic commodity. When we commented on the brutality of this beating to one of our hosts they replied ‘this country has to sort out its human rights before sorting out its animal rights’. I did wonder which was worse however – the yelping of the dog or David’s snoring.
Work
The whole basis of our role is to provide education and a support network for clinicians who are otherwise working in isolation. Our hosts were well educated but lacked some modern techniques and skills which it is hoped this link will provide.
Pathology
I was given my first introduction to the complications of ‘couching’. This is a very primitive and crude technique to treat mature cataracts. Although obsolete in the Western World since 1750, it is still common in Northern Nigeria where it is carried out by local traditional eye healers using a large thorn or unsterile ‘couching’ needle and a very ‘secret herbal solution’ known only to the couchers. The procedure is often not effective and can cause a painful blind eye. Patients present at this stage to ECWA eye hospital. If you’d like to find out more, here’s an interesting article on ‘couching’ by the way.
Having listened to the medical staff in the clinic, it was apparent that patient education will be as important as clinic throughput if blindness is to be significantly reduced in Nigeria.
Outpatient waiting area
My enduring memory will be of seeing a very sick child lying on a dilapidated hospital bed dying from the effects of retinoblastoma, an ocular cancer. The child had been abandoned by his mother who could not afford his upkeep and his father who considered him an embarrassment.
The ward had 20 beds and due to frequent electrical cuts had no fans for ventilation in the searing heat – truly horrendous. Relatives of patients admitted to the wards also cooked in the wards as the hospital is unable to provide food. Patients arrived at the hospital having travelled for almost a day and slept in the corridors until clinic resumed at 7am the next morning. One patient I spoke to had travelled 10 hours by car to get to the clinic. This was both a reflection of the lack of eye services in this country and a measure of the high regard Nigerians have for Dr Abuh and his team.
Nigeria
In some respects Nigeria’s image problem is not dissimilar to Northern Ireland’s of the past. Its dangerous reputation does not portray to the outsider the true reality of the warmth and generosity of its people. Everyone we met, from hosts to patients through to people we met on the streets, were extremely courteous and welcoming and our initial paranoia and nervousness quickly diminished.
However, there was no disguising the extreme poverty of this country. We were shown photos of the villages where the hospital staff travel to provide outreach clinics. The photos evidenced the lack of basic amenities which westerners take for granted. Poor sanitation also aids the spread of the blinding condition trachoma.
Compiled by Richard Gilmour, Optometrist
At the end of the cycle we had tea and goodies – thanks to all who helped. Thanks also are due to the staff at Halfords (Crescent link) for providing Martina with some free goodies which we gave to the cyclists at the end of the trip as a little reward for their efforts.
