In 2017, Eye Corps met Dr. Japhet Boniface, a Tanzanian ophthalmologist dedicated to addressing cataract blindness. Dr. Boniface is the chief of the Ophthalmology department at Mawenzi Hospital, the regional hospital for Kilimanjaro, Tanzania. Working side by side with Dr. Japhet we saw his dedication and commitment to his patients. We saw the challenges he faced to get proper care for his patients, and most importantly we saw his compassion and desire to make a difference in his community.
Beginning in 2018, Eye Corps began working with Dr. Japhet to help treat cataract patients in his region. Several meetings took place to hear his vision and meet all stakeholders in the region. Taking time to understand the challenges facing the community was the first step. Japhet stressed that education was the foundation of building a strong team. Access to continuing medical education is a foundation for quality care. Dr. Japhet advocated for all eye care team members to receive an education.
This aligned well with Eye Corps’ model. Education is the first foundation block. This includes the education of the team including optometrists, clinic assistants, nurses, assistant medical officers, and operating room nurses. Teaching focuses on surgical skills, sterilization techniques, ophthalmic assisting, preoperative and postoperative care, diagnosis, and treatment of eye diseases. Various teaching modalities are used including one on one skill transfer, lectures, discussions, and online teaching.
Second, ophthalmology requires instruments and medical devices to properly exam and treat patients. These instruments include microscopes, surgical tools, slit lamps, indirect ophthalmoscopes, direct ophthalmoscopes B-Scan, A-scan, and visual field machines. The price of opening an office is between 50-80,000 US dollars. It is difficult to buy the equipment without funds and it is difficult to find a bank willing to loan monies for the purchase. Eye Corps provides non-monetary loans of equipment with the understanding that 50 percent of the surgical cases must be provided to patients with low resources. In order to improve the clinic, Eye Corps also supported a modest renovation of the clinic space to improve the patient flow.
The last step is empowerment. These opportunities have turned Dr. Japhet into an even better surgeon, but what is more impressive is the leadership of Dr. Japhet. We see leadership as a critical piece of this formula to help the eye care team members work to their highest capacity. Leadership training includes formal lectures, but mostly small group discussions and one-on-one coaching. He is now helping to train other surgeons enabling them to combat cataract blindness in their own communities.
Eye Corps continues to support the eye care team with continuing education and training opportunities for his nurses and scrub techs.
Accomplishments in Moshi include:
- Surgical space renovation completed
- Equipment purchased and provided
- 2 nurses trained in ophthalmic outreach and surgical assisting
- 2 surgeons trained in cataract surgery and anterior segment surgery
- 2 surgeon currently in training
- 1 optometrist trained in biometry and A scan technology
- Lecture series in collaboration with Lahey Clinic
- Leadership development small group discussions
- Outreach training in collaboration with the Moran Eye Center
- Total surgeries: 1010
The Hai district is one of seven districts in the Kilimanjaro region of Tanzania. Currently, there is one AMO ophthalmologist in the region. While he is not currently operating, he has an active clinic practice. Eye Corps has provided him with some equipment and educational training for both the doctor and an ophthalmic nurse. Future plans include further education of the doctor and nurse, as well as more equipment donations for the office.
January 2020 was our first visit to the Lindi region in Tanzania. Dr. Mwita is an Assistant Medical Officer (AMO) and the Ophthalmology Medical Director of the Lindi hospital. He has been stationed in Lindi for 13 years performing about 50 surgeries per year. Our team composed of 12 US volunteers and 15 Tanzanian volunteers spent one week at the Lindi hospital. Following the Eye Corps plan, our first goal was education. Dr. Mwita obtained one-on-one-training including clinic management, triage, ophthalmology exam, pre-operative evaluation, surgical management of cataracts, and post-operative care of patients.
Additionally, five surgical nurses worked side by side with our nursing team. Topics reviewed included surgical technique, assisting surgery, proper cleaning and sterilization technique for delicate instruments, and maintenance of operating microscope and surgical consumables. Their education continued after the American team departed Lindi. Eye Corps sent three nurses from the Lindi team to a three-month training program at the Diocese of Central Tanganyika Mvumi Hospital Eye Department.
Additionally, Eye Corps is providing the regional hospital with equipment and renovations under the Eye Corps equipment loan program
Accomplishments in Lindi
- 400 Patients examined
- 130 cataract surgeries performed
- Comprehensive ophthalmic nurse training
- Outreach training in collaboration with the Moran Eye Center
Eye Corps’ next planned site is in the regional capital of Ruvuma, the municipality of Songea. According to the 2012 national census, the region had a population of 1,376,891, which was lower than the pre- census projection of 1,449,830. For 2002–2012, the region's 2.1 percent average annual population growth rate was the twentieth highest in the country. It was also the 28th most densely populated region with 22 people per square kilometer.
The region is named after the Ruvuma River, which forms most of its southern boundary with Portuguese-speaking Mozambique (where it is known as «Rovuma»). The region is also bordered to the north by the Morogoro Region, to the northeast by the Lindi Region, to the east by the Mtwara Region, and to the northwest by the Njombe Region. Ruvuma has many different tribes, such as the Mpoto.
Eye Corps has identified a resident, Dr. Charles Peter Hinju, who will graduate in the fall of 2021 with his ophthalmology degree. We are currently working to set up his clinic, train his nurses and staff and prepare a cataract surgical training program for Dr. Peter. Additionally, Eye Corps will complete a modest renovation at the hospital so he has an appropriate place for surgery.