The moment that I saw six-year-old Criscent playing his first ever game of football on the lawns of Ruharo Eye Hospital in Mbarara, western Uganda, was the moment I fully appreciated the name of Sightsavers’ Child Eye Health programme, ‘Seeing Is Believing’.
I was seeing this small child, delightedly running around after a bright pink and red ball. Yet on the previous morning, before his surgery, I’d watched him in the waiting room, clinging on to the wall and various objects in his path, completely blind. So I was struggling to believe it.
Before surgery, Criscent was unable to see your face, so he would come up close and be very tactile when you spoke to him, perhaps to get a better sense of who you were, and of your presence.
The only sign there was of him recognising any movement was when the low vision specialist, Johnson, shone a torch into his eyes during final eye checks prior to surgery. It was quite an incredible and moving moment, to see his face light up and his delight in seeing light and movement, enough to be able to reach out in the direction of the torch.
Criscent had expressed excitement about his surgery to his grandmother, unusual for such a young child, who would more often be scared the unknown procedure. I asked him what he hoped for after his surgery. Having little concept of what it would be like to see, he responded perfectly by saying simply ‘more light’. After another moment’s thought, he added he’d like to learn to play football.
The very next day, there he was, running around on the lawn chasing the ball, kicking it in the direction of the bigger boys, who were also enjoying their vastly improved eye-sight post-surgery, and were patient and gentle with him. Once the ball game was over, I had the pleasure of joining Criscent in his first ever game of Frisbee. He was so utterly delighted that the game lasted a long time and I worked up quite a sweat – I didn’t have the heart to stop! When we eventually paused to rest, I picked Criscent up onto my hip and spoke to him through our translator.
He turned his face towards me, his newly dark pupils (where the big and bright cataracts had been) focusing on my face, and I felt the intensity of the moment – being seen by him for the first time. I was probably a blurry mass of colours, because Criscent’s eyes had not yet recovered from the surgery and his vision will never be perfect. But he was seeing and recognising me none-the-less.
Later we spoke to both Dr Ssali and Johnson, the low vision specialist, about their predictions for Criscent’s outcome. Dr Ssali explained that he had been brought in late in his development – with the critical age at which vision pathways stop developing being seven years – and so would likely only achieve 50 per cent vision. But with continued checks, and once measured for good quality, suitable spectacles, he would be able to function well as a sighted person and hopefully even read.
On the day of the bandages being removed, Criscent was already talking about starting school. The hope is that when we follow up his story in a few months’ time, we’ll find him sitting in class, bespectacled and delighting his teacher with his polite and thoughtful manner, and strikingly sharp mind.
Two months on
It’s now two and a half months since six year old Criscent, from Bundibugyo in western Uganda, had a double cataracts operation to restore his sight. In that time he has been seen by the team at Ruharo Eye Hospital twice. The first was two weeks after his operation, when he was visited at home in Bundibugyo by Nelson Chwa, who checked that his eyes were healing. And today (18 April) he is back at the Ruharo Eye Hospital, to have his refractive glasses fitted.
His progress has been remarkable. “Criscent’s eyes have healed very well”, Joseph Magyezi, Children’s cataract Project Coordinator at Ruharo Eye Hospital in Mbarara tells me. “The operation was successful and he has good vision of 60 percent in his right eye and some navigational vision about 40 percent in his left eye,” he explains.
“Before his operation he could hardly detect light. When the bandages were removed for the first time he could see images. I remember he was excited. Now his field of vision is normal. He has direct vision of 6/19. This means he can see in six metres what a normal eye can see in 19 metres.”
Now Criscent is back at the hospital to be fitted for his first pair of glasses. Nelson Chwa is the vision therapist who has been assigned to him. One of only four trained vision therapists in Uganda, he is based at Ruharo Eye Hospital and will work with the optometrist to assess the strength of the refractive lens Criscent needs for his glasses.
As soon as the glasses have been put together, Criscent heads to Nelson’s examination room to try them on. Immediately his face erupts into a smile – a sure indication that he can see clearly. He even turns and looks directly at me, and the other people watching him.
“Having vision is a process” says Joseph. “Once Criscent gets his glasses he will learn to use his eyes through what he sees through them. This will now be how he interprets the world, whereas before it was through touch and hearing.” Criscent’s eyes will now regularly be tested and as his vision improves, the strength of the lenses will hopefully change.
On the long ride home from the hospital in Mbarara back to Bundibugyo in the car, Criscent sits by the window and stares intently at the world outside as it goes by. He is very quiet with the occasional quizzical look passing over his face, making you wonder what he sees. Beside him in the car is his grandmother, who is keen to get home and show off his glasses to the rest of the family.
Today (April 22nd) is the day when Criscent will visit the local government school in Galiraya, which his brother Isingoma Gilbert attends. He is wearing his best clothes and shoes for the occasion and although he looks confident and wants to go to school, admits that he’s a bit scared.
First, Criscent meets 43-year-old Deputy Headmaster Kiokiriza Joshua who has been teaching at the school since 2004. He tells Criscent that he is welcome to the school. All the while Criscent sits patiently on his grandmother’s lap. Next stop, the classroom.
Criscent enters the classroom excitedly and spots his brother writing the letter A and making the sound as instructed. Criscent joins in. The teacher gets all the children to make the vowel noise. “Aaaaa” he repeats after the teacher smiling to himself, proud of his achievement. He joins the class in holding up his arms along with the children. He is clearly enjoying school and his attention is firmly fixed to the front, on the teacher and the blackboard.
All the while his grandmother has been sitting outside the classroom on a stone step watching him, her face a mixture of pride and joy. Did she ever think this day would come? I ask. “No.” is her response. “I hoped and prayed it would but for so long I could not get him the help he needed because we were too poor to afford the surgery, so I accepted that his life would be one of blindness.”
Then it is time for us to leave. Criscent comes and says Chai, goodbye in his language and chatters away. I’m told that he is saying he is so grateful for his glasses, which he hasn’t taken off since this morning, and for us taking him to school.
As we descend his mountain home, he waves at us as he watches us walk away into the distance.
Joseph Magyezi, Children’s cataract Project Coordinator said: “Programmes like this Sightsavers supported one have helped change this situation for children like Criscent in Uganda. Through this and other children’s cataract outreach programmes we are reaching children much earlier and able to carry out surgery, and support with rehabilitation programmes.”
The ‘Seeing is Believing’ project is a collaboration with Standard Chartered Bank and The International Agency for The Prevention of Blindness. This child eye health programme is delivered through a consortium across East Africa. Sightsavers leads all activities in Uganda.