Most people have never heard of Togo.
It’s a tiny country West Africa on Ivory Coast with a population of just 8 million people that finally won its independence in 1960.
The main language in Togo is French, the main religion is Voodoo and 82% of the rural population lives under the global poverty line making Togo one of the world’s poorest countries.
It is almost entirely dependent on humanitarian foreign aid.
One out of every eight children in Togo do not live to see their fifth birthday. And many face disease, malnutrition, violence and exploitation at the hands of corrupt labor forces and human trafficking. Many children do not go to school as their parents cannot afford it.
We went to Togo as part of a medical mission staged by a US charity on a large hospital ship in the port of Lomé. While docked in Lome for five months, the ship would offer free training for dozens of local doctors while providing hundreds of free, life-changing surgeries.
There were around 30,000 children and adults in Togo who were blind from cataracts and could have their eyesight restored through a simple surgery that takes a little as 5 minutes. But there were just a handful of eye surgeons working in Togo and they did very few surgeries. This ship was a Godsend.
For six months, the local government-run radio station in Togo had been airing ads letting families know about the hospital ship and opportunity for children with cataracts to receive free surgery that would restore their eyesight.
Parents were invited to bring their children to the Lomé Port in May so their children could be screened and considered for free cataract surgery.
We arrived just as the screening process began. Hundreds of blind children with their parents and siblings had shown up from all over Togo. Some of them had traveled hundreds of miles. They know this might be their best, last and only chance to get their child the surgery that would restore their eyesight.
The team had put up a huge tent right on the dock next to the boat, where patients could be screened. We met a family with five children who were all blind.
For those of us from America, it’s hard to imagine children being born with or going blind from cataracts. In the U.S., only senior citizens get cataracts. But in the developing world, cataracts are ten times more prevalent and they affect people of all ages.
Children can get cataracts because of vitamin A deficiency, cerebral malaria, measles, rubella or malnutrition in the womb.
Once a child goes blind, the health risks to that child increase tenfold. The World Health Organization estimates that approximately 500,000 kids that are either born or go blind each year in the developing world.
And that 60 percent of children die within a year after going blind due to accidents and/or neglect.
Waiting in line to be treated that day was five-year-old Catherine, a little girl who was completely blind. We learned that she was one of these children who had wandered away and gotten lost but that she was also one of the lucky ones. She had come to the ship with her adoptive mother, Juliette.
Juliette was a seamstress, in the small coastal town of Agbodrafo, about 30 minutes’ drive from the capital. Her own children had grown up and moved away, and she lived alone.
Early one morning, as she was leaving her house, she found a small girl, about four years of age, sleeping in the dirt outside her doorstep. Juliette asked if she was okay. The little girl responded that she had lost her way and couldn’t find her home. She was wearing a gray dress, ragged with wear and grime. Now that the girl’s eyes were open, Juliette could see she was blind.
She took the girl’s hand and started looking for the girl’s family. She went from hut to hut and market stall to market stall until she found someone who recognized the child. The woman pointed in the direction of Catherine’s home, a small lean-to made of corrugated tin and cinderblocks. Here, Juliette met Catherine’s father. He explained that Catherine’s mother had left them and moved away, and that he worked long hours as a taxi driver, his only source of income.
“I don’t have anyone to watch her while I’m working,” he said, shaking his head. “I don’t know what else to do.”
Juliette left Catherine with her father, and went home. But she couldn’t sleep at all that night worrying about the little girl. The next day, Juliette went back to see the father and asked if she could take care of Catherine for a while, to give him some time to work and build up a little income. The father agreed. Juliette took Catherine home and never heard from the father ever again.
Juliette was growing fonder and fonder of Catherine, but she feared for her future. It was only a week after Juliette took Catherine home, that Juliette heard on the radio about eye doctors coming to Lomé on a medical ship, offering free surgeries to blind children.
She didn’t know if there was any chance of Catherine’s blindness being cured, but she wanted to find out. The day before the ship was scheduled to arrive, Juliette dressed Catherine in a new outfit, locked up her workshop, took the little girl’s hand, and they boarded a bus bound for the capital.
When we met Juliette and Catherine, the little girl had just been approved for her surgery. Catherine had cataracts in both eyes, and they were hopeful she would get her eyesight back.
Later that day we met Dr. Abram Wodome, one of the local ophthalmologists working on the ship.
Dr. Wodome was born in Lomé, the youngest of sixteen brothers and sisters. From childhood, his ambition was to become a doctor—but as the youngest of sixteen, he knew it wasn’t going to be easy for his parents to find the money to pay for his studies.
But he worked hard and won a scholarship to the local medical university. By 2002, he was working as a general physician in Lomé, when a friend introduced him to ophthalmology, and he learned about the great need for ophthalmologists in Togo.
Dr. Wodome received basic training in ophthalmology in Guinea, and traveled through Mali, Benin, and the Ivory Coast to improve his skills. But it was here in Lome, on board this ship, where Dr. Wodome learned the revolutionary technique called manual small incision cataract surgery.
MSICS, as it’s known, is a super low-cost and instant way to restore sight.
Since then, Dr. Wodome had performed hundreds of cataract surgeries and was training other local doctors in the MSICS technique.
In the United States, cataract surgery can cost $7,000 to $10,000. That was much too expensive for developing countries where 20 million cataract blind are waiting for surgery.
But in the early 1990s, Dr. Sandak Ruit, an outstanding eye surgeon from Kathmandu, Nepal, invented MSICS, a much cheaper, safer, faster surgery to treat his cataract patients that took as little as 5 minutes and cost as little as $25.
Since then, millions of poor children and adults have undergone MSICS in developing countries and today, this is taught around the world as the best low-cost surgical treatment of cataracts.
We scrubbed and went into the OR to watch Dr. Wodome perform MSICS on a young boy who’d been blind for half his life. The ship was impressive, with eight state-of-the-art operating rooms and more than 100 surgeons, nurses, and other medical professionals on board, all of them volunteers.
After administering a local anesthetic, Dr. Wodome made a tiny incision in the left eye, the hole was so small it wouldn’t require stitches. Then he extracted the cloudy lens which was preventing light from entering the eye and causing the blindness. He inserted a new artificial lens that cost approximately two dollars. The whole procedure took fifteen minutes.
Dr. Wodome said that he could do 25 of these life-changing surgeries a day.
The following day we got up early so we could be at the hospital in time to see the children wake up and have their bandages removed.
First, we watched a nurse unwrap the eyes of a twelve-year-old boy named Yao – the boy whose surgery we watched. At first, Yao kept his eyes tightly shut, terrified the surgery had failed. But with a little coaxing, Yao slowly opened his eyes and his face broke into a giant smile. His vision was perfect!
He looked straight at his dad and hugged him, tears streaming down his face. His dad was crying too, both of them overwhelmed with joy, repeatedly thanking the surgeon and the nurses.
In the next bed over, Ameline was having her bandages removed.
Even before the bandages came off Ameline couldn’t stop smiling and once they were finally taken away, the room practically lit up with her smiles and laughter. Ameline hugged her mom, she hugged the surgeons—she hugged anyone who came within five feet of her.
Next it was Catherine’s turn. Juliette sat next to her, nervously holding her hand. The doctor unwrapped the bandages, and Catherine opened her eyes cautiously. Juliette said her name, at which point Catherine turned her head, frowning and confused. Then, we saw a look of complete recognition flash across her face. For the very first time, Catherine had seen the woman who had saved her.
Catherine put her hands up to Juliette’s face, touching her cheeks, her chin, her eyebrows—as if she needed confirmation that this new world was actually real. “Thank you…” Catherine whispered in her ear.
Juliette started crying. And so, did we.
Then we all watched as Catherine, usually shy and fearful, got off the bed and took her first steps in a world she could finally see.
Ameline immediately joined her, taking the little girl’s hand, then turning and hugging her too.
In all my years visiting hospitals and meeting patients, I’d never seen anything quite so touching as those two little blind girls, seeing the world for the first time, together.
