It’s late afternoon in Dar es Salaam and we’re driving into the city from Julius Nyerere International Airport after 20 long hours of travel from New York. Ahead is a gridlock of trucks, cars, motorbikes, and brightly painted buses. From my seat in the back of the car, I lean against the window and look up at the sky. It’s a deep, scorched blue, the color of a swimming pool distilled to its essence—unmistakably African.
At my side is DeLois Greenwood, my right hand woman and companion on so many of these trips. For over two decades, DeLois and I have traveled to seventy-five countries all across the developing world, visiting hospitals, doctors, nurses, and patients. DeLois is here to find out how our charity, WonderWork—which funds and supports life-changing surgeries for children—can better collaborate with our partners in Dar es Salaam. My role as cofounder and CEO is to listen, observe, and learn. I’m also here to take photos and notes, so I can bring back the news, letting folks at home know about everything I’ve seen. Around my neck is my faithful Canon camera and in my pocket, my notebook.
We turn a corner and suddenly there’s a long strip of the ocean visible, light dancing off its surface in intense glitters. The sun is beginning to set now, dropping down below the horizon so rapidly it reminds us that we’re only a few hundred miles from the equator. All across the city, lights begin to blink on in buildings and drivers turn on their headlamps. By the time we finally arrive at our hotel, we’re hazy with jet lag and travel, with just enough energy left to climb the stairs and fall into bed.
The next morning, however, we’re up early and back on the road again. The city of Dar es Salaam is already buzzing with activity. People are shuttling to work, cars are honking in the traffic, and every corner feels hectic with commerce and activity. But we know that overall, Tanzania faces many challenges. Out of 180 countries in the world, it ranks eighteenth poorest. The average income here is less than two dollars a day, and according to UNICEF, malnutrition in Tanzania is a contributing factor in an estimated 130 child deaths every single day. In a country like this one, children with disabling conditions—such as the ones treated by our doctors—are facing unimaginable hardships. Often they cannot go to school; they’re ostracized by their communities, and are frequently seen as a source of shame for their families. These children are among the poorest of the poor.
Our first meeting of the day is at a hospital devoted to helping kids like these. It’s called Comprehensive Community Based Rehabilitation in Tanzania, or CCBRT, and it’s the largest provider of disability and rehabilitation treatment in Dar es Salaam. Children with all kinds of disabling conditions can come here and receive treatment free of charge or at subsidized rates. Today, we’re visiting the hospital’s very busy pediatric eye unit, where around 200 children with eye disorders are treated every single week.
As we turn in through the hospital gates, we leave the noisy chaos of the Dar es Salaam streets behind us. The hospital grounds are lush with leafy palms and green lawns. At the eye clinic entrance, a woman in a white coat is waiting for us, smiling and shading her eyes with a hand in the fierce morning sunlight. This is Dr. Sonia Vaitha, head of the pediatric eye clinic.
As Dr. Vaitha shows us around the facility, she explains that a well-equipped and well-staffed facility like CCBRT is the exception to the rule. In Tanzania, availability of healthcare of any kind is extremely limited.
“The majority of hospitals and clinics are concentrated in the major cities, like Dar es Salaam,” Dr. Vaitha tells us. “As a result, the further you travel into rural areas, the less likely you are to find a qualified doctor.”
According to the World Health Organization, in 2013 there were only eight medical doctors for every one million people in Tanzania. In other words, people living in poverty or in rural areas face often insurmountable barriers to receiving care. Either they can’t afford it, they live too far from a hospital, or both.
Dr. Vaitha knows about these realities very well. She was born and brought up in rural Tanzania, in Kigoma, on the shores of Lake Tanganyika. She tells us she first came to CCBRT as a student, for training, before returning to join the team after completing her studies.
“This job can get very hectic at times,” she explains, “but at the end of the day it is truly humbling and rewarding.”
We walk down a long, covered porch where children and their parents are waiting in line to be examined. Dr. Vaitha explains that many of these families have traveled great distances to get to the clinic. They live in rural villages in huts made out of sticks and mud, without plumbing or electricity. The parents are day laborers, farmers, ditch diggers. They make $15, $25, $30 a month at the most, barely enough to feed their families, let alone afford to pay for surgery.
Dr. Vaitha introduces us to the Lugenge family, a mother and father with two children. The son, Exaud, is four, sitting on his father’s lap. The daughter, LuLu, is three and clings to her mother. Both children were born blind and show its telltale signs—a yellowish film over the eyes. The father tells us that he is also legally blind; he can only see about two feet in front of him. We learn this family has traveled here by bus across a distance of over 125 miles. The father is a day laborer making less than a dollar a day. Together with his wife, he’d always assumed that surgery would be unaffordable and that his children would have to remain blind for the rest of their lives. Then one day the father saw an advertisement in a local paper for the CCBRT clinic. If they traveled to Dar es Salaam, they would be able to receive eye surgery free of charge.
Dr. Vaitha explains that she’s already tested the two children. They’re good candidates for surgery and she’s going to operate on both of them that morning. The surgery will take about 15 minutes per eye; then the children will have to wait until the morning to learn if the operation has been successful. If we want to come back the next day we can watch as the doctor unwraps the bandages from LuLu and Exaud’s eyes.
So that’s exactly what we do, driving back to the hospital the next day, arriving just in time to find Dr. Vaitha on the covered porch again with little Exaud and LuLu and their parents.
INSERT PHOTO: Tanzania LugengeFamilyBandages
The doctor removes the boy’s bandages first, unwrapping them slowly and carefully. But even after the last bit of bandage is removed, Exaud keeps his eyes squeezed shut, as if he’s terrified to open them. With Dr. Vaitha and his parents encouraging him, Exaud opens them, just the tiniest bit. He immediately recoils, grimacing in pain, and tightly closes his eyes again. Dr. Vaitha smiles. She explains that in fact, this is a very good reaction. It means light is flooding into his eyes. In other words, the surgery has been a success.
Exaud can see.
Little by little, Exaud opens up his eyes, wider and wider, as he becomes accustomed to daylight. He looks up to the ceiling and all around. By now he’s beaming, turning his head to every side, taking in this new world he’s discovering. He hugs his mother and hugs his father. Both parents have tears in their eyes.
INSERT PHOTO: Exaud&FatherSmile
Now it’s his sister’s turn. Dr. Vaitha begins gently unwinding the bandages, and as she does, the little girl starts to cry.
INSERT PHOTO: Tanzania -LuluBandages
She’s shaking all over and it’s clear she’s really afraid. Her parents comfort her and little by little, she manages to open her eyes just a crack. Like her brother before her, she recoils as the light hits her eyes.
We exhale with relief. Again the surgery has worked.
LuLu looks up at her mom’s face, and immediately folds herself into her mother’s arms. Her mother is crying. Then LuLu looks up and all around. She sees her father. Her brother.
I hold out my hand with one finger extended. Without hesitating, Lulu reaches out and grabs it.
INSERT PHOTO: LuLuGrabbingFinger
Then she lets go and turns to her mother again. At this moment, three-year-old LuLu starts singing, very, very softly. Dr. Vaitha explains that the little girl is singing a hymn. It’s one of the sweetest sounds I’ve ever heard.
INSERT PHOTO: Tanzania -LugengeFamilyKidPointingToSky
In the more than two decades since I started working to help families like the Lugenges receive the surgeries they desperately need and deserve, I’ve witnessed so many hundreds of these kinds of extraordinary transformations. The moments I share with patients at our partner hospitals and clinics never fail to move and astound me. After the children receive their surgery and leave the hospital, they’re cured. They can go to school, the parents can return to work, and the entire family gets a second chance at life.
When I come back from these trips, I share the stories of everything I’ve seen in mailings and newsletters. I talk about the blind children, like Exaud and LuLu, who’ve regained their sight. I show photos of children who’ve been able to walk for the first time after receiving treatment for birth defects like clubfoot. Children with severe burns who have been able to return to their villages finally healed after years of waiting for lifesaving reconstructive surgeries. The many hundreds of thousands of children whose lives our organization has helped to change.
But the reality is that these stories and people have changed me, too, in ways that, more than twenty-five years ago, when I first set out on this journey, I would have found very hard to imagine.
