Yes, it was extremely tough getting a new charity off the ground, but that first year was also a time of great personal fulfillment and creativity for my team and me. In many ways, it felt like old times. We were starting to raise money from incredibly generous donors who cared deeply about helping kids around the world, and we were tracking down doctors who inspired us with their incredible dedication. We got a major boost when Time magazine named WonderWork “One of the Ten Ideas That Can Change the World.”

There was only one thing missing, and that was being out in the field. DeLois and I agreed: we needed to leave the confines of our New York offices and learn about these new causes firsthand, meet patients, and see the surgeries with our own eyes.

We made our first WonderWork trip in May 2012. We had learned about a major medical mission being staged by a US charity on a large hospital ship in the port of Lomé, in the small West African country of Togo. Unlike a traditional mission, the ship was going to be docked there for five months, and during that time, the medical team on board was going to offer training to local doctors in addition to providing hundreds of free surgeries. There was certainly a need for both in Togo. In 2012, it was estimated that there were around 30,000 people in Togo suffering from curable blindness—many of them children—but there were only a handful of trained eye surgeons working in the country at that time. For the past six months, the local government-run radio station in Togo had been airing ads letting families know that if they brought their children to Lomé in May, the children would be screened and considered for free eye surgeries.

The following day after arriving in Lomé, DeLois and I headed toward the local port, where the screening and surgeries were taking place. 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. The team had put up a huge tent right next to the boat, where patients could be screened before boarding the vessel for their surgeries. DeLois and I saw about fifty blind children that day, each with a nervous parent or relative leading the way. Most of these families had traveled hundreds of miles in the hope of receiving surgery.

Although some of the children were suffering with incurable blindness—which tragically the doctors weren’t going to be able to treat—the vast majority had a problem that was completely treatable: cataracts. For those of us born and raised in the West, it’s hard to imagine children going blind because of cataracts. We think of them as something affecting senior citizens, and besides, they can be treated easily and effectively here. But in the developing world, cataracts are much more prevalent and they affect people of all ages. Children can get cataracts because they’re deficient in vitamin A, or they contract cerebral malaria, or measles, or rubella. Even babies can be born with cataracts due to malnutrition in the womb.

Then, once a child goes blind, the health risks to that child increase tenfold. Parents in the developing world are often so poor they have to work as hard as they can to survive, and as a result, they can’t always devote the necessary time and attention to caring for a blind child. The World Health Organization estimates that of the approximately 500,000 kids that are either born or go blind each year in the developing world, about 60 percent die within the first year of blindness due to accidents and/or neglect. It makes sense: if a blind child is left alone, then he or she may wander off and frequently end up in danger.

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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. With the help of our interpreter, we learned their story.

Juliette explained that she worked locally as a seamstress, mending and making clothing 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 evening, as she was leaving her house, she found a small girl, about four years of age, sleeping in the dirt outside her doorstep. Juliette put her hand on the child’s shoulder and 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.

“What’s your name?” Juliette asked.

“Catherine,” the child replied.

Now that the girl’s eyes were open, Juliette could see that they were glassy and covered in a yellow glaze. Catherine’s head moved from side to side, involuntarily, as if looking for light. Juliette realized she was blind.

So she took the girl’s hand and started out to find 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.

“How could you let her just wander away like that?” Juliette demanded.

The father 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 saw the blank look in the father’s eyes, a familiar sight in the town. Years of suffering and poverty had numbed him to the point that it was hard for him to feel emotion anymore. With a heavy heart, Juliette left Catherine with her father, and went home. That night, Juliette went to bed, but couldn’t sleep all night worrying about the little girl.

The next day, Juliette went back to see the father again. She asked if she could take care of Catherine for a while, to give him some time to work and build up a little income. Then maybe he could take better care of his daughter. The father agreed.

That night, Juliette made Catherine dinner, but the little girl struggled to eat, so Juliette helped feed her. In the coming days, Juliette learned that Catherine needed assistance with everything; getting dressed in the morning, finding her way around, everything was challenging. Juliette wondered how Catherine would learn to read and write, and whether she would ever be able to care for herself.

The little girl agreed to call Juliette “Tatie” (the French word for Auntie). Juliette made Catherine two new dresses right away. And she put away Catherine’s ragged gray dress, keeping it to remind her of the day they’d first met.

During the week, while Juliette was working, mending or making clothing, Catherine would sit at her feet, running her fingers along the lengths of fabric that had fallen to the ground. Juliette told us she rarely saw Catherine smile, that the little girl was always very quiet and subdued. Wherever Juliette went, Catherine clung to her, and wouldn’t let go. Many blind children in the developing world—and even in the West where we have greater resources—become inhibited in this way. When you don’t have the ability to see, you don’t have as many opportunities to interact with the world and so social and emotional development can be held back.

Juliette was growing fonder and fonder of Catherine, but she also feared for her future. Then, only a week after Juliette took Catherine into her home, something astonishing happened. Juliette heard on the radio that there were eye doctors coming to Lomé on a medical ship, offering free surgeries to blind children. She hadn’t known that there was any chance of Catherine’s blindness being cured, but she wanted to find out whether it was possible. The day before the ship was scheduled to arrive in Lomé, Juliette dressed Catherine in one of her new outfits, locked up her workshop, took the little girl’s hand, and boarded a bus bound for the capital.

When we met Juliette and Catherine, the little girl had just been approved for her surgery. The doctors would operate on her later that night.

Catherine had cataracts in both eyes. Treatment was possible. In all likelihood, she was going to be cured.

INSERT PHOTO: CatherineBefore

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That day in Togo, we also 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. Dr. Wodome worked hard, however, graduated high school, and was admitted on a scholarship to the local medical university. By 2002, he was working as a general physician in Lomé, at which point a friend introduced him to the field of ophthalmology, and he learned about the great need for ophthalmologists in Togo.

Dr. Wodome received his basic training in ophthalmology in Guinea, and then traveled through Mali, Benin, and the Ivory Coast to improve his skills. Then, in 2010, he made contact with Dr. Glenn Strauss, an American eye surgeon volunteering with a medical ship traveling around Africa treating the blind. Soon after, Dr. Wodome was admitted into a fellowship program aboard the boat. It was Dr. Strauss who had trained the young doctor in a revolutionary technique of cataract removal called manual small incision cataract surgery. MSICS, as it’s more commonly known, is a low-cost and rapid way to restore sight. Since then, Dr. Wodome had performed hundreds of eye surgeries, and when we met him, he was working alongside Dr. Strauss, performing surgeries and training other local doctors in the MSICS technique.

Until recently, cataract surgery was far too expensive for most patients in the developing world to easily afford. In the United States it can cost anywhere from $7,000 to $10,000. Then, in the early 1990s, Dr. Sandak Ruit, an incredible eye surgeon working out of his clinic in Kathmandu, Nepal, developed a much cheaper surgery to treat his patients that cost as little as $25. Today Dr. Ruit’s method is taught around the world as the best low-cost surgical treatment of cataracts available.

That day in Togo, DeLois and I scrubbed up and went into the OR to observe Dr. Wodome performing MSICS on a young boy who had been blind for half his life. After giving the child a local anesthetic, Dr. Wodome focused a small microscope on his left eyeball. Taking up his scalpel, the surgeon made a tiny incision in the eye, explaining that the hole was so small that he wouldn’t even need to use stitches for it to heal.
Then we watched as Dr. Wodome carefully extracted the cloudy lens that was preventing light from entering the boy’s eye and causing the blindness. Next he inserted a new artificial lens that cost approximately two dollars. The whole procedure took no more than fifteen minutes. Dr. Wodome told us that, with a well-trained team, he could complete some twenty-five of these surgeries a day.
The next morning, after the boy spent the night in the recovery ward, Dr. Wodome and his team would remove the bandages, and learn if the surgery had been successful.

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The following day DeLois and I 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 as one of the medical staff unwrapped the eyes of a twelve-year-old boy named Yao. At first, Yao kept his eyes tightly shut, terrified that the surgery might have failed. But the surgeon and the nurses kept encouraging Yao, and he slowly opened his eyes. Now that his eyes were fully open, Yao’s face broke into a giant smile. 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. The surgery had been successful.

INSERT PHOTO: YaoAndFather

Meanwhile, in the next bed over, a little girl named Ameline was also 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.

INSERT PHOTO: Ameline

Next it was Catherine’s turn, the little girl who had been found on the doorstep by the seamstress. Juliette sat next to her, 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, still 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 Tatie,” Catherine said.

INSERT PHOTO: JulietteCatherineAfter

Juliette had tears of emotion in her eyes. Then we all watched as little Catherine, usually so shy and fearful, stepped down from the bed and took her first tentative steps in a world she could finally see. Ameline immediately joined her, taking the little girl’s hand, then turning and hugging her too. To those of us watching, the morning light streaming through the ship’s windows seemed like a benediction.

In all my years visiting hospitals and meeting patients, I’d never seen anything quite so touching as those two little girls, once blind, now able to see, standing in the middle of the ward, embracing.

Good Reads: Before and After by Brian F. Mullaney, Co-Founder of Smile Train and WonderWork.