Keffi surgery (Follow-up April 2013)

The Foundation had previously conducted a health outreach in January 2013 to provide malaria medication, mosquito nets, and other medical services to people in Keffi Local Government Area, Nasarawa State. We conducted eye screening and registered people who were in need of cataract surgery. 43 people were shortlisted and registered for the surgery. Our follow-up trip to Keffi was dedicated towards performing surgery and providing follow up medication and treatment to those identified as needing cataract surgery.

On Friday April 5th, 2013, at 10:00am, the AMA team arrived in Keffi to meet with the cataract patients. The AMA team was made up of eleven personnel including medical doctors, nurses, volunteers and other management/logistics. The AMA team had to prepare the patients for surgery by first conducting a pre-operative assessment of their health. Each patient had their urine and blood pressure tested before the commencement of the surgery in order to verify which patients were diabetic or those whose blood pressure was above normal. The patients were escorted to the hospital by their close relatives who assisted them before and after the surgery, as most of the patients were elderly and ranged between 60 to 70 years old.

Pre-Operative Assessment

The patients that arrived for the pre-operative assessment varied in age, gender and severity of visual impairment. A touching case was three-year-old Salisu Ibrahim who arrived with his father. Salisu is the youngest of his thirteen siblings and the only member of his family with cataracts in both eyes. Salisu’s father, a driver by profession, had visited a medical centre in Keffi to diagnose his son’s eye condition. He was planning on travelling to Kaduna to seek medical treatment of his son’s condition when he heard about the AMA Foundation’s health outreach. Dr Amina Hassan, the lead ophthalmologist working with AMA, through her examination of Salisu’s condition concluded that it is likely that he developed cataracts a few months after birth. Dr Amina noted that unfortunately, Salisu has been taken to a traditional healer who has worsened the condition of one of his eyes. Dr Amina diagnosed Salisu as having complicated cataracts and amblyopia. Amblyopia is a condition where the vision in an eye is poor because of lack of use of the eye in early childhood. Surgery is Salisu’s best option to be able to regain back his sight.

Hassan Mai Kasuwa right after successfully undergoing a cataract surgery.

Another patient who arrived for the pre-operative assessment was Hassan Maikasuwa, a 74 year-old man who has been suffering with cataract since 1957. He has completely lost sight in one of his eyes. He informed the AMA team that he has travelled far and wide to find suitable medication for his ailment. He has travelled to hospitals in Kano, Kaduna, Abuja and Saudi Arabia in order to receive treatment. He’s received prescription glasses a number of times in the past but they always end up being broken by his children. Hassan used to work as a farmer but the development of the disease in one of his eyes has prevented him from farming. Hassan is head of a large family consisting of four wives, twenty-four children and forty grandchildren.

Aishatu Musa, a 60 year-old woman, had been suffering from cataract for close to a year. She said she fell ill one morning and tried to perform ablution in order to do Islamic morning prayers when she discovered that she had lost vision in one of her eyes. Aishatu’s brothers and sisters have passed away, leaving her as the matriarch of her family. Her niece and daughter escorted her for the pre-operative assessment that morning.

Aishatu Musa being prepped for cataract surgery at Keffi, Nigeria.

At the end of the pre-operative assessment, out of the 43 patients that were initially registered for cataract surgery, only 32 patients turned up for the follow up treatment. The pre-operation assessment had identified three patients who had high blood pressure. These patients were given medication to lower their blood pressure and were asked to return for surgery the following day. Some of the patients failed to return for their surgeries. However, 29 patients were screened and approved surgeries.

Cataract Surgery

Cataract surgery is a simple procedure that lasts between 10 to 15 minutes depending on the patient and the facilities. The AMA medical team prepared the patients for the surgery by putting eye drops that will dilate (enlarge) the pupils in their eyes so that the ophthalmologist would be able to have a better visual of the opaque lens that will be extracted. A nurse injects the patient’s eye that has cataract with an anaesthetic that would numb the eye and then the ophthalmologist surgically removes the opaque lens and replaces it with a clear artificial lens. The AMA team were successful in completing all of the cataract surgeries between Friday evening and Saturday afternoon. All of the patients were provided beds in the hospital for them to recuperate from their surgeries.

Post-Operative Assessment

During the preparation for the cataract surgeries on Friday night, some of the elderly patients were visibly frightened by the procedure. Some showed fear when the nurse was injecting their eyes with an anaesthetic. However, by Saturday morning, the patients looked well rested and sat up in their beds, talking with their relatives and friends. Members of Keffi community flooded into the hospital to either visit a relative/friend or observe the results of the cataract surgeries. The AMA team were greeted with smiles by the patients who thanked the Foundation for its work.

The founder of AMA Foundation, Mr Musa Bello Abdullahi arrived on Saturday morning to check on the patients, observe the opening of their eyes, which were bandaged after surgery and announced that the AMA foundation shall conduct another follow up visit to Keffi to provide the patients with eye medication that would last up to six months.

Once the doctors conducted a post-operation assessment on all the patients and certified that each patient had a successful surgery without any complications, they were permitted to return home. Each patient was given eye drops that would last for two months with instructions to apply them three times a day. The doctors gave these instructions also to the relatives of the patients so as to ensure that they assist them in taking their medication.

Dr Murtala Mohammed Umar- the other ophthalmologists that conducted the cataract operations, remarked, “We just did a post-op examination. A lot of them who were not seeing at all are now so happy because there were no obvious complications. Now, the most important thing is medication. They need to be under medication for at least six weeks. That will help the recovery of the eye and the restoration of vision”.

The second Keffi heath outreach was concluded Saturday afternoon once the patients who all had successfully cataract surgeries without any complications were discharged from the hospital. The AMA Foundation will return to Keffi next month to provide a follow up examination and medication to the patients who received cataract surgery. This will enable the foundation monitor the recovery of the patients and the full restoration of their eyesight.

Salisu Ibrahim – the youngest cataract patient who will be operated on in Kaduna, Nigeria.

Three year-old Salisu Ibrahim will be taken to Kaduna where Dr Amina Hassan will conduct his cataract surgery. The Keffi hospital did not have adequate facilities for his surgery, as children require general anaesthesia before the surgical procedure. Through the surgery, Salisu will be able to regain his sight, go to school and with the support of a low visual aid, he may also be able to read.

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