Dr Chris Galadima, who is the first Cornea and Anterior Segment Specialists in the North that has successfully performed a corneal transplant in Nigeria, reveals the country has no less than eight million blind people out of the 36 million in the world. The eye care specialist, who runs the Lissi Eye Centre and is also a consultant ophthalmologist at the National Eye Centre, all located in Kaduna city, speaks on eye health care issues and the passion behind a Non-Governmental Organisation (NGO) known as Amana Community Eye Health Foundation he founded to provide free eye care services to Nigerians living at the bottom of the ladder. These are some of the issues, among others, he spoke on in an exclusive chat with SIMON REEF MUSA. Excerpts
How did you come about with the idea of starting an NGO for providing eye care to the less privilege?
Around 2013 I moved to that upstairs building located in Barnawa in Kaduna-South Local Government Area. I had two boys supporting me that I ended employing as optometrists. Then, the thing was still growing, and I was looking forward at how I could get more space. Eventually I had to travel to India, and because it is still a small business, heavily dependent on me, throughout my one year duration in India, I had to close down the business.
While in India I got in touch with this man in the USA who told me he was following what I was doing back in Nigeria and requested me to think of what I could do at a higher level when I eventually return home. I told him I was planning to scale up my business at the time. The man happens to be a veteran with the US Marines and had up to 40 years of experience in the ophthalmic world. He has retired, but still runs his private business. He also runs an NGO.
Our interactions showed me that I cannot give back to my community based on the way I was operating as in strictly for business purposes. Corporate Social Responsibility is not a trending style within our business climate in Nigeria, so I thought running your own business alongside a non-profit arm of it could make a lot of sense. So, the idea of setting up an NGO sprung up. Halfway through my studies in India, I came back for a break in Nigeria, and went to my boss who trained me to give him a piece of my mind based on what I saw in India. I requested him to be the chairman of my NGO, and he agreed.
We also set about getting other members of the Board of Trustees. I talked to my mentor in the US and he agreed to be on the board. I got Stella Yahaya who was in the USA, as well as another friend of mine on board. We did the paperwork and the NGO was inaugurated and named, Amana Community Eye Health Foundation. So, that is the summary of the whole thing about the foundation. It is still in the inception stage. Some of us have not even met face-to-face. I created a social media group where we interact. The trustees are shouldered with policy direction for eye care foundation.
We are looking at engaging the community. We have seen eye care to be something that is in high demand from a lot of causes.
What is your assessment of eye care in Nigeria?
I think we have been making a steady progress. I began ophthalmology in 2000, and I know we have made a lot of progress, in terms of making the service available and affordable. Even the quality of services has really improved. The output of work has gradually increased over the years. I would not say it is yet uhuru, but I think we are making steady progress in terms of the number of surgeries we perform and other yardsticks. This NGO arm of the eye care services is also an effort to widen our reach.
What other thing, apart from surgeries, are you doing to create awareness?
Certainly, when someone has a challenge, like a blind person, one of the challenges is even knowing where to go, apart from the issue of the distance to the place and other logistics involved. If we sit in our big hospitals as big doctors, and only get to see the elite and educated, and that is the reality, the majority of the cases in the rural areas will not have access to what we have to offer. So publicity is key, and it is to step out to meet them, at least somewhere, if not in their homes.
What is Cornea transplant?
I am a cornea specialist and I trained in India on this. The cornea is the front transparent part of the eye that is glassy but made of human tissue. It is like the windshield through which light strikes first into the eyes. It can become diseased in a lot of ways and by so many factors- bacteria, fungi, virus, natural causes, and the rest. When it is damaged, it does not allow light into the eye, and the next option is to replace it with a clearer cornea. In developed countries, there are tissue banks and eye banks. Before people pass on, there are some who normally sign away their body parts for use in research and for the betterment of mankind. When they die, staff members of the hospital are invited to access the body parts for storage in the banks available. Therefore, cornea transplant is essentially the replacement of a diseased cornea with a healthier and more functional cornea.
Is cornea transplant routinely being done in Nigeria?
It is not routinely done in Nigeria because of the challenge of functional eye bank in Nigeria. There was one formed in the 1970s in Lagos, and throughout that time till now, only one person agreed to donate his eye. The major reason is lack of awareness. Some people think the problem is religious, but it is not, except for the Jehovah Witness religious group. The cornea is one of the easiest to transplant because it is readily accepted, compared to that of the kidney. The blood reaching it is minimal, compared to that of the kidney. So, it is not routinely done because of the dearth of tissues. We have trained manpower, so it is not a question of manpower. There are times when tissue is imported, and you know naturally it would cost a lot. It would have been nice to develop our own eye banks and get donors to solve the issue.
Does it mean that there are no other synthetic measures in the face of scarcity of donors?
This is a very interesting question. Yes, there is a lot of progress made in a bid to getting synthetic cornea for this purpose. There is bio-engineered cornea, very similar to the natural cornea. The technique in transplanting this is slightly different, in that the back parts of the eye cornea are left out during the process. It has been tested in some universities in Canada and Sweden with very interesting results. But you know that getting new inventions in the medical field for use in human beings is usually a challenge, you know, getting approval from the graft agencies and all of that processes could take a very long time before final approval.
What is the population of blind people globally?
Blindness is a serious issue, and from statistics, there are over 38 million blind people in the world. This is excluding visually impaired people in the world, which is at least three times that figure. Half of those blindness cases are caused by cataracts, which makes our priority intervention project. We get the patients and get the cost of intervention affordable. In India, the policy is that no one should be turned down from accessing treatment for lack of money, and it has worked for them. They have a section that treats people for free, and free means free in the real sense of it. There is also a section where you can pay normal rates to access high quality care. A president of India once accessed free eye care in one of the hospitals, not because he could not afford it, but because he wanted to identify with the masses.
What is the percentage of blind people in Nigeria?
The last national survey on blindness was done in 2007, in collaboration with the London School of Tropical Medicine, of course, in collaboration with the Federal Ministry of Health. The percentage of blind people in the county stood at 4.2 percent. If our population is say 200 million you know what that translates to in actual figures. It is quite a sizeable figure, roughly eight million people. When we talk of blind people, also remember visually impaired people. Don’t forget like I said earlier, that the number of visually impaired people is like three times that figure. So if we have 4 percent actually blind it means there are at least 12 percent of our population visually impaired. It’s a huge figure.