Awash & Kelwan, Afar - Jan/Feb 2015

Sunday 18 January, saw the first Team on the way to Awash, 217 kms from Addis along the main road to Djibouti. Our hotel was approx 1 km walk to the Health Centre where we found that 250 people had already been registered hoping to receive surgery.

By early Monday morning our supplies had been unloaded, the required rooms set up, and 83 patients suitable for cataract surgery were screened. It didn’t take long for the crowd to build up. Many were desperate to get seen and so the situation became very noisy with people pushing each other to get in front.

Local police had to be called in to calm the crowd. For patients who had travelled long distances from outlying areas, EFA arranged and paid for meals to be supplied by the cafe owner in the grounds of the Health Centre.

Shiro and Injera was provided at 11 Birr (less than $AUS1.00) per patient, and they drank tap water. To assist EFA with screening and post-op follow up appointments after EFA left Awash, EFA agreed to hire an Ophthalmic Nurse, Endris from Dubti. He stayed at the Awash Health Centre.

Prior to EFA's arrival, mobilization had been carried out by radio and mosque announcements, and the local bush telegraph known as ‘Dagu’. However by the second week the number of new patients coming in was dropping off so Julie Tyers and Michael van Ewijk took Ephrem Addisu the Health Centre Manager into the back streets of Awash to look for more people with cataracts.

The poverty they encountered was very confronting but they managed to find a small number of potential cataract patients. Like on previous campaigns we had a number of young patients ranging from 13 down to two years of age.

The Health Centre's anaesthetic machine had not been used for many years, but Dr Margaret Watson our volunteer Anaesthetist managed to get it operating and administered the general anaesthetic on a two year old boy with bilateral cataracts, and a four year old with a traumatic cataract. Both had to be given oral Phenergan one hour pre-op to calm them before surgery. Both post-op outcomes were excellent. Electricity supply in Ethiopia is an ongoing problem and the Health Centre power failed on many occasions, so that Ophthalmologist Dr Abu Beyene performed approximately seven cataract surgeries under torch light.

We had recently purchased our own generator. But our ophthalmic microscope wouldn’t work with it because the voltage fluctuated too much. We took it back to Addis Ababa at the end of the Awash clinic and swapped for one that would run the microscope. This new generator worked but was a much larger diesel model that was very heavy.

Training involved Team Leader Julie Tyers teaching local Ophthalmic Nurse Endris how to use EFA's ophthalmic equipment such as the I-care, the A–Scanner and the Keratometer; and how to choose the correct dioptre intraocular lense for a patient.

The final outcome was 1,929 patients screened, 171 cataract surgeries, 5 Pterygiums and 3 TT surgeries.