The Gambia – Swansea Vision 2020 Eye Link

Here is my blog from the visit to The Gambia 21st March-28th March 2014:

Friday

I arrived in The Gambia with David Laws, paediatric ophthalmologist, and Stella Elliott, Link Co-ordinator after the six hour flight from the UK. Musa the driver from the Sheikh Zayed Regional Eye Care Centre (SZRECC) picked us up and drove us to the Kombo Beach Hotel. We were given a programme for the visit which we quickly read before unpacking and heading off for a trip to the Ebunjan theatre. This beautiful new building is the only theatre in the country. The performance entitled Women of Owa was fascinating although we were all shattered after our long flight.

Saturday

After a delicious breakfast we were taken to SZRECC for a meeting with the senior team to discuss the timetable for the week and review the current activity plan for 2012-2014. This is a detailed document which was written in partnership to decide on the priorities for the link during this time. We then moved on to writing the plan for 2015-2017. The meeting was very positive and a draft document was produced. We brought the staff some  t-shirts with the link logo on which we had made for a fund raising sponsored walk last year. Musa, the driver put his on straight away! Following the meeting staff from both sides of the link enjoyed a delicious lunch at the Sunbird Beach resort and relaxed in the gardens overlooking the beach. During the evening we discussed the activity plan and everyone was very positive about the meeting and how the link was progressing.

Sunday

Stella, Dave and I sat in the hotel restaurant and worked on the draft activity plan. After a quick walk along the beach we were picked up to go to a wrestling match at Serrekunda. This was like nothing we had seen before as  in The Gambia wrestling is taken very seriously. The build up to the match was more exciting than the actual event with rival teams parading round the field gaining support from the spectators. At one stage a fight broke out and police had to break it up! Unfortunately we had to leave before the end to pick up another member of the team from the airport. Colm McAlinden, optometrist was unable to fly out with the rest of the group on Friday. This was Colm’s first visit to Africa.

Monday

We were picked up for our first full day at SZRECC and arrived with our donations of equipment for the centre. I had brought two sets of Cardiff Cards and some prism bars. The first hour was devoted to teaching. I gave a presentation on vision testing in children. David gave a talk on common causes of blindness in the world and an overview of the Vision 2020 project. I then went to the clinic with the others where I was introduced to Mam who is a nurse attendant who has learnt to test the children’s vision. I observed Mam who had been taught by Babucarr who was now a refraction technician. Also observing were some of the students from the refraction course, two new Ophthalmic nurses and Kato, the matron. We then proceeded to assess all the children who were there for the busy out-patient clinic. We saw a mixture of children ranging from 12 months upwards who had a variety of conditions including cataract, conjunctivitis and squint. Some children had good well fitting glasses which was reassuring. Colm spent the day with Haruna, an optometrist and Dave was also in clinic. Later in the afternoon we met with Balla from a charity called Sightsavers, Modu and Lisa from One Sight an American charity and both sides of the team. The meeting was arranged by Sarjo, Director of the National Eye Care Programme at the Swansea team’s request to discuss the objectives of each team and to see how all the groups could work together. The meeting went well. We then went back to the hotel and explored the local area before typing up the notes from the day’s work.

Tuesday

We arrived in SZRECC for teaching. My presentation was on strabismus. Colm presented on binocular refraction. After teaching we went to the clinic and I taught Orthoptics to a small group of students and SZRECC staff. There were no children in clinic to assess so there was plenty of time to concentrate on learning cover test, ocular motility and prism cover test. In the afternoon I wrote some competency sheets for the staff who I had taught in the morning and updated the website. Dave, Stella and Colm went to theatre and finished at 7.30 pm. We  were meant to be going out for a cultural evening but as we were all so tired we postponed it  until tomorrow !

Wednesday

There was teaching again today. Dave presented on squint surgery. We then went to clinic. Wed am is paediatric day so  was very busy. Together with Mam, who does the children’s vision, Kato, the matron, three students and two ophthalmic nurses we assessed 30 children. The morning clinic ran onto four o’clock! It was a long haul but  very enjoyable as all the staff were enthusiastic.

In the evening we  were treated to  an evening of African music at a local beach restaurant called the Kunte Kinte beach bar hosted by the team at SZRECC.

Thursday

At SZRECC  Dave and Colm gave presentations then I went down to clinic  to give a tutorial to Mam and Babucarr. I taught them how to test and measure squints and ocular motility. We also talked about the link in general. I then taught the refraction students the same topics during a practical session.

We then broke for lunch and I met with Stella and Colm where we reviewed all the paediatric notes of children who had had cataract surgery during 2013 for an audit. Colm input the data and produced an audit to present at teaching the next day. This audit showed that there was an overall  improvement in children’s vision following surgery. This information will be useful data when applying for future grants.

In the evening the senior team from SZRECC met with us all and we enjoyed a meal in The Captains Table, a restaurant opposite our hotel. Everyone from SZRECC was really positive about the visit and said how much they had enjoyed the teaching and the contribution from the Swansea team. We also said how rewarding the visit had been and gave thanks for the hospitality.

Friday

This was our last day. We couldn’t believe how quickly the week had gone. At teaching Colm presented the paediatric cataract audit and I talked about amblyopia. We asked the students and staff to give us written feedback on the visit. The comments were really useful and positive. In particular there were many good comments about the Orthoptic teaching which was reassuring. The general consensus was that The Gambians would like us to visit for longer next time!

After teaching I went to clinic and saw three patients and said goodbye to Mam and the other staff. We then went to theatre as Dave was adjusting the sutures on a patient who had had squint surgery the previous afternoon. Following theatre both teams went to the meeting room for a debriefing meeting. We all took it in turns to describe what we had done during the week, who we had taught and our suggestions for improvements. The SZRECC staff took the suggestions on board. Everyone was positive about how the link was progressing and how things in SZRECC had improved over the six years that it had been in existence.

We then said our goodbyes and took our last photos before leaving with Musa to catch out flight back to the UK. Hopefully it won’t be too long before we will return!