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Were blind but now they see
Looking up: An opthalmologist checks a patient’s eyes before cataract removal surgery in Kemenuh village, Bali
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Looking up: An opthalmologist checks a patient’s eyes before cataract removal surgery in Kemenuh village, Bali. JP/J.B.DJWAN
Anxious parents line the walls of the waiting room of Puri Raharja Hospital in Tohpati, Denpasar.
The air is charged with emotions swinging from hope to fear to excitement. The atmosphere feels very like that in childbirth waiting rooms in hospitals all over the world; women chat in hushed tones while their husbands pace the floor like nervous roosters protecting their broods.
In some ways this is a delivery waiting room - these are the parents of nine children blinded by cataracts. They will be reborn with their sight restored.
The youngest child here is just six months old - born blind from cataracts. Surgeons say the baby has an excellent chance of gaining full sight after an operation to remove the cataracts and insert new lenses into her eyes.
The oldest child is a 14-year-old boy. He looks nervous, but stays brave as he is wheeled into the operating room - the white orbs of cataracts have drowned his pupils and once chocolate brown irises - the clouds of cataracts allowing him less than a spider's webbed view of the world.
"Around the world every five seconds someone goes blind," says ophthalmologist Dr Wayan Gede Dharyata during a short break from intensive surgery. "Every minute of every day a child goes blind."
Indonesia is leading the world in blindness: "Here, 1.5 percent of the population is blind," according to Dharyata. Across the country there are believed to be between three and four million people blind from cataracts. There are 3,000 new cases annually - that's almost 10 every day - in Bali alone.
The leading cause of blindness in Indonesia is cataracts - a treatable disease.
"In countries where blindness rates are less than 0.5 of a percent of the population it is classified as clinical. Where it falls between 0.5 and 1 percent of population it is a public health problem. Here we have a social problem," Dharyata says of the impact of the disease.
He points out that a person who loses his or her sight can no longer work or properly study. Loss of sight can therefore effectively remove members of a household - often the breadwinners, compounding the already pressing weight of poverty for many cataract sufferers.
"In Bali 1.5 per cent of the population translates to 45,000 cataract blind people. That number is growing by 3,000 every year. When people go blind they can't work and they need someone to look after them - then it becomes a serious social problem," Dharyata says.
In remote regions of Bali, particularly in the Karangasem area, cataract blindness is endemic. Babies that go blind in uterus can have lifelong problems if their cataracts are not removed soon after birth.
"If we don't restore sight before the age of six months the child will have shaking eyes for the rest of their lives - even post cataract removal. This is because babies need vision to develop the correct formation of the brain's *sight* connectors," Dharyata says.
To help combat the problem, last week Dharyata introduced the world's best practice for child cataract surgery to Bali. Working side by side with him was Dr Bill Ward, an Australian ophthalmologist from Perth's Princess Margaret Hospital.
The surgeons were using the latest technology in cataract surgery, which allows a greater area of damaged eye membrane to be ruptured, preventing the membrane that causes cataracts from closing over.
"This is one of the difficulties of this surgery in children," Ward explains. "The membrane becomes opaque very quickly in children after surgery and they are again blinded. With this technique we can make a larger hole in that membrane which does not then close over."
Dharyata and Ward have both volunteered their expertise to restore the sight of these children. The John Fawcett Foundation from Sanur has funded hospital placements for the children and the use of surgeries at Puri Raharja Hospital.
"This is a joint program between government, the private sector, NGOs and professionals," says Dharyata, who is known across Bali for his work with The John Fawcett Foundation.
Over the past 19 years Dharyata has performed many thousands of cataract removals and trained many young ophthalmologists in this highly skilled procedure that for the parents in the hospital waiting room and their newly sighted children is more of a miracle than medicine.
