Wednesday 30th August – Part 2
In the afternoon we visited a health centre, to meet a village health team. These are all volunteers, who are trained by the local government in a wide range of health issues, including eyecare. They then encourage people in their community to come to the centre if they have problems. They had pulled together a drama group of young people, who performed a series of sketches and songs which were aimed at educating people about eyecare. (They also showed us one about HIV/Aids). I was taken aback at the high quality of the performance, although it was a bit sobering to see the casual acceptance of domestic violence as a key cause of eye trauma. They included a section on traditional healers, with a satire on witch doctors – it was clear that many in the community fully understood the need not to use traditional herbs for eyecare, (they can exacerbate corneal damage) but we still saw evidence of it everywhere.

Wednesday 30th August – Part 1

Still at Jinja, we spent the morning visiting a school and a blind child (at home as school was on holiday other than for those doing revision for public exams). At Budondo school we met an itinerant teacher, who covers both visual and hearing impairment needs. This teacher was responsible for 24 schools in the district, as well as teaching science at Budondo. Not all the schools had children with special needs, but this was still a workload which was too much for one man on a bicycle. He was only able to visit each school about once a month. The teachers are not paid extra for this, although it did make them more likely to gain promotion – this teacher had become the Deputy Head of Budondo, which of course added to his workload! Apart from this, his main concern was the limited number of Braille books available.

We visited Susan, a 9 year old girl who had suffered cerebral malaria when she was about 3. This had left her totally blind. She also had trouble with her legs, but it seemed that this might have been because her mother had assumed that she shouldn’t walk, as she seemed to be improving her mobility since going to school. She looked about six. Her mother was homeless, and she moved around before the school had found her. She sang a number of gospel songs, and had a beautiful voice. It was hard to be optimistic about her future, as she lacked the supportive family which Dennis had.

Tuesday 29th August – Part 2

I saw my first case of trichiasis in Jinja. We met an old lady who had had a trichiasis operation some time ago, but her vision had been badly damaged before we had found her. She was now totally blind as she also had a cataract in the one eye which had retained some vision. A number of the blind people we met on this trip had more than one problem, which complicated the question of whether and how to operate.

In the afternoon we met Dennis, an 11 year old boy, blinded by measles followed by the use of traditional herbs at a young age, who had only been going to school for about a year. His parents had thought that blind children were incapable of this until the local village team discovered him and referred him to the project. He is now able to find his way around quite well – he is able to find the latrine, walk to school or to the local market. He washes his own clothes and has started his own patch where he is growing vegetables. Although still very shy, he had clearly made stunning progress in just a year. As an aside, I couldn’t help but compare what a young blind child is expected to do in Africa (wash his own clothes, grow food, walk several miles to school alone) with what a sighted child is expected to do in the UK, and wondered at the different levels of independence!!

Tuesday 29th August – Part 1

We set out first thing for Jinja. We fund a major Comprehensive Eye Services (CES) project called ‘Busoga CES’, and Jinja is one of the districts which is part of the overall programme. I confess to a childish excitement at the fact that we briefly visited the source of the White Nile, although it is now much less dramatic than when Speke discovered it, as the dam has changed the river from rapids to one which is wide and slow – it is hard to see where Lake Victoria ends and the Nile begins!

Our partner in Jinja is the local district government. We were escorted by a number of their key people including Moses Wakaisukaki and Lydia Namuwaya. They were clearly well on top of their roles, and both were well respected in the community. They took me to meet a number of beneficiaries who had received rehabilitation training of various kinds. This included functional literacy for those who had been able to read before going blind, and help from the National Agricultural Advisory Service, who provided piglets or goats and training as to how to care for them to those who had been farmers.

I was rather shocked that one of the biggest concerns several had was that their white canes were being stolen. Apparently the local witch doctors think that a white cane has ‘guided a blind man through the world’ and is therefore a symbol of good luck which can ‘show you the way’. They were stealing wooden ones, breaking them up, boiling them and then selling the remains as allegedly powerful spells. It is hoped that this problem will reduce as we now distribute metal canes. This was the first time in my travels that I have heard such a thing.

There was an increasing emphasis in the CBR schemes I saw in Jinja on income generation. Obviously we still cover mobility and orientation, personal living skills and subsistence agriculture, but at the Jinja Association of the Blind it was clear that people were clamouring for more help to be economically included not just socially included. I think we need to consider how we can do more for people in this area.

Monday 28 August – Part 3

In the afternoon the Uganda country office gave me a presentation about their work. The areas we work in have a high level of visual impairment. There is a significant amount of trachoma in many areas, and residual blindness amongst some of the older people from the days when oncho (river blindness) was rife. We have submitted a proposal to International Trachoma Initiative (ITI) for parts of Uganda to be included in the Pfizer azithromycin donation project, and are optimistic that we will be successful.

Education for visually impaired children seems to be further advanced in Uganda than in some of the other places I have visited. There is universal primary education, where everyone is now entitled to 7 years of education. However, there is still the usual issue of equipment, Braille books and adequate teachers to ensure that all visually impaired children can benefit. The numbers involved are significant when you take into account the fact that the average number of children per woman in Uganda is seven. I was worried about what happened to all these children after primary education – apparently the President is seeking to introduce universal secondary education next year.

One major challenge which our programme faces is that the number of districts is proliferating. We work closely with government at the district level, and each time a district is split, there is pressure for us to duplicate project management, which obviously increases costs.