Into Africa,
Seeing and Believing

Raymond V. Gilmartin, chairman of Merck, distributes some of the sight-saving drugs his company donates.

By Frank Shouldice, Contributor
December / January 2004

We’re juggling with numbers here. Every five seconds someone in the world loses his/her sight; a child goes blind every minute. That amounts to seven million cases a year. Add that to 45 million people already blind and another 135 million with limited vision. Patricia Hallahan, regional director with Sight Savers International, confesses she’s not very good at figures but calculates that four in five cases of blindness could be prevented or cured. Clearly her experience in East Africa puts some numbers at her fingertips.

“Knowing it’s reparable or avoidable is what makes me feel so energetic,” she says forcibly. “Because we’re not doing half enough about it!” You can tell that working with those in the dark has changed the Dubliner’s appreciation of light.

Born the eighth child in a family of nine, Patricia Hallahan’s Phibsboro upbringing on the city’s northside was normal but busy. After working for a year in the bank, she took up nursing, then qualified in midwifery and extended herself further by taking up Social Sciences at UCD where she gained an interest in overseas development. When she saw a Concern notice seeking volunteers in Bangladesh in 1982 Hallahan didn’t hesitate.

“I was going to get that bug out of my system and come back to my `real’ life here — and here I am 21 years later!” she laughs, as though surprised at the thought. “It was all hands on deck for everybody,” she reflects, recalling when floods hit in 1988. “There are times you think about in your life when things just clicked. I think back to that time when we had a small team with limited resources.

“Bangladesh certainly had a huge influence on me. It was a very good experience. A very difficult environment but I learned a lot. What strikes me about the people I meet in such difficult circumstances is the power people have to overcome diversity. It’s that human ability to thrive or overcome circumstances that are sometimes unimaginably difficult. At an individual level the indomitability of the human spirit is amazing.”

In between lifting flood victims to safety she met Peter Benson, a welder and teacher from England who was working in Bangladesh with the Volunteer Service Overseas. They got married and after a spell working abroad returned to Trócaire’s head office in Dublin. Six years later Hallahan was offered a posting to East Africa. Whatever impulse existed before, boarding the plane this time was less straightforward. The couple had two young children — Róisín and Tadhg — and the Africa job was long-term.

“It’s the challenge, I suppose,” says Hallahan. “I mean there’s so much work to be done at home but for me it’s just about being close to where things are happening. It was also an opportunity for the children to experience a different life, exposure to different societies and cultures.”

Bags packed, the family adventure resumed, bound as a foursome for Nairobi. Two years later she was approached by Sight Savers International to take over as regional director for its East, Central and Southern Africa operation. On temporary leave from Trócaire, the answer was again, yes.

Her remit includes Kenya, Uganda, Tanzania, Malawi, Zimbabwe, Zambia and South Africa, treating 945,000 patients from a general population of 65 million. Sight Savers — originally set up in 1950 by blind patron John Wilson as the British Empire Society for the Blind — deals exclusively with sight-related issues. The vast majority of the world’s 45 million sightless are in the developing world, with nine million in India alone. It is estimated that the global figure will rise to over 70 million within two decades, which is why the World Health Organization is coordinating Vision 2020, a multi-agency program aimed at eliminating avoidable blindness by the year 2020.

To most people `avoidable blindness’ is a strange concept, but untreated cataracts are the biggest single problem in the developing world. A simple 20-minute procedure to insert an Intra-Ocular Lens (IOL) can restore lost vision. Local anaesthetic is sufficient for adults, and the lens is far preferable to wearing glasses, which are expensive, breakable and difficult to replace. Each IOL procedure costs about $30 and last year Sight Savers performed 176,086 cataract operations worldwide.

“I find this type of work very satisfying,” says Hallahan. “I came from a general nursing background, and this is a very focused area where it’s easier to measure impact. The way I see it, these are human rights issues and I’ve had the experience of taking the bandages off patients — it’s really exciting when, for instance, a woman sees her grandchildren for the first time.”

Sight Savers is also heavily involved in distributing Mectizan, a drug which can prevent onchocerciasis (river blindness). The disease is caused by a bite from black (or simulium) fly, a species which inhabits areas around fast-flowing rivers. The bite plants thousands of tiny parasites which cause intense itching and travel through the human body towards the eye, eventually causing irreversible blindness. In the delta towns and villages of West Africa widespread blindness is not uncommon — in fact the former Northern Gold Coast was known locally as `Country of the Blind.’

One Mectizan tablet a year is enough to kill the parasite. “Small input, big output,” explains the Nairobi-based director. In an epidemic crying out for optimism, one of the most startling developments is the ongoing contribution made by Merck &Co., a U.S. pharmaceutical company.

Merck produces Mectizan and in 1987 the company undertook to donate it free of charge for as long as necessary. Last year alone Sight Savers distributed 8.8 million Mectizan tablets across ten African countries.

“Sometimes in development we tend to see things as all good or all bad,” feels the Dubliner. “River blindness is a huge problem, and for us to get the drug free makes a huge difference. Merck deserve credit for this.”

Other procedures carried out by mobile units — such as treating trachoma — are more difficult, and despite the miracle-working aura of restoring sight, not all blindness is treatable. “There’s a lot of fear about working with the eye and there’s a lot of superstition about health care in general,” she feels. “There’s also a lot of discrimination against people with disabilities — and sight disabilities in particular.

“We work in a region where HIV and malaria are the top two priorities. Blindness is probably about fifth or sixth on the list. I thought the eye was a small thing, but when you go into it there’s so much to learn,” adds Hallahan. “Especially the fact that 80 percent of blindness is preventable.” ♦

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