The Foundation and its partners have developed a blindness prevention program in Kenya’s Rift Valley Province that is so successful similar programs are being set up throughout Eastern Africa.
Since 2004, The Foundation has been supporting partners in Kenya to deliver eye care services to people living in the rural Rift Valley Province.
There are more than 224,000 people living with blindness in Kenya. Approximately 43% are affected by cataract, which can be treated with relatively simple interventions.
Trachoma ranks second to cataract as the main cause of avoidable blindness in Kenya, and 11 of the 18 districts where trachoma is endemic are in the Rift Valley Province.
Tackling blindness in Kenya is a challenge because existing eye health services are concentrated in urban centres. Our aim is to improve access to quality eye care services for those living in rural and underserved areas like the Rift Valley.
The Foundation has been working in partnership with the Nakuru Provincial Hospital in the Rift Valley Province since 2004, and in 2010 formed new partnerships with hospitals in South Nyanza district on Lake Victoria.
Working together with our partners, The Foundation:
- Performed 4,730 cataract operations and 11,667 other sight saving or improving interventions
- Trained 13 surgeons, 28 clinical support staff and 1,448 community health workers
- Screened 38,117 people for eye health
- Delivered $156,768 in medical equipment
- Constructed, upgraded or renovated four facilities. Began construction of a new referral Eye Unit at Migori District Hospital which will serve a population of almost one million people
- Doubled surgery rates for the trachoma program and distributed Azithromycin to 570,730 people
- Undertook two trachoma surveys in Makueni and Koibatek districts to complete mapping for the country.
About the program
In late 1995, with funding from AusAID, The Fred Hollows Foundation began training 130 doctors throughout Eastern, Central and Southern Africa in modern cataract surgery. The doctors were from Botswana, Ethiopia, Kenya, Lesotho, Malawi, Swaziland, Tanzania, The Gambia, Uganda, Zambia and Zimbabwe.
The training program was completed in 1999 and participants received an initial donation of intraocular lenses, sutures and surgical instrument sets.
Some doctors were given additional support to become trainers, so they could pass their new skills on to colleagues.
In 2002, The Foundation started planning a return to East Africa. Dr Wanjiku Mathenge was employed to carry out an assessment of the eye care needs in the region and to assess what role The Foundation could play.
As a result, in 2004, The Foundation formed a partnership with Kenya's Nakuru Provincial General Hospital in teh then Rift Valley Province in order to provide sustainable eye care services in the region.
The long-term objectives of the Nakuru District Blindness Prevention Program are:
- to help build up existing eye health services so that the public health system can effectively treat and prevent avoidable blindness
- to reduce the backlog and incidence of cataract and other causes of blindness in this part of Africa
To this end, in 2006 the Nakuru Eye Unit was refurbished and the operating theatre upgraded with the support of The Foundation. The Foundation also purchased the medical equipment necessary to increase eye care service delivery in this rural area.
With further support from The Foundation, the unit opened a Low Vision Centre in 2008 to screen and support children and adults with irreversible low vision.
In 2010, after a review of the Nakuru program, The Foundation expanded its work to support three additional rural eye units in Nakuru county, Baringo county and Samburu county. The Foundation also began working in the counties of Homa Bay and Migori in South Nyanza – a remote region along the shores of Lake Victoria in Kenya’s South West.
In 2012, we also scaled up our efforts to support the Kenyan Government in the eliminatation of trachoma – a painful and permanent blinding disease that affects the poorest of the poor. The Foundation is now working in five counties to eliminate this contagious disease, and will further expand this work in 2013.
One of the challenges in developing a sustainable eye health care system in Kenya is that although universities in Kenya have stepped up their training of ophthalmologists, in line with the World Health Organization's Vision 2020 goals, there is a significant problem in retaining university graduates in their government postings. Graduates often say they are posted to eye units that are ill equipped and not suitable for performing operations. As a result, many move across to the private sector.
The Foundation is working to address this issue by supporting rural eye units with the equipment and infrastructure necessary to deliver services, and by providing opportunities for career and skill development for mid-level ophthalmic staff.
Dr Wanjiku Mathenge
The hard work and dedication of Dr Wanjiku Mathenge has been critical to the success of The Foundation’s program in Kenya.
Dr Mathenge was a consultant ophthalmologist at the Rift Valley Provincial General Hospital from 1996, and began working with The Foundation in 2002 when she conducted an assessment of eye care needs in East Africa on our behalf.
Following the assessment, she joined The Foundation as Eastern Africa Medical Advisor and established an eye care program in Kenya as a starting point to addressing avoidable blindness in the region.
As Medical Advisor, Dr Mathenge plays a key role in program and partnership development.
As we expand to other countries within East Africa and around the world, Dr Mathenge provides a crucial clinical perspective and ensures our programming is guided by the most recent research and models of best practice in eye care service delivery.
In 2006 the British Council for Prevention of Blindness (BCPB) awarded Dr Mathenge its first ever Sir John Wilson Prevention of Blindness Fellowship. As a result, Dr Mathenge undertook a PhD at the International Centre for Eye Health (ICEH), based at the London School of Hygiene and Tropical Medicine, which she completed in 2011.
Dr Mathenge now works in Kigali, Rwanda, and is the Director of Training and Research at the Rwanda International Institute of Ophthalmology and Dr Agarwal's Eye Hospital.
Facts and figures
|Number of blind people||250,000|
|Main causes of blindness||cataract (43%), trachoma and corneal scarring (19%), glaucoma (9%), and childhood blindness (6%)|
|Number of people with cataract blindness||107,000 (backlog) and an annual incidence of 14,500 cases|
|Number of cataract operations performed annually||Kenya's cataract surgical rate is 730 operations, per million people, per year|
|Number of ophthalmologists||about 85 (approx 33 of these ophthalmologists work in Nairobi)|
|Reasons for low cataract surgical rates and backlog||shortage of eye health personnel and inadequate supply of equipment and consumables|
|Childhood blindness rate||there are 16,800 blind children in Kenya|
|Life expectancy||57.7 years|
|Infant mortality rate (per 1,000 births)||55|
|Adult literacy rate||87%|
|Population living on $1.25 a day||43%|
|Children (0-5 years) underweight for age||16%|
|Number of doctors (per 100,000 people)||1|
Sources: Human Development Report 2006, Chief Ophthalmologist of Kenya, Kenyan National Eye Care Plan 2005–2010 & UNDP Human Development Report 2010 & 2011. UNICEF State of the World's Children Report 2013
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