A Long Road to Eye Surgery

The Long Road to Blantyre

Six o’clock in the morning. The car kicks up the red dust from the road, which immediately settles in our airways—we’d better keep the windows closed.

We’re on Highway M1, traveling from Lilongwe, the capital of Malawi, to Blantyre, the secondlargest city and the country’s economic hub. Children pass us by. With their containers balanced on their heads, they’re on their way to the nearest well. Along the roadside, vendors offer their wares: tomatoes, potatoes, and dried fish lie there, carefully arranged and artfully stacked.

We have a little over 300 kilometers ahead of us. The GPS says it’s a four-hour drive, but we’ve allowed six hours—factoring in breaks, goats on the road, and road construction. What we didn’t account for, however, was being stopped by police checkpoints. In the end, it turns out to be seven hours. We have to postpone the appointment until the next day.

In Blantyre, we’re meeting with Dr. Esther Sanga Misanjo, one of the leading experts in the field of ophthalmology in Malawi.

I’m traveling with Marc Zedler, program director of GoodVision Malawi, and Peter Isaley, a driver for GoodVision and so much more to us on this trip: He handles the negotiations with the police, explains the cultural nuances to me, and interprets in conversations with the people who come to our eye camps from deep in the hinterland. Because even though English is the official language, many people—especially in rural areas—leave school before they’ve truly learned it.

Here, you have to know Chichewa, the most widely spoken language in everyday life in Malawi.

What the Journey Means for Families

Dr. Misanjo welcomes us the next morning at the eye clinic of the state-run Queen Elizabeth Central Hospital.

The eye clinic is the primary point of contact for people in southern Malawi. The Queen Elizabeth Central Hospital is a leader in pediatric ophthalmology throughout Malawi.

Dr. Misanjo explains that, aside from herself, there is only one other female doctor who is capable of performing these complex eye surgeries on children. She works in Lilongwe, but there she has neither a suitable operating room nor the necessary medical staff to handle the high-risk anesthesia. Those resources are available only here in Blantyre.

This means that every child in Malawi who needs eye surgery must travel to Blantyre. For families from remote rural areas, this entails a long and arduous journey that also comes with significant costs. For family members who are indispensable at home and who, in some cases, earn less than a dollar a day, this is difficult to manage.

And since the hospital shares some diagnostic equipment with other hospitals, certain tests are only performed once a week. A missed appointment means a week-long wait—and for a mother with her child, it may mean she has to return home empty-handed. A trip she might have been able to afford only once. We’ve just experienced firsthand just how unpredictable such a journey can be, despite having our own car and Peter.

Where GoodVision Helps and What’s Still Needed

GoodVision serves as an important partner here. The team travels to the villages, conducts on-site vision tests, educates families, identifies children who need surgery, and connects them with the clinic.

I ask Dr. Misanjo what her clinic needs most urgently. Her surprising answer: a renovation. During a tour of the clinic, it becomes clear what she means: The toilets are broken, the tiles and walls are damaged, and the pediatric ward is short on mattresses. A fresh coat of paint would also do the eye clinic—built in 2005—a world of good. After all, only when the clinic looks presentable and is well-equipped will even affluent Malawians come here for treatment—which provides vital revenue for the underfunded clinic.

Dr. Misanjo has prepared a list of urgently needed equipment. She was advised to always keep this list with her—just in case someone asks for it, she says with a smile. Today, I’m that person.

Spark plugs, mice, and a fuel pump

With quite a few impressions to process, we begin our journey home. Marc and I immediately start going over different support models for the clinic. But we don’t get very far. Halfway there, the car starts sputtering and we come to a stop. Immediately, we’re approached by five boys who are selling fried chicken and grilled mice on sticks by the roadside. They watch Peter curiously as he, well-prepared, replaces a couple of spark plugs. And off we go again.

But after a brief glimmer of hope, we’re stuck again. This time, fortunately, in a larger town. It’s no use—the fuel pump is broken. Peter gets the replacement part and the mechanics, who then quickly replace it right there on the side of the road. It’s now 4:00 p.m., and dusk is setting in. We don’t know if we’ll make it home that same evening. The unlit roads with their potholes are treacherous.

We had actually planned to have dinner with the team. When Violet Gladzon, chef at GoodVision Malawi, calls everyone to dinner, almost everyone shows up. Her kitchen is something like the heart of the office. That evening, however, we’ll have to skip the group dinner. We’ll reach Lilongwe too late, but safely, thanks to Peter.

At the End of the Road

This visit showed me just how much it takes to provide eye care to a child in Malawi, what GoodVision Malawi is already doing to achieve this, and what still needs to be done—all while keeping Dr. Misanjo’s list firmly in mind. Our team goes where it’s needed, to places where there is no access to eye care. Without his dedication, many families would never find their way to Blantyre.

What also impressed me: The GoodVision Malawi team has more than doubled the number of pairs of glasses distributed within a year—and they did it on the same budget. That’s no small feat. It’s the result of people who know their country, who don’t give up when something doesn’t work, and who figure out anew every day how they can reach more people.

For me, these trips are incredibly valuable. They give me the opportunity to listen, understand, and learn from the local people. Many contexts and needs are difficult to grasp from a distance in Europe. The experiences and knowledge I gain on the ground help us develop sustainable concepts together that truly suit the country and its people.

Text: Esther Holsten