My eyes shrunk in size, affected my walking

Take the case of 18-year-old Joshua Bosire Mogambi who underwent a cornea transplant this August after unsuccessful management of allergic reactions that left his eyes itchy, forcing him to constantly rub them to ease discomfort.

"I started experiencing the itchiness at the age of seven, it persisted to the point that my mother took me to hospital," recalls Mogambi, but the allergy treatment was not successful. Not even wearing eyeglasses as recommended by medics helped alleviate the itchiness.

"My eyes shrunk in size, I could not open them fully, it even affected my walking," says Mogambi whose family "resorted to herbal medicine to remedy his condition, but that also "did not work."

Mogambi's eyesight was slowly deteriorating, and without proper diagnosis, he was slipping into a dark world he dreaded.

His school life was not spared as learning became a challenge a teacher noticed he was struggling to read what was written on the board.

"I would just rely on my ears to note down what the teacher would say," recall Mogambi who was losing hope and was just waiting for the dark day to arrive.

But as fate would have it, treatment options for his thinned cornea were not exhausted.

He still had a chance to save his sight after a successful two-hour surgery done via a donated cornea whose patients are more than the delicate organs.

Christopher Mung'ala, an Ocular and Birth Tissue retrieval specialist at Lions Sightfirst Eye Hospital in Nairobi, explains that "currently all the cornea donations we get come from the Asian community."

He attributes this low reception among African communities to cultural beliefs associated with burial rights as some "believe the deceased will still require eyes to see in the next world."

Lack of awareness on how to donate, what can be donated and the importance of organ donation in Kenya is also to blame for the low number of pledges from African communities.

To illustrate the situation, Mung'ala says there were only eight retrievals done against a list of over 900 patients waiting to receive a transplant.

Mogambi was lucky to have his transplant surgery and he is not the only beneficiary of a cornea transplant as there is also Victor Jumba from Vihiga County.

His eye allergies resulted in discomfort from itchiness and a cornea transplant surgery this June is part of his recovery process alongside adhering to medication.

"I use one eye drop from every bottle on a daily basis, these drops have to be applied at an interval of two hours," he says adding that "my phone alarm always reminds me when the next eye drop is due."

It is one thing, however, to undergo the surgery and another to sustain the transplanted cornea: The National Hospital Insurance Fund (NHIF) caters for cost of surgery, but the patient bears the cost of costly medicine.

For instance, Jumba spends about Sh3, 500 on medicine alone besides footing for every clinic consultation fee of Sh2000. He refills the medicine every two weeks translating to a bill of Sh11, 000 every month.

While Mogambi and Jumba have been lucky for their successful cornea transplant surgeries, Makena Nkatha is still waiting, hoping for a donor for the past four months.

"I feel like giving up most times, I've waited for so long and the more I do that the worse my eyes get," says the 27-year-old.

Mung'ala from Sightfirst Eye Hospital explains that most of the cornea donors are often aged 70 years and to complement the low number of donated corneas, the hospital imports from the USA or Italy to meet the high demand of which children make up a huge number.

"Most children are unable to sit exams because they cannot see and often have to wait until they are 17 to undergo a transplant," says Munga'ala explaining that it's because tissues from younger donors are hard to come by.

Again, corneas have to be harvested at least six hours after death when the cells are still fit for use, but the deceased has to consent before death through a pledge form that identifies them as donors, thus complicating matters.

The corneas have a short shelf-life, but due to the high demand are often utilized before being rendered unfit after 14 days.

Blood tests also have to be done to determine the fitness of deceased donors.

Dr Deepak Gupta, a senior consultant in Cornea, Cataract and Glaucoma, calls on Kenyans to pledge their corneas to help save sight as the success rate of donated corneas stands at 90 per cent.

"The common side effects which can happen is rejections which sometimes do happen but they are around 10 per cent almost everywhere in the world," says Dr Gupta adding that "the advantage and beauty of this procedure is from one eye we can help up to two people."

After surgery, the recovery can take up to one and a half years before a patient regains full sight.

The first two weeks post-operation, however, are considered crucial in the patient's healing journey as patients experience side effects including "some pain, some discomfort but we give them an eye shield which protects the eye during the day," offers Dr Gupta. "Or we tell them to wear sunglasses or a patch for protection."

Dr Gupta says a corneal transplant costs Sh250, 000 which NHIF caters for. This type of surgery is often successful in about nine out of 10 people with advanced keratoconus.

Mogambi and Jumba may never know who their donors were, but through the corneas they donated, they are now able to at least see life from a different perspective.

"I was shocked that someone died and gave me something that changed my life completely, I wish I was there to thank them because they did something that most people cannot do," said Mogambi.

Statistics from the Ministry of Health indicate that about 75,000 people have corneal diseases in Kenya. These same people are in need of a corneal transplant.

Although organ donation remains a thorny issue in Kenya, corneal blindness remains the second most prevalent eye condition globally. Yet, to rehabilitate impaired visions a corneal transplant is the best shot, meaning more people are needed to make pledges to donate their corneas after death.