“I don’t want my son to become a rickshaw puller like me. I did not get a chance to go to school in my childhood. But I want him to read and write so that he can find a better job” says Bechan, a poor rickshaw puller of Pokharbhinda village of the state of Uttar Pradesh, India. Bechan has come to Shree Rana Ambika Shah Eye Hospital, Lumbini, Nepal to treat his son, Jai Bhagwan, who has lost eye sight in both eyes due to cataract.

Bechan with his wife and three kids eke out living in abject poverty. With his minimal income of USD 30 per month, it is difficult for him to fulfill all basic needs of his family. Thanks to the Government of India’s pro-poor educational policy, all his children can at least avail education free of cost in the village school. Bechan works very hard and he wants do whatever he can to ensure a better and bright future of all his kids.

Bechan never thought that his son has poor eye sight, until his school teacher told him one day that Jai Bhagwan has difficulty in reading and writing. A child who has poor eye sight often does not realize that his/her sight is poorer than others. A child often can not voice his or her problems. This unexpected news was nothing less than a mental shock for Bechan, who had no idea of childhood eye diseases and no money to seek treatment.

Eventually Jai Bhagwan was dropped out from school. He started spending most of his time at home. Bechan approached an eye doctor in his village to seek treatment for Jai Bhagwan with whatever savings he had. After having a preliminary eye examination, the doctor prescribed spectacles and eye drop. Poor Bechan had still no idea of what has happened to his son, but he had profound faith on the doctor. He believed that with the prescribed medicine and spectacle, Jai Bhagwan will be able to see well.

One year went by. There was no improvement in eye sight of Jai Bhagwan. In fact his eye sight deteriorated further. Worried Bechan rushed to the village clinic and to his surprised found that the doctor who treated his son has left the place forever. With the advice and recommendations of his friends and neighbours, he went to another eye doctor in a nearby town.

Jai Bhagwan was diagnosed with Congenital Cataract, an opacity in the lens of the eye that is present at, or develops shortly after, birth. It causes the immature visual system deprived of the stimulation needed for normal development resulting permanent blindness in children. Cataract can only be treated surgically.

 

The doctor informed Bechan that a surgery has to be performed immediately to treat the condition and that would cost Rs. 6,000 (more than his 4 months income). After expressing his inability to pay this amount, the Doctor was willing to give a concession of Rs. 1,000, but poor Bechan could not afford the treatment cost and returned home with tremendous pain and frustrations.

Anxious Bechan did not give up his efforts. He used to consult his friends and other villagers for a solution. Some old villagers advised him to go to Shree Rana Ambika Shah Eye Hospital where they underwent cataract surgeries. They told him that this hospital in Nepal offers good quality services at an affordable cost. Convinced by the advices of his friends and neighbours, Bechan made up his mind to visit this hospital which is just 3 kilometer away from Indo-Nepal border. His father-in-law, Ramsurat, agreed to accompany him.

On May 7th 2007, Bechan along with Jai Bhagwan and Ramsurat crossed Indo-Nepal border and reached Nepal. Shree Rana Ambika Shah Eye Hospital is one of best eye hospitals of Nepal that performs more 30,000 cataract surgeries every year. Almost 80% of the patients who seek treatment from this hospital are from north India, especially from two populous states, Uttar Pradesh and Bihar. This is because access to affordable and quality eye care services is grossly limited in this part of India.

 

Along with adult cataract patients, many children like Jai Bhagwan also come here with a hope of getting back their eye sight. However, until recently, there were no specialized pediatric eye care services in this hospital. Managing childhood eye diseases including cataracts is a huge challenge: treatment is often difficult, tedious, and requires a dedicated team effort. To assure the best outcome for cataract blind children, early treatment by a team of trained pediatric eye care personnel is essential.

ORBIS, a global eye care organisation, was first to realise the need of setting up a dedicated pediatric eye care services in this hospital. Apart from building a competent team of paediatric eye care professionals and installing essential equipment, this newly established child-friendly eye care center offers quality eye care services at an affordable cost.

 

 

“On an average, 5 pediatric eye surgeries are being performed every day here” says the Pediatric Ophthalmologist, Dr. A S Karthikeyan who was trained in an ORBIS supported training center in Southern India. “Surgical technique and protocols followed here are in line with the best practices followed by most hospitals handling high volume surgeries while providing quality patient care”, he adds.

Dr. Karthikeyan and his team examined Jai Bhagwan and prescribed surgery immediately. “Early treatment of pediatric cataract is essential. If the treatment is delayed significantly, there is often a chance of development of amblyopia (irreversible loss of eye sight in one eye) and nystagmus (dancing eye that leads to squinting). Fortunately prognosis of Jai Bhagwan’s eye sight is good and he is likely to gain very good vision after surgery”, Dr. Karthikeyan says.

Bechan seems to be very happy today. He is extremely satisfied with the attitude and conduct of the staff and ambiance of the hospital. Till he came to Nepal, he could not contact his wife. “It is very expensive to make a phone call from Nepal to India. I want to save whatever I have for his (Jai Bhagwan) treatment. I am sure he will be able to see again and most importantly go back to school” exclaims Bechan.

The pediatric eye care department of Shree Rana Ambika Shah Eye Hospital is very much child-parent-friendly with play area and baby feeding area. More than 60 patients from Nepal and India visit this center every day. Most of them can not pay. “The policy of our hospital is that no one should go back without treatment because of lack of money. We receive patients mostly from underprivileged communities and therefore almost all services here are heavily subsidized. My job is to identify patients who have no capacity to pay even this nominal fees and waive off his/her treatment cost fully”, says Ms. Bhumikala who has been trained in patient counseling by ORBIS.

“ORBIS has made a huge impact by helping us setting up this department and training our staff. We had no trained pediatric ophthalmologist or a full time anesthesiologist and we used to operate children on Ketamine, an anesthetic agent that is not used in developed countries. But now we have a trained team and adequate anesthesia services. The colourful pediatric department has set a new standard of high quality patient care in our hospital”, says Dr. Manoj Sharma, Director of Shree Rana Ambika Shah Eye Hospital.

“No child should remain blind needlessly. Our objective is to make eye care services affordable and accessible to all and with this objective we have established this pediatric eye care center. The generous grant from Guernsey Overseas Aid has helped us to do this. We have established 20 such centers in different parts of India and planning to set up another 30 by the year 2010. So that pediatric eye care services are easily accessible to thousands of children like Jai Bhagwan who suffer from needless blindness. To fulfill this mission, we need generous support from all section of the society”, says Dr. G V Rao, Country Director, ORBIS India.

When ecstatic Bechan returns to his home with his son and father-in-law, he actually falls in love with this place, the birth place of Lord Buddha. He promises the hospital team that he will comeback for the second surgery soon and also for all follow-up visits advised by the doctor. In his heart, Bechan believes that Jai Bhagwan will again go back to school and will surely find a better job one day!