Sofia Lima is about seven years of age. Wearing a pink gown and a white hairnet, she is sitting with her mother Lorena Lima in a clinic in the Brazilian city of Coari. While patiently waiting for her operation, she repeatedly puts her hand over her right eye. Even as an infant, she couldn’t open her eyes in really bright light. She had great difficulty walking around and playing. She constantly knocked into or tripped on things. Sofia’s mother shows a picture of her from her early childhood days. She has very good memories of this time:
I couldn’t understand what was wrong with Sofia for a long time until somebody explained to me that my child was suffering from congenital cataract.
Cataract is the term used to describe a clouding of the natural lens in the eye – it can happen to one or both eyes, have genetic causes or, for example, be triggered by infections in the mother’s uterus or by environmental influences. However, cataracts occur not only in children, but also frequently in older people. If the condition remains undetected, the person’s sight can rapidly deteriorate, leading – in the worst case scenario – to poor vision for the rest of his or her life.
In Brazil’s Amazonas region the number of afflicted people is particularly high – Sofia is only one of many. One of the causes is the intensive sunlight to which people are exposed in the tropics. This damages the natural lens of the eye and plays a major role in the gradual worsening of the condition.
The big problem: apart from the capital city of Manaus, even the simplest medical treatment and routine surgery are a real challenge in the Brazilian rainforest. Two of the reasons are the poor infrastructure and the rudimentary health care system in the region. There are four eye doctors for every two million people.
Imagine a big city like Munich only having four ophthalmologists’ practices for its entire population! Well, that’s what it’s like in this region of Brazil. The great poverty in this area of the country is another reason why the inhabitants cannot possibly afford surgery without financial assistance.
Prof. Dr. Walton Nosé
Our work is so valuable because we bring young doctors to the region. This enables us to exchange our experiences and ideas, and a better understanding of the different cultures in the various regions of Brazil is the result.
Dr. Jacob Cohen founded the “Project Amazonas” aid program. Twice a year a group of 12 surgeons and a 12 person strong team of medical personnel make their way to the remote areas of the Brazilian rainforest. Their baggage includes medication and leading-edge medical equipment, including state-of-the-art medical technology from ZEISS for ophthalmic examinations and operations.
They travel by boat to the eagerly waiting people in the interior of the Brazilian Amazonas region. With its many tributaries, the vast river is up to 20 kilometers wide even in the dry season and bursts its banks several times a year. Many huts have been built on stilts in the water, making cars and trucks absolutely useless in this environment.
And precisely because the doctors can visit them so rarely, they are eagerly awaited every time they come. Dr. Lincoln Freitas explains: “We operate on people who have waited an average of eight to ten years for cataract treatment.” During their two-week itinerary the doctors examine the condition of the patients’eyes and test those who need a surgical procedure. The actual surgery is performed in public hospitals and medical facilities on site. The treatment is offered free of charge, also thanks to the support of ZEISS in Brazil.
Prof. Dr. Walton Nosé is one of the doctors on the team. He considers the annual visits to be highly beneficial: “Our work is so valuable because we bring young doctors to the region. This enables us to exchange our experiences and ideas, and a better understanding of the different cultures in the various regions of Brazil is the result.”
Within the framework of the project, the specialists show local doctors how to treat their cataract patients in line with the most recent research.
New, non-invasive methods for cataract therapy and special training are also part of the program. “These are techniques, which may seem more expensive at first, but they provide better results over the long term. Therefore, this project has been trying to innovate: innovate in terms of both assistance and in service and use disruptive technologies more and more”, affirmed Prof. Dr. Rubens Belfort Jr, a doctor involved in the aid program. The use of these techniques results in fewer complications during surgery and lower costs during post-surgical treatment.
Little Sofia also regained her sighted as a result of the program. After the procedure is over, she wakes up in her mother’s arms. She strokes her daughter’s cheeks affectionately with obvious and understandable relief. In the past five years 3000 people have been saved from blindness thanks to these surgeries.
Photos by Julio Bittencourt