How Rehema's paying it forward

Mohammed can remember how it felt to see his little sister being bullied.

He’d stick up for Rehema, who was blind, as much as he could. He’d tell the other children not to laugh at her, but it didn’t stop them teasing and hitting her. Mohammed, who’s 19, would step in to protect Rehema, take her home and clean her up as well as he could – but when he wasn’t around, there was nobody to protect her.

Rehema had already had a lot to deal with in her short life – her mother Makasi tells us she was born with a fever, and had a bad cough and other medical problems as a baby. Her right leg didn’t develop properly and now turns inwards, making walking a challenge.

Although her eyesight seemed fine at first, when Rehema (who’s now nine years old) was about four it became apparent that her vision wasn’t good. She would turn her head to see out of one eye that seemed to have better sight than the other. She couldn’t find her way around the house or village, and she couldn’t go to the toilet without help. Makasi could see that her daughter was struggling.

Life wasn’t easy for the family; Makasi had four other children to support and worked hard to earn an income farming. Most days she’d have to leave Rehema at home while she worked and the other children were at class – Rehema would sit on her bed until someone came back as she couldn’t see well enough to go anywhere on her own. That’s a lonely existence whatever age you are, but especially for a little girl who just wants to be learning, playing and making friends like anyone else her age.

When Makasi realised Rehema’s problem wasn’t going to sort itself out, she took her daughter to the GP, who told her there was nothing that could be done. But she persevered, eventually learning that there were other health services available, and took Rehema to a local primary health care unit where she was referred to the Sightsavers-supported team at Mnazi Mmoja Hospital. Makasi had seen people with cataracts before (the condition is caused by a buildup of protein that makes the eye appear distinctively cloudy) and thought that this might be the source of Rehema’s sight problems, and when the diagnosis came back this was confirmed.

Although Zanzibar has a population of more than 1.3 million people, there isn’t a single paediatric ophthalmologist. And for many families, the difficulty and cost of travelling to mainland Tanzania means it’s just not an option. But the Sightsavers outreach team was able to arrange for Rehema to fly with them to a hospital in Dar es Salaam, Tanzania for cataract surgery – surgery that would change everything for her.

The procedure, which involves replacing the eye’s lens with an artificial one, is slightly more complicated for children than adults as it requires a general anaesthetic. But it went off without a hitch, and the next day when Rehema’s bandages were removed, she could see clearly for the first time in years.

After Rehema’s operation, Makasi tells us, it felt like a burden had been lifted from her shoulders. And when they returned to the village Rehema didn’t need Mohammed to protect her anymore; nobody was laughing at her or trying to hurt her. Now she helps her mother at home with sweeping, cleaning and cooking, she’s able to play with friends instead of being left on her own, and best of all she’s been able to study again.

Sitting with her big brother on a low wall outside her home, Rehema cheerfully chats to us about her favourite subject (English) and shows us her glasses, which she’ll need to wear for the foreseeable future. Her life has totally changed, although it’s not all plain sailing for her from here. She’s got a lot of catching up to do, because her sight problems meant she was delayed in starting school and she’s three years behind most children her age.

The school she’d like to go to is six kilometres away, and that’s too far for her to walk with her weak leg, but the Sightsavers team is looking at how to get around these challenges and keep Rehema on track with her education. She wants to be a doctor when she grows up, which would help meet Zanzibar’s desperate need for health professionals (it currently has one of the lowest doctor to patient ratios in the world) and mean that another child in her situation might get treatment faster, more easily and at lower cost. Makasi hopes Rehema will keep studying and go to university, rather than marrying young (the custom for girls living in rural areas here).

When we’re finished talking, Rehema skips off to play. Mohammed looks on, no longer worried about his little sister as she mixes with the other children without fear. Where there was once a hesitant, bullied child, there’s now a confident, happy nine-year-old. It’s an amazing thing to see – not a statistic, one of thousands of operations performed in 2014, but a real life, changed beyond recognition.