One ophthalmologist for eight million people

There is only one permanent ophthalmologist in all of Southern Sudan. So this poor eye doctor has to serve over eight million people. When a mobile ophthalmologist visits a village, hundreds of blind or sight limited people will show up, too many for the staff to care for.

From this IPS article that we found at All Africa, writer Skye Wheeler describes the eye diseases that are prevalent in South Sudan.

Dozens visit the eye clinic in the semi-autonomous region's capital every day from across the South trying to have their sight restored, mostly old and silent, waiting their turn with a helper. The Ethiopian doctor has performed hundreds of cataract operations - removing the protein build-up that covers the eye - that miraculously bring back sight.

Reversible cataract is probably responsible for half the cases of blindness in the South, but Mulugeta and government officials in the health sector know there are thousands who have no access to treatment. They also know - although no comprehensive studies have been done - that many thousands are at risk from two of the world's leading blindness-causing infectious diseases; river-blindness and trachoma.

"South Sudan looks to be the worst. Maybe two percent of the population is blind," Mulugeta, who works with the Christian Blind Mission, said. This estimate is an extrapolation of numbers from neighbouring Ethiopia where 1.6 percent of the population is visually impaired but where there are far more public health services and infrastructure.

The Director of Eye Health at South Sudan's health ministry, Ali Yousif Ngor, oversees the South Sudan part of an Africa-wide attempt to combat river blindness, also known as onchocerciasis (O.V). It is a disease spread by the black fly that carries larval forms of a worm parasite. These worms grow and breed, releasing thousands of larvae that move all over the body causing intense itching and blindness.

River blindness is prevented by widely dosing communities in affected areas with a drug called ivermectin. For the last two decades ivermectin has been provided free of charge by a U.S. pharmaceutical company in an attempt to eradicate the disease in endemic countries, mostly in Africa.

It was only at the end of the 22-year civil war in Sudan in 2005 that international health organisations and government officials were given a chance to reach many rural communities. "It is so hard to get everyone to take the drug at the same time, twice a year. That would really hit the transmission of the disease," Ngor said.

Part of the problem is that officials like Ngor simply do not know how widespread the disease is. Ngor said that the government does not even know if O.V is more or less common than trachoma, another major cause of blindness in the South. Trachoma occurs when untreated, repeated infections of the eye by bacteria eventually causes scarring so extensive the eyelid partially turns in on itself. The lashes scratch the cornea causing intense pain and often first reversible and then irreversible blindness.