Cataracts Are Curable – The Gambian Project is a UK based charity that was formed in 2019 specifically to provide eye care to the poor of The Gambia. We pay for cataract operations for the poorest of people.

Since our formation, we have paid for 1,414 cataract operations.

We also collect and transport donated ophthalmic equipment to the National Eye Health Programme.

Many Gambians go blind because they cannot afford the cost of a cataract operation. For £40.00 we can restore someone’s sight.

96% of our income (including trustees’ donations) is spent on eye care in The Gambia

Cataracts in Africa

Cataracts are common throughout Africa; from the Straits of Gibraltar to the Cape of Good Hope; people go blind because of them.

The combination of high levels of ultra-violet light from the sun and poor diet causes the lens in the eye to become opaque so that, over time, sufferers can only tell the difference between night and day.

In general, cataract sufferers in Africa are younger than those in Europe.

The lens can be replaced in a straightforward operation.

But medical care is not free in The Gambia and the cost of the operation, together with the cost of travel to the hospital, board and lodging for the patient and a guide, is beyond the means of many people.

The World Health Organisation (WHO) states that restoring sight is one of the most cost effective health interventions to reduce povery.

For a graphic illustration of how cataracts affect vision go to

https://www.sightsavers.org/cataracts-simulator/

 The Gambia

The Gambia is the smallest country in Africa – no bigger than Yorkshire. It is also one of the poorest. It has little productive land and no mineral wealth.  

Life is tough if you are poor. Being poor in The Gambia is really tough.

Tourism is the largest industry. It is also an industry that can thrive one year and be in dire straits the next.

Tourism is concentrated on the coast.  Very few tourists venture “up country”. Even if you work in the tourist industry, it is not continuous employment; the season lasts from November through to April when most hotels close and the staff are laid off.

When the severity of the COVID 19 pandemic was realised in early March 2020, the tourist industry collapsed suddenly and dramatically. The majority of tourists left The Gambia in just a few days.

It was not until October 2021, 18 months later, that tourists started to return.  Hotel occupancy during the 2021-2022 season was approximately 10%, rising to 50% in the 2022 – 2023 season.

Tourism accounts for about one third of GDP. The Gambia was not hit hard by the disease, but the economic consequences have been catastrophic for people’s incomes and government revenue.

Even the shape of the country is a handicap: it occupies a narrow stretch of land along both banks of the River Gambia. The largest urban conurbations are near the coast on the south bank of the river and that is where the main medical facilities are located.

To reach a major hospital, people living in the Upper River Region need to travel about 200 miles by road, the distance between London and Plymouth. Travel from the north bank involves crossing the river – never an easy task.

The National Eye Health Programme

The National Eye Health Programme (NEHP) is part of the national health service in The Gambia.  It is based at the country’s only dedicated eye hospital, the Sheikh Zayed Regional Eye Care Centre (SZRECC) in Kanifing.

Satellite facilities, Secondary Eye Units, are located throughout the country.  Straightforward operations to treat mature cataracts are carried out at these units.  More complex cases are referred to the SZRECC.

Cataract operations are not expensive in The Gambia; the charge for an operation to remove a mature cataract is the equivalent of £20.00 but travel and subsistence for the patient and their guide will increase the cost beyond the means of many families, especially in the villages “up country”.

The NEHP is acutely aware of the number of people suffering from cataracts due to poverty - they call it “the cataract backlog”.

“Cataract Camps”, at which 50 or more people are operated upon, were introduced to reduce the cataract backlog.  Cataracts Are Curable (CAC) was set up to provide free cataract operations for the poor of The Gambia primarily by funding cataract camps.

When funds become available, Cataracts Are Curable inform the NEHP.  The NEHP select the area for the next camp and request the Senior Opthalmic Medical Assistant (SOMA) in the local Secondary Eye Unit to prepare a budget for an eye health survey (aka Community Screening).

During the survey as many people as possible are examined, non-surgical conditions are treated, mature cataract patients are referred for surgery at the local secondary eye unit and complex cases referred to the SZRECC.

The SOMA then prepares a second budget to cover the cost of operating upon the number of mature cataract patients that have been identified during the survey.  These surgical lists can be any number, the most recent were of 75 and 82 patients.

The Costs of Community Screening and Cataract Camps

Community Screening

Cataracts Are Curable pay for the following:

• Medical supplies

• Transport and subsistence for the staff

• Advertising on the local radio

Cataract Camps

Cataracts Are Curable pay for the following:

• The cost of providing the operation and after care

• Transport of the staff and equipment

• Lodging for the medical staff

• The cost of radio advertising (often, but not always, given free)

• The cost of refreshments for the patients (and their guides) who have travelled, usually on foot, distances of 15 miles or more

• Transport of house bound patients

• Fuel for generators and many other small costs

The cost of Community Screening is variable because it depends on the number of villages to be visited, the population of the villages, the distance to be travelled and the state of the roads.

Community Screening of a typical area costs, on aveage, £1,000

The cost of providing a cataract operation £40.00 and the cost of a camp depends entirely on the number of operations to be performed.

50 operations cost £2,000; 80 operations cost £3,200.

 Who Benefits and How?

Cataracts Are Curable is a very small charity and our resources are limited, however, between May 2019 and December 2023, we have funded over one thousand cataract operations.

We do not know what proportion of the “cataract backlog” this amounts to but we do know that we have transformed the lives of 1,235 people; they can live independently, tend their vegetable plots, go to the toilet unattended, return to work and contribute to their families and communities.

It is common for a child to be kept back from school to act as a guide for a blind person. At one camp, a lady was accompanied by a 7 year old boy.

The cataract operation on only one eye gave them both freedom.

Just as importantly, we give people with cataracts hope that they will be treated, if not at one camp then at the next to be held.

Without hope, many become resigned to the fact that they are blind. Others turn to practitioners of “traditional medicine” whose crude methods often damage eyes irredeemably.

What We Do

We raise FUNDS and organise CAMPS

We provide the money to pay for surveys and cataract camps. We enable the NEHP medics to restore sight to the neediest of Gambians. We help organise cataract camps.

We PROCURE equipment

We procure ophthalmic equipment and spare parts for the NEHP. Some we buy new, some secondhand and some is donated. Procuring equipment in the UK is only the start. It requires considerable effort to pack and transport the instruments 3,500 miles by sea. It is also very costly. The cost of transporting goods by sea or air has risen steeply in recent years and, as a result, we have to carefully balance the cost versus the benefit of accepting each donation.

What we want you to do

Donate what money you can. It is a wonderful thing to restore someone’s sight. We only require £40.00 to transform someone’s life. Money for community screening will benefit hundreds of people. Money can also help buy equipment; we are currently buying replacement bulbs for operating microscopes and slit lamps.

In 2022, only 2% of our income was used to raise funds. Support costs amounted to another 2%.

Cataracts Are Curable is very small and very efficient.