MAKING A DIFFERENCE
A young Australian doctor in Swaziland
IT was a hot day. Sweat beaded off my skin on to the stethoscope that hung around my neck like the jet black arm of an old friend. We had been driving for hours over rocky, red-clay roads lined with maize, thatched huts and occasional sunflowers.
The challenge at each homestead we visited was not simply to hand out food and medicine, but to listen closely and to understand the many reasons why someone was sick. Then we could help them overcome their obstacles to recovery.
There are 34 communities, and that amounts to literally thousands of patients. I don’t know how those in the home-based-care team manage to know not only the directions to every hut or homestead, but the story behind each person. However, I am grateful that they do.
Late in the afternoon we came to a poorly constructed stick-and-stone house with a sheet metal roof. It was hard to believe that it was still standing. I asked the others in the team about the house and the person who lived there.
It was Make Maposa who shared with me the story of the man that we had come to see, one of the family members who lived in the house that now stood before us. ‘‘We have heard there is an old man here with untreated TB. He is refusing to come to hospital.’’
At the entrance to the homestead we got out of the truck and were greeted by a vibrant, young Swazi man, one of the breadwinners for the household. He told us to follow him into the home where his family were awaiting us. As the group was walking towards the house, I stopped short. Huddled in a lonely corner, just outside the house, I saw an old woman. ‘‘Who is she?’’ I asked. ‘‘Our Gogo,’’ the young man replied. ‘‘Why is she sitting like that?’’ ‘‘Don’t worry about her, Dokotela. She is old now and blind. And that is where she always sits.’’ ‘‘Can she walk?’’ I added. ‘‘Not really. Only a few steps. We bring her food. We take her in to sleep at night. Her legs don’t work any more.’’
I knelt down beside her in the burning sun. The flies swarmed. Looking in her eyes, it was clear that she had bilateral cataracts. I had a hunch that it was visual impair- ment, as opposed to decreased mobility, that had rendered her unable to walk.
I asked her to stand. She did. We gave her a walking stick, and asked her to walk if she could. By then other members of her family had gathered around. To her family’s surprise, Gogo began to walk.
I explained to the family, with Make Maposa helping with the translation: ‘‘The reason that Gogo cannot see and isn’t walking is because she has cataracts covering her eyes. She needs an operation to have them removed. Afterwards, she will be able to see.’’
Gogo, whose face had remained downcast for our entire conversation, lifted her face towards the blinding sun, and smiled. That day, as so often happens, we tended to several people in the one house, when only one person was on our list.
In the developing world, blindness often drastically reduces lifespan. Blindness means that people become unable to fend for themselves in already difficult conditions. Yet cataract blindness is an eminently treatable condition. The surgery is inexpensive and it takes about 20 minutes. My friend Jonathan Pons does most of the cataract surgeries in Swaziland. He is a person of enormous integrity and deep compassion.
I have stood in Jono’s clinic at the Good Shepherd Hospital the day after men and women have had cataract surgery. There will never be words to describe what it is to watch as a group of people, who were blind just 24 hours earlier, have the white bandages removed from their eyes and find their sight has been restored.
They start to sing, in groups, in four and five-part harmonies, without any prompting. This is an edited extract from Vula Bevalile: Letters from a Young Doctor, by Maithri Goonetilleke (Ilura Press, $32.95). The book is a collection of vignettes by Goonetilleke, an Australian doctor who has been contributing his time voluntarily in Swaziland, a country devastated by extreme poverty and HIV/AIDS. All profits from the book go towards Goonetilleke’s humanitarian efforts in the African nation. More: possibledreamsinternational.org.
Australian doctor Maithri Goonetilleke with a Swazi boy