Chinese medics offer vision of hope overseas

A group of volunteers is providing free treatment for people with cataracts. reports from Kampong Cham, Cambodia.

It was a big day for Om Saroeun, because the doctors she had consulted at the Kampong Cham Provincial Hospital in Cambodia had promised that she would soon regain her vision.

The 74-year-old went blind in her left eye four years ago and a cataract meant she could barely see with her right.

When she learned she could have the operation, Om Saroeun was nervous but elated. “If I could see again, I would no longer be a burden on my niece, who has cared for me over the years,” she said.

Two days later, a volunteer medical team from the Guangxi Zhuang autonomous region in southern China performed cataract surgery on her right eye.

The operation, which was provided free of charge, was performed in one of two mobile operating rooms. The units assembled in Foshan, Guangdong province, and then crossed the border, stopping just a few kilometers from the hospital’s ophthalmology unit, which is located in a dilapidated cottage.

When Om Saroeun entered the mobile operating room, she was asked to lie on a surgical table. A nurse injected anesthetic into her right eye before a physician extracted the opaque lens and replaced it with an artificial one. Om Saroeun was only conscious of the low hum of the surgical instruments, and within 15 minutes of the surgery starting, she was ready to leave.

A few days later, she could see clearly again through her right eye. “I could not afford the surgery, so I am grateful to the Chinese doctors,” she said.

A preventable problem

Cataracts are an age-related degenerative condition that affects seniors across the world. They cause clouding of the lens, resulting in impaired vision and even complete blindness.

The condition is considered the leading cause of visual impairment in many developing countries, accounting for 47.9 percent of all cases. Southeast Asia, including Cambodia, has the highest rate of preventable blindness, about 28 percent of the world’s visually impaired people, according to World Health Organization estimates.

In developed countries, cataracts are preventable and readily treatable because the surgery is relatively inexpensive, but in Kampong Cham, the most populous area of Cambodia, most seniors are unable to afford the operation.

Now, the problem is being alleviated by Chinese volunteers working to assist people in countries participating in the Belt and Road Initiative.

The average cost of cataract surgery in hospitals in the province is $100. That’s not a huge sum to Westerners, but it is a fortune to people such as Om Saroeun.

As a result, the condition is often left untreated, and as the cataracts worsen the patient usually experiences pain.

Om Saroeun used to work in a rice paddy, earning just enough to scrape by. Her plight is common in Kampong Cham, an agricultural area where 80 percent of residents are “peasant laborers” who grow rubber, rice, corn and other cash crops. When she lost her sight, Om Saroeun also lost her livelihood.

About 8,000 people in Kampong Cham have cataracts, but only about 300 operations to rectify the condition are performed at local hospitals annually.

In 2012, an official survey predicted that people ages 60 and older would account for 9.4 percent of Kampong Cham’s population within five years, and the number would rise to 14.3 percent by 2030. The estimates point to a looming issue as a growing number of seniors lose their sight to cataracts every year.

Noting the gravity of the situation, Leung Chun-ying, the former chief executive of Hong Kong who is now a vicechairman of the National Committee of the Chinese People’s Political Consultative Conference, established a humanitarian project called The Belt and Road Cataract Blindness Eradication Campaign and asked eight medical professionals from Guangxi to join him.

The project, the first of its kind to pledge help for every cataract patient in Kampong Cham, required close collaboration between surgeons from Hong Kong and the Chinese mainland, the Cambodian Ministry of Health and the Chinese business community in Cambodia.

“Our medical team will stay until the last cataract patient has had surgery,” said Leung, who wants to treat all 8,000 patients in Kampong Cham within the next 18 months.

Within three weeks of the campaign starting on May 17, the team from Guangxi had helped to restore the sight of more than 440 people in the province.

Operations, education

Om Saroeun’s surgery was performed by Zeng Nairen, chief ophthalmologist at the People’s Hospital of the Guangxi Zhuang Autonomous Region and lead surgeon of the visiting medical team.

Kampong Cham has a high incidence of cataracts, partly because it is home to the largest number of elderly residents among Cambodia’s 24 provinces, and partly because most locals are not aware of the damage that results from long exposure to direct sunlight, Zeng said.

The local people not only fail to wear sunglasses, but actively object to them.

This bias was illustrated by Muth Koeung, 84, and her sister-in-law Chhim Sambath, 74, who both had cataracts for years.

When they applied for the cataract surgery program and were asked why they didn’t wear sunglasses, the women chorused, “Sunglasses are for blind people.”

Chen Lifei, an assistant surgeon with the Chinese team, said, “The locals think wearing sunglasses is bizarre, and the language difference means it’s hard for us to educate them to wear sunglasses to protect their eyes.”

During postoperative care, the medical team works hard to persuade the patients to wear sunglasses. Thanks to a combination of a few words of Khmer and large amounts of body language, the Chinese nurses eventually helped Muth Koeung and Chhim Sambath to understand the importance of wearing sunglasses.

The stigma surrounding sunglasses and the widespread poverty among the local people have contributed to the relatively high rate of cataracts in Cambodia, according to Zeng.

In a study published in 2000, cataracts were found to account for 65 percent of blindness and 75 percent of visual impairment in the country. Those rates are probably higher now, given the rapidly aging population.

Heavy case load

Another factor contributing to the problem is that although 8,000 people need cataract surgery in Kampong Cham, there are only two resident ophthalmologists in the province. One is Por Norin, head of the Ophthalmology Department at the provincial hospital.

“It’s a given that we’re undermanned,” he said, adding that he and his colleague perform an average of 300 cataract operations every year, but they would need to perform more than 1,000 to significantly reduce the case load.

He said a lack of medical professionals and poor public awareness of optical health has restricted the number of operations performed in the past decade.

“It’s great to have Chinese doctors and nurses with us in Kampong Cham contributing their expertise and time to help ease the workload,” he added.

The two mobile operating rooms may eventually enable local medical staff to visit isolated villages and help people who require cataract surgery.

Impaired vision and blindness are also a blight on the Cambodian economy because they affect productivity. The global economy loses $227 billion every year to lost productivity as a result of poor vision, according to a 2016 report from the World Economic Forum.

Ngy Meng, director of the National Program of Eye Health in Cambodia, said the cataract surgery campaign will help to strengthen Kampong Cham’s economy.

“The current situation regarding cataracts in Cambodia reminds me of the Chinese mainland 15 years ago,” said Zhong Haibin, a lead ophthalmologist with The Belt and Road Cataract Blindness Eradication Campaign.

“As China’s healthcare system has matured, we, the nation’s physicians, feel it is our duty to provide help in countries participating in the Belt and Road Initiative.”

Many members of the medical team have spoken of the satisfaction they gained from helping cataract patients.

In an exclusive interview with China Daily, Leung, of the CPPCC, noted that the campaign goes far beyond the usual economic collaborations that underpin the initiative, and it has created an unprecedented medical partnership between the Chinese mainland, Hong Kong and Cambodia.

He said the campaign aims to “achieve shared growth through discussion and collaboration”, which is a major part of the initiative as proposed by President Xi Jinping and accords with China’s actions to deepen reform and opening-up.

A new life

Back at the hospital, Om Saroeun was able to walk into the examination room unassisted. Having listened to the doctors, she was wearing sunglasses to prevent irritation to her right eye.

Sitting among a group of locals who had also just undergone surgery, she was told she could go home.

“The first thing I want to do now is work in the rice paddy so I can maintain myself,” she said.

The operation only took 15 minutes of Om Saroeun’s life, but the effect has been miraculous. She has been spared a life of darkness and is now ready once again to take care of herself and earn a living.

Contact the writer at honeytsang@ chinadailyhk.com