One man’s victory in unequal fight for sight
A PE man has had his sight restored after fighting for a cornea transplant for 10 years.
The specialist ophthalmologist who performed a cornea transplant free of charge for a Port Elizabeth man who had been on the waiting list for close to 10 years has published research showing that state patients are allocated the smallest share of the few available corneas.
It is a disturbing trend that made the determination of Aphiwe Mene, 25, to fight for his sight to be restored even more remarkable. When Mene was told by doctors that he would have to be on a waiting list for more than a decade to have his sight restored, he refused to believe there was no other solution for his rapidly deteriorating sight.
When Mene’s sight was restored through a cornea transplant earlier this month, doctors, members of Lions Club International and hospital staff all praised him for his remarkable resilience and determination.
However, research done by his transplant ophthalmologist, Dr Nick York, showed that there are many patients in state hospitals who will probably never get help, as the system has become skewed against them.
York’s research published in the South African Medical Journal has found that poor public awareness of and cultural issues regarding organ donation, high HIV and hepatitis prevalence and poor education and “buy-in” of medical personnel with regard to referring potential donors to transplant co-ordinators have all contributed to the low numbers of corneal donors in state hospitals.
“Only a very small proportion of patients who die in SA government hospitals become organ donors. More than two-thirds of donated corneas were allocated to the private sector at all three of the major eye banks, even though there is much greater demand for corneas in the public sector,” he says.
York explained that eye banks treat each private practice ophthalmologist and each public sector ophthalmology department as an individual practitioner and attempting to distribute the corneas evenly among them is complicated.
“Eye banks are non-profit organisations, whose sources of income to cover running costs and salaries arise from financial donations and remuneration for corneal tissue supplied. While private sector patients are able to pay for corneal tissue through medical aid funds or personal finances, public sector ophthalmology departments have very limited budgets available to pay for corneal graft tissue and a much slower turnaround time for payments,” he says.
He also found that legislative changes barring eye banks and transplant co-ordinators from accessing personal details of deceased people held at the state’s mortuaries have also led to a decline in cornea transplants.
At the age of 12, Mene was diagnosed with a disease called keratoconus, which causes the cornea to thin and gradually bulge outward into a cone shape.He was eventually placed on the waiting list for a cornea transplant, but in South Africa, patients wait for about a decade for the procedure.
“I have been on that list forever,” he says.
Despite his increasing struggles to see, he passed matric and began a degree in public relations. But in 2016 his deteriorating sight forced him to drop out of university.
In 2019, Mene, who by then had sight in only one eye, lost almost all his vision after an accident in which he received a blow to the eye that still had some vision. He visited a doctor in Cape Town and tried to raise funds for a private transplant using a cornea from overseas, but when that didn’t work out he turned to Lions Club International for help, and got in touch with Freddie Erasmus from Lions Clubs in Nelson Mandela Bay.
Erasmus took Mene for medical consultations, ending up with York at Life St George’s Hospital in PE. Various Lions Clubs contributed to the cost of importing a cornea.
“To access a cornea internationally will cost between R35,000 and R43,000, depending on the exchange rate,” York says.
“After I examined Aphiwe I discovered that his injured eye could not be saved, but he was a prime candidate for a cornea transplant on the other side,” he says.
York – who did the operation free of charge – said the transplant, performed last week, went very well, and added that he was confident that Mene would make a full recovery and regain sight in his remaining eye.
A happy Mene says: “I can see now. My sight was a big problem for me. My family is very excited.”
Riaan Croucamp from Life Healthcare said they had carried the hospital costs for the transplant, as they also wanted to help Mene.