A day in the life: the only ophthalmologist in Karamoja

My daily routine

I usually wake up quite early, do my aerobics and make breakfast. By 9am I’m usually at the hospital. My clinicians arrive at the hospital before me and start seeing patients.

In Uganda, untreated cataracts are the main cause of blindness – 43.8% of all cases. A lot has to be done to improve eye care in Uganda, and we rely on donor funding. If Sightsavers had not supplied me the microscopes and everything that I use for surgery and for diagnosis, I would be a very redundant ophthalmologist here.

As the boss, I see any patients with challenging conditions. Our team sees about 50 patients for consultations and treatments, and book them in for cataract surgery.

If it’s a theatre day, we work on an average of 10-12 patients each day, and end at around 3pm or 4pm. If it’s a normal working day, we close the clinic at 5pm. I’m usually free at the weekends, but we work on call in case there’s an emergency, and then I’m there.

Some days are interrupted with hospital activities such as quarterly performance review meetings and quality improvement meetings. But I try to balance them and ensure that everything is running as required.

The challenges – and the rewards

There are many challenges in my work. One: being female – it’s hard. There’s always a tendency to overlook females who are in positions of leadership and who head up a department. It’s challenging to manage people who can’t imagine how I, as a young woman, can come in and tell them what to do.

Another challenge is that I’m also the only ophthalmologist in Karamoja – I keep hoping that with every year, I’m not still saying this. When I go on leave or if I fall sick, service delivery is cut and this disadvantages the patients who have travelled from many kilometres away. Imagine if someone is referred from another district of Karamoja that is more than 20km away, and they come in and find I’m on leave. I’m trying to do as much as I can, but it’s not a nice situation.

Before I came, Karamoja subregion had never had an ophthalmologist. My job comes with a lot of responsibility and a lot of work because I oversee the entire eye care service in the subregion. Karamoja has a population of around 1.2 million people and the catchment area is approximately 2 million people.

That means that despite my work here, I also have to make sure that the other smaller health facilities that have ophthalmic clinical officers are running well. I have to support, supervise and enhance their skills and ensure that they’re referring the patients. So generally, I am everywhere!

The inclusive eye health programme

The official name of the inclusive eye health programme I help deliver is ‘Improved access to affordable, quality eye care services for people with and without disabilities in South-West region, Malawi and Karamoja, Uganda.’ This is a three-year programme that aims to reach people who traditionally face barriers in accessing health care, including people with disabilities, nomadic communities, and women and girls.

Since it started in 2020 the programme, funded by the UK government through UK Aid Match, has helped more than 21,800 people access basic eye health.

There are lots of barriers that people with disabilities face when trying to get access to eye care. In many cases there is no one to bring them to the hospital and they cannot come on their own, so they often have to rely on someone else. This is really a very huge barrier.

To tackle it, we now work in collaboration with the division of disability and rehabilitation services; if people can’t reach the hospital, we can go to them in their homes and bring them to the health facilities.

A lot of people also don’t know about the services being offered. They think that because cataracts mostly affect older people, it’s just a normal disease and nothing can rectify it. This is a big lack of information.