‘There’s hope for him now’: how a poor rural Chinese boy was saved from going blind
China, the world capital of preventable blindness, is training doctors and working with NGOs to give its rural poor a chance at a clearer, brighter future
Gu Kaiwen always knew something was wrong with his son’s eyes after the child was born four years ago. Xiaolong would stare at lights for long periods of time, and his eyes rolled in a strange way.
He constantly fell because he could not walk steadily without the support of an adult, and his face had to be very close to, almost touching, the paper if he tried to look at what he had drawn.
However, being from a poor ethnic Yi minority family in the mountainous Guangnan county in western Yunnnan province, Gu did not have many options.
Soon after Xiaolong’s birth, Gu left the child in his grandmother’s care while he and his wife went to work in a factory in Yangjiang, Guangdong.
But Xiaolong’s fate took a turn for the better in June when a team of doctors from Wenzhan prefecture visited the family’s remote Weinaji village and diagnosed the boy with congenital cataracts and amblyopia, also known as “lazy eye”.
Xiaolong soon underwent surgeries in Wenshan Prefecture People’s Hospital. Gu paid 1,100 yuan (US$160) for two hospital stays, and the Fred Hollows Foundation, a global eye-health organisation, paid for an imported intraocular lens, an implant that treats cataracts and myopia.
“He can play in the cornfields because he doesn’t fall easily any more,” Gu said. “Doctors said his amblyopia will improve later. There is hope for his future now.”
China has the highest number of avoidable blindness cases in the world, accounting for 17 per cent of the global total.
Cataracts, typified by clouding of normally clear eyes and worsening eyesight, is the No 1 cause of blindness. China has around 5 million cataract patients, mostly rural residents without easy access to quality ophthalmology services like Xiaolong.
If a patient has no other eye diseases, cataracts can be treated with a simple surgical procedure that removes the clouded lens and replaces it with a clear artificial one.
A national five-year plan said blindness caused by cataracts among the poor, rural population remained a serious problem, worsened by uneven medical resources.
“Most surgeries in ophthalmology department involve microsurgery, and China is a latecomer in that field,” said Amanda Huang, country manager of the Hollows foundation, a non-profit group that trains ophthalmic specialists and helps reduce cataracts and other eye diseases. “It is understandable that you will find more ophthalmic surgeons in more developed areas and less medical resource – more patients in the less developed west.”
“We think cataract should be treated in a county-level hospital, but not all such hospitals have an ophthalmology department or have a team that are capable for performing cataract surgery,” Huang added.
Beijing has recognised the problem, and since 2009 a government drive has worked to treat poor rural residents with cataracts. By 2015, the cataracts surgery rate for every one million Chinese reached 1,500, and the government is hoping to increase the rate to 2,000 per million people within two years.
Non-government efforts like the Fred Hollows Foundation are helping relieve the burden.
“You see many eye-health organisations and you wonder why there are still so many people needing help – China is turning into a grey society, and 80 per cent cataract patients are elderly people over 50 years old,” Huang said. “Their access to ophthalmology service is limited.”
That was the case for Xiaolong, His family lives in a remote part of Yunnan, a six-hour drive to the prefecture centre.
After the visiting doctors’ diagnosis, Xiaolong was taken to the prefecture hospital for two operations, one on each eye. Although his sight is not yet normal – doctors told Gu it would take one or two years for his son’s amblyopia to improve – the boy is expected to be healthy in time for school.
Soon after the operation, Xiaolong told Gu: “Dad, I can see things now.”
In China, the foundation that helped Xiaolong has screened nearly 3 million people for cataracts, diabetic retinopathy and refractive error and performed more than 93,000 cataract surgeries with partner hospitals in 20 years.
It has partnered with health authorities in Jiangxi, Yunnan, Inner Mongolia, Xinjiang and Anhui to establish a training centre at a provincial-level hospital to educate county-level doctors.
In counties where there is no ophthalmology department, willing doctors can be sent to hospitals that are strong in the field for study and hands-on training until they are ready perform cataracts surgery on their own.
Zhang Jinyang, a doctor of internal medicine in Lixin People’s Hospital in Anhui, joined such a training program three years ago, studying ophthalmology in Yunnan, Tianjin and spending three months learning to do cataract surgery in Hefei.
Zhang, who can now perform cataract surgery on his own, said the happiest moment in his career was when he heard a patient’s comments after he removed the dressing from her eyes.
“The doctor is very good-looking,” she said.