African Oyster Trust director Lady Kira Dalton reports on the latest eye Jappineh Eye Clinic, which helped more than 90 patients in a single day at a cost of £2.50 per eye-test.

On Saturday 16th March the African Oyster Trust (AOT) helped to organise the Jappineh Eye Clinic which 91 patients attended.

It took place at the Jappineh Health Centre, run by the Trust. We provide all the medicines for the clinic and pay a small allowance to the local sight team from Soma Hospital, comprising an Optometrist, Surgeon and two students, for working at the weekend.

We test using an ‘illiterate eye chart’ (they have to say which way the legs are pointing on the letter E). Anyone who cannot see the middle line is referred to the sight team, who then check for refractions and issue them with trial frames. They choose the nearest available from a large collection of donated second-hand spectacles. Some also get reading glasses, as the chance of finding bifocals to suit is very unlikely.

Others are referred to the eye surgeon at Soma, about half an hour away.  There they diagnose more serious problems and prescribe medicines for glaucoma, and schedule cataract or other surgery. The Soma Hospital team are happy to work with the Trust as we were able to donate a slit lamp and other equipment to their unit a few years ago.

Usually, we have a small budget to fund a few operations for those who can’t afford to travel to Soma.  This includes the elderly, as this is a country where no pensions are paid.  

Of the patients who attended this year, 5 needed cataract surgery, and 3 have dates arranged.  25 will need future surgery for cataracts and 22 others for pterygiums.  Both these conditions are related to lots of sun exposure, which is why we give our staff sunglasses.  9 patients received glasses, including 2 children, and many were given eye drops.

The total cost of this the Jappineh Eye Clinic was 15,000 dalasis, which is about £230 - roughly £2.50 per patient - which I’m sure you will agree is money well spent. And there are enough eye drops and spectacles left to last the whole year.  This means that Jappineh Health Centre can now organise days like this maybe twice a year for a few pounds (to pay for transportation costs and providing lunch and rewarding the Soma people for working over the weekend).

A visit to the optician is something we take for granted in the UK and the rest of the developed world, but in The Gambia it simply doesn’t happen. The impact of this one day will have lasting benefits for the people who attended and help them to see a brighter, more in-focus future.

This is the final of four articles from Trust director Dee Bixley, reflecting on her recent visit to our projects in The Gambia.

Pursuing a longstanding land dispute case on behalf of donors to the Trust, Kira has received notification to attend court at 10am on Wednesday. I must attend too, she says, because it will be an excellent addition to my ‘Gambia Experience’.

General Manager Fanding has driven us here and he will help with translation. We arrive spot on time.

Naively, I’d assumed there would be some sort of Court building but as we walk into the Chief’s compound, I see rows of plastic chairs under the mango trees and realise this is Court. The chairs are empty and yet their presence does suggest that something will happen, sometime.

Gradually people do arrive, greet friends, sit down, have a chat or a nap. There’s an overwhelming air of resignation.

Meanwhile, all around and seemingly oblivious of our presence, the women of the compound go about their unceasing work, collecting water, pounding grain, hanging out washing - whilst tiny tots play in the sand, and goats, hens and chicks weave in and out of the chairs.

I find myself thinking about an old Fry’s chocolate advertisement for Five Boys: “Desperation. Pacification. Expectation. Acclamation. Realisation. It’s Fry’s”.

Three hours later, when the Court Clerk arrives, I have my Fry’s moment, entering what I can only describe as a state of ecstasy. OK it isn’t the Chief himself, but something is happening! I watch as the Clerk carefully dusts the table and then - is it him or the Court Usher - who wheels in the special Chief’s chair? And where did the Call to Prayer fit in? When you’re ecstatic you tend to lose track of the order of things. Meanwhile, Kira continues with her crosswords.

Fifteen minutes later the Chief himself arrives and tackles the first case of the day; witnesses bob up and down stating their evidence, and documents are scrutinised. Then, four hours and twenty minutes after we arrived, the morning session is over. Amazingly, Kira is beckoned forward and given a future date for her diary. She seems quite pleased. This Gambia Experience, it’s exhausting!

This is the third of four articles by Trust director Dee Bixley, reflecting on her recent visit to our projects in The Gambia.

One of the heart-warming aspects of Kira’s largesse is that everyone in her neighbourhood know that she’s there when they need help.  If a family can’t afford to pay for a prescription or they can’t get to a medical centre, Kira or her watchmen - all experienced first aiders - step in.  They have dealt skilfully with all manner of emergencies over the years.

I was there when the little girls, pictured here, came to support their friend, while her wound is checked, and bandage replaced.  A minor matter, perhaps, but their big smiles tell the story.  

Urgent knocking at the gate can occur at any time of day or night.  Late one afternoon, I happen to be nearest the gate - what calamity will I face?  

Three attractive young girls stand before me, looking robustly healthy to my untrained eye. They seem disappointed at the sight of me but then Celberr appears and it’s fascinating to watch the fluttering of their extension eyelashes. One girl makes a show of putting a hand protectively over her arm, but we hear later that there was nothing to be seen on her arm.  

My theory is that they came to admire Celberr and, well, who can blame them?!

This is the second of four articles, as Trust director Dee Bixley reflects on her recent visit to our projects.

We have booked a two-night stay at a modest guest house in Soma near Jappineh.  On arrival, we find the staff dazzled by the upcoming opening of the nearby Senegambia Bridge.  A momentous achievement, it promises to end centuries of trade chaos, and has taken 7 years to build.  Not surprisingly, journalists and photographers have been jostling for rooms, which is why (we discover later) our rooms for tomorrow have been double-booked.

Meanwhile, we surrender to our parts in a situation comedy.   My role has three room changes because the keys don’t fit or don’t lock or there’s no lighting.  So, I flit about unpacking, packing, unpacking and although it’s a non-speaking part I do indulge in some fruity ad-libs.

Kemo’s role is that of a gentleman, which requires no acting skill because he’s like that anyway.  As for Kira, she merely gives one of her famous shrugs and remains sanguine throughout.   
 
Strangely, my third room is behind fretwork bars, with a door that also has keys.  Kemo wants to make quite sure that my door key will work this time, so I proudly demonstrate my ability to double-lock.  We both jump in horror when the door swings open anyway!  Still, I’ll be safely behind bars.  

As we eat our evening meal, huddled on a tiny balcony, we receive light entertainment from the electricians alongside. 

“Did you know that roosters can crow all night?” is our question to each other over breakfast.  And who would want a second night being kept awake by them?  We’ll squeeze in more meetings today and drive back to Kombo later.  

As we get ready to depart, it is Kira’s turn to lose track of keys: her car keys.  Without them we are stuck!  Happily, she finds them in her handbag, and we drive away from the place.  Kemo shakes his head in bewilderment.  “Did that madness really happen?” he asks, as he forages for his phone - whoops!  He’s left it in his room. 

African Oyster Trust director Dee Bixley shares some reflections on her recent visit to the African Oyster Trust projects. This is the first of four updates, the rest of which will follow over the coming days...

Kira, Kemo, Fanding and I head up country to the Jarra Region, where the Trust supports the Jappineh Health Centre, a psychiatric service, and a school.  

The many boxes of medication with us must be kept cool, so we’re in a hire car with air-conditioned luxury.  
Kira’s own car has no air-con.  As she says, it’s reliable and very economical to run, so why change?  And she is not impressed with charities who waste money on costly cars for their staff.                     
         
During a community meeting in the Centre’s grounds, Kira and the team report on a very busy 2018.  The need for a further nurse is underlined, to help with the increasing flow of patients.  This is being addressed by Officer in Charge, Ansu Manjang.   

It’s a lively meeting with many points of view, proving the community’s passion for its clinic.  The Bank Book is passed around, and there are updates on significant progress towards long-term sustainability.     

Another development is that under the auspices of The Global Fund - an organisation designed to accelerate the end of AIDS, tuberculosis and malaria - Gambia’s Ministry of Health & Social Welfare has built a brand-new laboratory alongside the Centre.  Kira has since been advised by the Ministry that they will donate a fair few items for the lab.

The Trust continues to fundraise for more equipment, and to maintain supplies of all the consumable items needed to run a laboratory successfully.

There is 1 doctor for every 15,000 patients in Gambia.  If that isn’t a statistic that underlines the importance of the Jappineh Health Centre, I don’t know what is.  Our experienced nurses and technicians serve a catchment area of 30,000, with up to 1,000 patients a month.