Samson Lokele is a dedicated health worker and surgeon based in Turkana in northwest Kenya. His work is helping to bring the country closer to eliminating trachoma, the world’s leading infectious cause of blindness.
Samson has been a trachoma surgeon for more than 10 years and has operated on more than 4,700 people throughout his career.
“I started working in eye care in 2007 and that’s when I found out that there wasn’t any attention being placed on trachoma in the area,” Samson says. “People had this belief that there was no trachoma in Turkana. I became the first trachoma surgeon in the county.”
It wasn’t until 2010 that research began to discover how widespread trachoma was. That year, surveys were carried out across Kenya: the findings showed that trachoma was endemic in Samson’s region.
“The findings of the survey were extremely alarming,” Samson says. “Turkana was the leading trachoma-endemic district in Kenya.”
Samson’s work is part of the permanent exhibition Medicine: The Wellcome Galleries, which features replicas of the surgical equipment used by Samson.About the exhibition
Turkana is a remote county with desert terrain, and these dry, dusty conditions, coupled with a lack of water and sanitation, had enabled trachoma to spread. Following the survey results, health workers introduced a strategy known as SAFE (which stands for surgery, antibiotics, facial cleanliness and environmental improvements), endorsed by the World Health Organization, to try to reduce the spread and prevalence of the disease.
The residents of Turkana are nomadic communities. Many people rely on livestock for their income, which can mean it takes priority over their own health. Often, the communities are not aware that help is available to them.
“We aim to educate communities and traditional healers so they know we are there to help and explain how they can prevent this disease from reoccurring,” says Samson. “After many years of education, advocacy and social communication, attitudes are slowly changing.”
To help reach the nomadic communities, Samson and his team take health services directly to them, but this brings its own challenges.
“Getting to isolated communities can be dangerous,” he says. “There are often no roads, or there is thick jungle you have to cut through. I’ve lost count of the number of times my car has been stuck in mud or sand. But you can do this surgery almost anywhere, as long as the quality of the surgical procedure is up to standard.”
Samson doesn’t need high-tech surroundings. As long as the equipment is sterile, pop-up operations can take place anywhere in the Kenyan desert – including in well-lit churches, schools, or even outside.
“The best part of my job is when I reach someone with trichiasis who is willing to have the surgery, and I am able to restore their sight,” Samson says. “They are always so grateful and thankful, and most are keen to become ambassadors themselves, bringing others from their villages who need the surgery.”
Kenya’s national trachoma programme, supported by Sightsavers and partners, has helped expand the county’s trachoma team to include nine other surgeons, 18 ophthalmic nurses, three optometrists, 38 assistants, 252 community health workers and almost 2,200 volunteer case finders.
This intensified effort has had a significant impact, as shown by the dramatic decrease in the number of people requiring trichiasis surgery. Mass surgery camps in Turkana have now ceased as they are no longer required.
Samson currently works for the Kenyan Ministry of Health, where strategies are being put in place, with Sightsavers’ support, to ensure people in remote areas like Turkana are no longer left behind. But there is still work to be done, as Turkana still lacks adequate water and sanitation.
As part of collective efforts to eliminate trachoma, Samson takes part in cross-border missions in Uganda, Ethiopia and South Sudan, to reach more people living in remote areas who have not been able to access treatment.
“The challenge in cross-border work is that there is no specific body in charge of the borders, where neglected tropical diseases are prevalent,” explains Samson. “There are no networks, no roads and no social amenities to help get to these hard-to-reach areas.”
In 2010, while working in Turkana, Samson met Akiru, a 23-year-old mother of two who had trichiasis in both eyes. “Despite my attempts to advise her that she needed surgery, she refused,” says Samson. Six years later, he learned the nomadic community had moved into Uganda, and he was part of a cross-border mission there when he saw a familiar face.
“The outreach started in Kobebe, and the first patient I met was Akiru,” Samson says. “She was in a lot of pain and now had severe trichiasis in her eyes with some scarring. I was so excited to see her; this woman who had refused surgery all those years before was here to receive surgery. We performed surgery on both her eyes and her sight was saved. It gives me hope that my people will not have to go blind like they used to.”
Samson is proud to be part of the efforts to eliminate trachoma. “I have followed this programme since the beginning, and I have seen a huge amount of progress,” he says. “It’s great to see more people backing this idea and striving for a world that is free of trachoma.”
Images © Tommy Trenchard and Tobin Jones