An eye for an eye

One in every ten Nepalis is visually impaires and corneal defects are the second boggest cause of blindness after cataracts. The transplantation of a new cornea is the only way to cure such blindness

by RUBEENA MAHATO

FROM ISSUE # 176 (August 2010) | IN THIS ISSUE
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ALL IMAGES: JANA ASENBRENNEROVA

Bishnu Bhattarai, 41, is a teacher from Surkhet. He thought he knew what it meant to pass on the light of knowledge to his students. "I had been teaching for many years and felt happy about opening the eyes of my students," he says, "but then the unexpected happened."

After minor discomfort in his left eye and blurred vision, Bhattarai woke up one morning with excruciating pain. Within days, he was completely blind in one eye and his right eye was so sensitive to light he couldn't open it. For two months he stayed in a dark room. "I thought that was the end of my life," Bhattarai recalls. "Being a teacher, being blind was as good as being dead."

Today, thanks to the eye donation program at the Tilganga Institute of Opthalmology, Bhattarai has regained his sight with a corneal transplant to replace his, which had been damaged by a fungal infection. The cornea that allows Bhattarai to see came from a seven-year-old girl who committed suicide. The girl's father, who had brought his daughter for cremation to Pashupati two weeks ago, consented to donate her eyes after Tilganga's Eye Bank team convinced him.

The Eye Bank is the only one of its kind in the country, and has been harvesting corneas for transplantation from the nearby cremation site since 1996. The team try to convince grieving relatives that donating the corneas of the deceased can help the blind see again. It is not an easy job, and most refuse. But Tilganga's cornea excision centre at Pashupati has seen an increase in the number of donors. The Eye Bank team at Pashupati harvested 214 pairs of corneas in 2008, compared to just two in 1996.

One in every ten Nepalis is visually impaired and corneal defects are the second biggest cause of blindness after cataracts. The transplantation of a new cornea is the only way to cure such blindness.

"Most of our corneas are a result of grief counselling of relatives in Aryaghat," says Sankha Narayan Twyana, manager of the Eye Bank. But the taboo against organ transplantation is still very strong, meaning few people pledge donations. "We have very few voluntary donors and most of them are the relatives of the people who have received such transplants," Twyana says.

Tilganga offers free transplantation services and the patients only need to pay for medicines and a small entry fee. "We thought that if there were no money involved, we could discourage the black market in organ transplants," explains Bhola KC of the Eye Bank team.

Most grieving relatives think the eyeball itself is excised and the deceased will be disfigured, but many consent once they realise what they are doing will transform the lives of two people. A pair of donated corneas is always given to one eye in two people.

When Saroj KC prepared to cremate his seven-year-old daughter at Pashupati, the last thing he wanted was to be approached by someone asking him to donate his child's eyes "I was in grief. My child was gone. I didn't want to give anything to anyone. I just told them to leave," KC says.

The Eye Bank team had already left when KC sent someone to call the team back. KC still can't explain why he changed his mind. "I thought if her eyes could help two people to come out of the darkness, at least they would bless her soul," he says.

And the child is blessed indeed. "I pray for the girl every day," says Devi Bhattarai, wife of Bishnu Bhattarai. She cannot stop thanking the family who agreed to the donation: "My husband got his life back. Is there anything more one can do for strangers?"

Devi has herself pledged her eyes for donation after her death.

The names of the donors and recipients have been changed to protect their identities.