ALTHOUGH blindness appears to a lesser health problem in Tanzania, there is a growing population of people with visual impairments. The most critical cases are in the central zone.
Indeed, the nation carries little responsibility in terms of blindness and visual impairment. Caring for a blind person is a monumental task. This task is even much greater if that person is a child.
Indeed, the predicament parents and guardians face when raising a blind child can be daunting. Adult blind persons are, however, more demanding. It is a situation that evokes a lot of compassion, for some children are born with visual impairments.
Unfortunately, in rural villages in Tanzania some blind people, including children, face great discrimination and abuse. Here blindness is a taboo and is seen as a result of a curse caused by bad customs such as witchcraft.
Discrimination is so deeply rooted in some minds that people do not want even to touch a disabled person. There remains, therefore, no help or respect for the blind or for the mothers who are seen to have caused the disability of their children.
In some cases, the father will shun the family after the birth of a blind child and will leave all responsibility to the mother. Blind children are marginalised and often grow up without education, skills or disability aids and with significantly poor health.
Many schools are not equipped or designed to teach disabled children. They do not have the specialist staff nor the necessary equipment, for example books in braille.
Whatever the case, all parents, the government and society generally must protect the blind. A common folklore in some Tanzanian tribal settings has it that a young man who was blind right from birth was accorded by Almighty God a brief moment, about two seconds, to see.
The man appraised his surroundings in a hurry with amazement bordering on awe. He was astonished to see a donkey grazing about three metres away from him. He was, indeed, overjoyed by what he saw.
The object, which was busy eating grass, was stunningly beautiful. Unfortunately, before he could apprehend the world around him, his blindness returned. He was told by those around him that he had just seen an animal called a donkey.
The blind young man remarked that the donkey was “stunningly beautiful. One day the blind man heard some men talking about the beauty of a young woman. He asked rather impatiently: “Is the woman you are talking about as beautiful as the donkey I saw the other day?” Everyone was dismayed by this question. However, one of the men understood the blind man’s predicament.
He answered: “Yes.” A child who is blind has a high degree of vision loss. However, about 18 per cent of blind children are totally blind -- most can distinguish between light and dark.
Childhood blindness has an adverse effect on growth and development. Parents should make sure that severe visual impairment and blindness in infants is detected as early as possible to initiate treatment to prevent deep blindness (amblyopia).
Although difficult, measurement of visual acuity of an infant is possible. Screening in the first few weeks of life can prevent blindness. When a child is partially sighted, he has a less severe loss of vision.
Partially sighted children can see more than blind children but less than good sighted children. We cannot read the minds of young children. If we could, there would be many surprises.
A child who is born blind does not know what it is like to see. Until he or she is old enough to begin to understand how other people do things, blindness seems normal.
Like other children, blind children need to learn about appropriate and inappropriate behavior. This gets a little complicated sometimes because blind children should do some things differently.
For example, it is okay for a blind baby to feel your face, and they often do. But this becomes socially unacceptable later. Before school age a blind child needs to learn that it is not a good idea to put their hands all over other people.
This means parents have an extra responsibility in teaching social skills to their blind children as their ages advance. They need information even when they don’t ask for it and don’t take it.
We must keep reminding our children when we see inappropriate behavior. Therefore, a small child will not feel bad about blindness until someone teaches him or her directly or indirectly to feel bad.
Blindness is something we explain little by little as a child progresses toward school-age. Because nobody knows when a blind child really understands what blindness is, it should be discussed with him in a positive manner.
Anything associated with blindness should also be approached positively. Learning to use a white cane or being able to read Braille can be an opportunity and a privilege, not a last resort.
Braille is a special way for the blind to read with fingers. These positive approaches inform the blind child that it is okay to be blind. Parents or guardians must not lament in the presence of their blind children about their inability to see.
This conduct is likely to wreck the life of the already unfortunate child. So, it is not helpful to make comments such as: “I wish you could see the birds out the window,” Or “I wish you could see the pictures in this book.” But we can say, “Do you hear the birds singing? They sound nice.” Or, “Do you hear that cat meowing? It is hungry.”
Parents and caretakers must share what they see with a blind child as a pleasant and normal part of communicat ing, not as a constant sad reminder of something a child is lacking.
It is not proper to ask a blind child: How much can you see? Can you count my fingers? Can you see that color? Can you see that cow? Sometimes the child tries to cooperate, and sometimes he doesn’t.
Too much talk about what he can see will bore or confuse him. Why does it matter so much? Is the amount a child can see really the most interesting and important part of him? Of course the doctor must do eye tests, and as a parent you want to have some idea of what your child can use vision to do, but this is enough.
As mentioned before, blindness can be brought on by numerous disorders and accidents. Some people, including children, suffer from a non-fatal but highly repugnant eye ailment called trachoma trichiasis.
This is a chronic disorder that mainly affects the inside of the upper eyelid (tarsal conjuctiva) due to repeated infections by a causative agent called Chlamydia trachomatis.
However, trachoma is a highly treatable disease that, in most cases, affects the unclean. These agents are produced by tiny flies (Musca sorbient) that are much smaller than the common housefly (Musca domestica).
The tiny flies breed the agents in a pit latrine, animal dung or human excreta. Children living near animal enclosures risk contracting the ailment. Total blindness ensues about twenty years later.
The tiny flies introduce the agents (Chlamydia trachomatis) into human eyes when they settle on the eyelashes to feed on the watery discharge (tongo tongo). Gray lumps (follicles) or small swellings appear in the inner side of the eyelids after an incubation period of one month.
A child (or adult) who experiences the uncomfortable itchy sensation is likely to rub the infected eye with the back of his hand. He may, unwittingly rub the other eye with the same hand transferring the trachoma causing agents and ending up with quite a conundrum.
Affected eyes redden and develop an itchy sandy sensation with a continual watery discharge. The irritation develops into an inflammation that disturbs blood vessels in the area.
Later on the swellings disappear as the case advances into an ugly trachoma scar. Both eyelids contract with the insides getting rougher. Repeated infections worsen the eyelids’ condition with the scars developing folds and the itching sensation worsening.
After about 20 years the continual scratching of the eyeballs as a result of callous eyelids damages the cornea.