Sunday 7 August 2016

Visual Impairment in Uganda

Visual impairment, is reduced ability to see. Visual impairment cannot be correct by glasses or other usual means. Blindness is used to describe complete or near complete loss of vision. Visual impairment may cause problems with activities like reading, driving, socializing and walking.

A gentleman helps lead a 
visually impaired elderly 
woman to receive 
treatment at Lira hospital
Key facts to be taken from the World Health Organization Visual Impairment Fact Sheet are that:
  • 285,000,000 people are estimated to be visually impaired worldwide: 39,000,000 are blind and 246,000,000 have low vision.
  • About 90% of the world's visually impaired live in low-income settings.
  • 82% of people living with blindness are aged 50 and above.
  • Globally, uncorrected refractive errors are the main cause of moderate and severe visual impairment; cataracts remain the leading cause of blindness in middle- and low-income countries.
  • The number of people visually impaired from infectious diseases has reduced in the last 20 years according to global estimates work.
  • 80% of all visual impairment can be prevented or cured.
The World Health Organization Visual Impairment Fact Sheet says that globally the major causes of visual impairment are:
Uncorrected refractive errors (that require glasses: Myopia, hyperopia or astigmatism), 43%
Unoperated cataract, 33%
Glaucoma, 2%.
An estimate of the Number of Persons With Disabilities (PWDs) in Uganda has been given in this blog. Based on 2014 population figures 376,975 people have some form of visual impairment.
There is a further risk of blindness and visual impairment in Uganda. River blindness is a parasitic skin infection. The African Programme for Onchocerciasis Control (APOC) states that in 2006 2,758,366 were at risk of river blindness or Onchocerciasis in western Uganda. A 2015 Onchocerciasis Study in Northern Uganda shows that an estimated 5% of the people in the at risk areas tested positive for the river blindness in skin tests. River blindness is a significant socioeconomic burden that can be treated with antibiotics. A 2013 article published by the World Health Organisation, Uganda interrupts transmission of river blindness in almost half of the endemic areas has the following comment:
Uganda has successfully interrupted transmission of onchocerciasis (River Blindness) in 8 out of 18 localized areas (foci) endemic for the disease and is likely to eliminate it by 2020.
This excerpt from an article from New Vision, about a married couple that are both blind makes interesting reading. Angella Apuuli and Sembataya live in Mawoto sub-county in Mukono district, a little south and to the east of Kampala. They have 3 children who are all blind:
"Sorry to make you wait," Angella Apuuli, Sembatya's wife, apologised as she put down what she was carrying. "I had gone to tend to the pigs," she said. The rat-hole of a kitchen and the mud-and-wattle pit latrine just a few metres away that lets out a foul stench, are pointers to the misery and poverty the family lives in.
Despite being visually impaired, Apuuli is a good-natured woman with a personality that puts others at ease. She is sociable with a high sense of humour and also speaks fluent English.
Seated on the veranda of their two-room house, Apuuli reminisces how she lost her sight. Her birth on December 11, 1982 in Kumi district was normal. She had her sight, but at only two years old, she lost it after suffering a life-threatening measles attack.
Measles attack
 She attended Madera School for the Blind for her primary education, studying all the subjects taught in a conventional school. The only difference was the use of a braille machine to read. She dropped out of school in S4 when her education was interrupted by the Lord's Resistance Army (LRA) rebel attack on Teso.
How they met
Apuuli's mother took her to Mbale Vocational School for the Blind in Nabumali, where she acquired skills in handcrafts, knitting and basket weaving. It was here that she met her husband.
"I was about 20 years old then. Sembatya approached me and proposed marriage. I did not take him seriously. After training, I was bound to return to Mawoto to take care of my sick mother. I gave him the directions and asked him to come and meet my mother if he meant what he said," she said. Apuuli was surprised when Sembatya, barely two weeks after she had left the institution, made the trip.
The couple's three children are visually impaired
Two things struck her; a visually impaired Sembatya coming all alone and by water via Luzira landing site.
"He pleaded with me, saying he wanted to marry me since both of us were visually impaired. He said we could take care of each other and told me that his mother had died and he was staying with a stepmother, who was mistreating him," she said.
Sembatya's emotional plea moved Apuuli to believe that he was truthful and serious. Her mother gave him a condition to take good care of Apuuli. He had just returned from the institution in Mbale and was jobless, staying with a relative in Mbiko.
"He visited me a number of times," Apuuli says.
After her mother's blessings, the duo rented a room at Mawoto trading centre in 2001. Two years later, they managed to build themselves a small house. Apuuli describes her husband as caring, supportive and loving.
Blind children
Her first born came in 2003 and brought her the happiness of being a mother. But her joy was short-lived when the child's eyesight started getting dimmer. He eventually lost his sight. They went to many places for treatment, but nothing could be done.
As if that was not bad enough, their second and third children were born visually impaired. Innocent Kabogoza, the first born, is now 11 years old and is in P3, Tito Muganga, 8, is in P2 and Timothy Jemba, 6, is in P1. They all go to Salaama Rural School for the Blind in Mukono.
The children were taken to Mengo Hospital where they were operated upon.
Muganga is now partially blind.
Apuuli says visually impaired children need the support and encouragement of their parents and it is important that they are given opportunities to explore, discover, learn and grow into responsible people.
"I am grateful to my parents for never discouraging me from doing anything based on my visual impairment. I was encouraged to do anything I wanted, including riding a bike, engaging in sports, cooking and studying braille," she says.
Apuuli's typical day
I have a wake up prayer in the morning. If I have somewhere to dig, I do so until about midday. Then I mop the house, prepare breakfast and fetch water and food for my pigs. Then I chat with my friends.
Most times, her husband is not at home to have meals with her as he leaves early by boat. Being a musician, he spends most of his time rehearsing or going around churches and functions entertaining people.
Apuuli is good at farming, but lacks land to cultivate. She has turned to piggery instead and a bit of digging. She sells the piglets and potatoes to supplement her husband's income.
"Someone may deny me a job because of my blindness, yet I can do almost everything. I can bake cakes, but I was shocked when I tried to sell mandazi at the trading centre but people refused to buy from me. I had to bring all of them back. Fortunately, my children were on holiday and they ate them. I can do any business if I get support," Apuuli says.
Sembatya was born blind
Sembatya, 32, is the fourth of eight children born to Musoke Senkungu of Mbiko in Buikwe district. He believes measles could have robbed him of his sight, though his parents still insist it was witchcraft.
He went to Spire Road Primary School (section of the blind) in Jinja up to P7. He then had to live a quiet life helping his parents rear pigs and chicken to get more income for his family. He joined Mbale Vocational School for the Blind, courtesy of Father Keveti, a Catholic priest, where he studied braille. Being intelligent and studious by nature, he quickly grasped special skills in handcraft and agriculture.
It is here that he met Apuuli, who offered him her heart and care. Sounding philosophical, Sembatya says: "Each one of us values certain things in ourselves. We look for complementary characteristics in each other."
"We always have to dig deep within ourselves to ensure that we are not making assumptions based on our condition and letting those prejudices spill over into our interactions. Obviously, blindness is a part of our lives," he adds.
Seeing his future in music
Sembatya is a humble, average man, who undertook an extraordinary feat singing gospel music. The Bible passage in John where Jesus says: "We must do the works of the one who sent me, while it is still day..." inspired Sembatya to preach the gospel through music. "My condition has not stopped me from pursuing my dreams.
I see my future in music. I write my own music, drawing inspiration from real life experiences. I sing about Jesus because there is nothing greater to sing about," he says.
You can sing about love, he stresses, but there is no greater love than the love of God. He started singing in 2005 and recently recorded a six-track album Fena Twagale Yesu.
The children were taken to Mengo Hospital where they were operated upon. Muganga is now partially blind
Community life
Sembatya is loved and respected in and outside his community. He says people are truly nice and supportive, understanding and helpful in a constructive way. He feels happy about himself and his family, their good health and their ability to move on.
He says visually impaired people move by instinct.
"Every day, we are changing what it means to be visually impaired. The sight of a blind person crossing the street independently, grocery shopping, travelling long distances and the thousands of other things we do really make a difference," he says.
Sembatya is grateful to the Lillian Foundation, a charity organisation based in Mukono that pays part of school fees for his children. Each child pays sh200,000 per term.
He also thanks the RDC of Mukono, John Kasenge, who often invites him to perform at district functions, where he gets financial assistance.
Angella and Sembatya both make a positive contribution to their community socially and economically. They have overcome stigma and prejudice to lead fulfilling lives.

For more information see Uganda National Association of the Blind's website and Facebook page.

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