Esther Ibrahim

I: we will like to know your name and your age? R: my name is Dahiru Abdulakadir Karofi, I am 54 years old I: can you describe to us the kind of job you do? R: I am retired from Government work, I am now on my own and I am a registered nurse, I did an advanced diploma in community Eye, by the grace of Allah when these volunteers came looking for those who studied optic related courses, they trained us on TT surgery, by the grace of Allah after the training, I have done a diploma in eye surgery, I received a training at the National Eye Center on this aspect of Trachoma but even with that , they came and retrained us, tested us and gave us certificates. I am among those that conduct operation since they came to Katsina state for the past four- five years I: can you give us detailed explanation on how you implement your work from the beginning of the eye surgery in the theatre till the end? R: Trachoma is a sickness which is gotten in areas where is lacking clean water especially in the villages, before we commence work, advocacy is the first paid to the community leaders with volunteers to explain to them the purpose of why health workers are coming into their communities. We tell them we are looking for those with eyelashes that touches the eyeballs/ cornea regularly which may burst the eyes leading to blindness (God forbid), but by the grace of Allah, if we go for advocacy and get the approval of community leaders, we go ahead to train people within the community who will go into the houses, mosques, naming ceremony gatherings to create awareness, if they get people with this predicament, we come to where they are because in almost all the villages there are hospitals, the hospital closest to them is where we go and conduct the procedure When they come, we will explain to them that the surgery does not require us touching the eyeballs but it’s the skin around the eyelid that is used to fix the eyes, we don’t call it eye surgery because if we use the term eye surgery, people have the fear that we are going to remove their eyeballs completely, so we tell them we are going to fix their eyelid/eyelashes which we have been doing and it’s been successful by the grace of Allah I: why did you choose work in the eye field? R: just like I said, in our training on the general nursing curriculum, when you finish there is something called Post-basic: post-basic is when you go and specialize in a particular field and I chose to specialize on the eye because within my immediate community there is nobody that studied eye related course. Firstly when I finished school of nursing over 20 years ago, I went for diploma at ABU (Ahmadu Bello University) in the eye field, after which I proceeded to continue my work, then National eye center opened a new study line of Advance Diploma in community eye. This Advance Diploma is done after you have done a first diploma on eye, in every state one or two persons are selected, in short we were only two from Katsina state they were sent to undergo this course, after we came back, we continued with our normal jobs when this health organization came along and told us they wanted to work on Trachoma, we were sorted after and they trained us though we’ve been trained already and we were selected I: Approximately how many years have you been working on the eye health department/field? R: I have worked for approximately 20years in the eye field I: how did you find yourself working on Trachoma? R: when it was time for survey, they looked for those who studied eye related courses in Katsina state, this survey included all the small communities where there were possibilities of finding Trachoma cases, after the training our names where the first to get enlisted for the survey, after the training we conducted the survey and submitted data, you know how NGO operates, 3-4 years after the survey they came back and looked for those that did the previous survey, they picked and examined, if you pass the examination then you will be selected I: after this, is there any other training you received on Trachoma? R: yes, there is usually a review after the training where you will be called and shown new concepts/ ideas on how to work because every work evolves and improves over time. For example, with the coming or Covid-19 we were retrained we the TT Surgeons on how to wear Mask shield for our patients so as to prevent the spread of the disease (Covid-19). We were trained on that I: Are there challenges faced on the job? R: Just like you know there is no job that is void of challenges, the challenges we are facing is after training young persons that will go scout for those with this ailment, they end not doing the work. Out of 10 persons trained only about 2 will diligently do the work, that is the reason why after the survey, you will know there are cases in the villages but they don’t come forth I: can you estimate the number of persons you’ve conducted surgeries on? R: honestly just like I told you I have worked for five years and there is no local government area within Katsina state that I’ve not gone to work I: will they be up to 100 persons? R: honestly they will be more than a hundred persons I: 500? R: they are more than 500 I: do you have an estimate number of persons you have operated on? R: approximately or averagely 3,000 persons I: what motivates or gives you joy in this job? R: my greatest joy is when a person comes with a blurry or poor sight that can’t see, with teary eyes but by the grace of Allah one - two weeks after the surgery they come back appreciating and thanking us. Some of the villagers come with groundnut to express their joy and thanks for the surgery and it’s those successful surgery patients that will refer more patients to you I: how do you feel when you see you’ve assisted a person to regain his/her sight? R: as a health worker, the joy knows no bound I: how will you compare or explain the lives of those that are blind in this area/ environ? R: blindness is challenge sent by Allah, if there is a blind person in a house, it might end up affecting the lives of his/her children or grandchildren because the blind person need constant assistance going to the toilet, fetching water, washing, etc. so you can see that the blindness will end up affecting a lot of people not just one person I: how does TT affects the lives of those with it? R: like I said earlier, this ailment affects those that live in a poor hygiene environment, where there is no clean water, dirty environment etc., first it will affect your daily live Secondly, it will stop you from acquiring education, it will stop you from doing business, and it will stop you from living your best life which makes your life come to halt I: why do you think some people will not come to seek medical assistance? R: just like I said earlier, Trachoma cases are mostly from the villages where there is no proper awareness and people from those villages lack the resources to come to the big cities for surgery I: what do you think will happen to the person who does not get operated on? R: the eyes can be compared to clothes, if the eye lashes keeps rubbing against the eyeballs it will burst the eyes will lead to blindness I: what are the effects of the Trichiasis surgery? R: this Trichiasis is a condition where two- three eyelashes rubs against the cornea, continuous rubbing against the cornea regular can lead to great danger but when a surgery is performed, by the grace of Allah firstly the poking will stop, secondly if the damage isn’t much the sight will restored back which will enable him/ her to live a normal life just like the rest of the people in their society I: How does the Accelerate program helps in curtailing this disease? R: we want to sincerely appreciate God almighty for bringing Helen Clark and sight savers in collaboration with the Katsina State Government, there is nothing greater than giving your society health especially eye related I: what is the importance of seeing/sight? R: If 10 people were asked to choose between removing their hands or eyes, I am positive that all of them would go for their hands because nobody wants to live without their eyes. The eyes are our mirrors, with the eyes you can read, drive , you can do so many things but without them you would be limited. I: How has COVID-19 affected your work? R: The eyes affects everything, including the brain, there is also an interconnection between the ears,nose and the eyes. COVID -19 definitely has an effect on the eyes, that is why we were specially trained. I:What were the effects of the stoppage of work during the COVID-19 global pandemic? R: It’s a global pandemic and for African Countries, especially our nation Nigeria where there is high rate of poverty. The patients were always calling to ask us when we would be resuming and those that had had the surgery were eager to bring new patients for us to work on. I: How do you feel about being back to work and what are some of the preventive measures you have been taking against COVID-19? R: I have already worked with the government for 35 years and its been almost 2 years since I retired but my thoughts are always on how I can help my community especially in the area of eye health. One of the down side is that if you are not properly trained, you wouldn’t be able to do anything. I: What impact does this job have in your life? R: Like I told you, I am a pensioner, have served and done my work but at he same time there is work that needs to be done because sometimes when I am at home, people come and seek help for their eye problems. I: Are there benefits that you have obtained from this job? R: The benefits would be to thank God for everything, because you don’t really earn much from this job. I: Do you think the preventive measurs that are being taken to curb COVID-19 will in turn help the people in preventing Trachoma. If yes, why? R: Before COVID-19, we have been encouraging the people to practise good personal hygiene. It is one of the ways of controlling Trachoma, even when we go for community visits, we always tell them to wash their faces and we also give them drugs. So I feel with the COVID-19, preventive mesures have been an added advantage. I: You mentioned villages that don’t have clean water and COVID requires using of clean water, how do you think they will protect themselves from COVID-19, when it has been established that protecting themselves from COVID will in turn help them curb Trachoma? Do you think there are other preventive measures that can be given to them, like maybe giving them hand sanitizers or what do you think? R: There is this program called WASH, it is really helps in relation to Trachoma, especially in schools, toilets are being made for them and clean water is also made available for them to use. Its going to be very hard to find a school that doesn't have toilets and clean water available, this has helped a lot too. I: There is an application called TT tracker, what is its use and how is it being used? R: We were trained on TT tracker specifically, TT sergeant and TT assistant were trained. When you are at home, you can keep tracks of those with the case by accessing and also you have their addresses, so its easy to identify those with the cases. I: Does it help during post surgery follow up? R: yes it helps a lot. I:What do you think are some of the reasons that hinders the effective use of the TT tracker? R: The biggest challenge is that some of the things we use require electricity and we don’t get constant electricity. That has been one of the down side of using the TT tracker because anything that requires electricity and electricity is not constantly available becomes a problem. Our major challenge is how to charge the tracker I: what do you advice can be done to better the services for your people? R: The government should encourage the NGOs, the encouragement should be whatever they need, the government should make it available. I: What are some of the things that they have done to ensure successes? R: If you have the zeal and you have someone to encourage you, you will definitely achieve a lot. The community leaders have been very supportive as well. The advocacy group has been so helpful, the government should encourage more of advocacy. I: When the outreach program Is over, what are you going to do to ensure that those that did not get the procedure done will also get the procedure done? R: There are some trainings that we have been giving the TT assistants, they are the community health assistants, community extension health workers. Nowadays its very rare to find a hospital no matter how remote it is where the people working there have no idea of what Trachoma is. Even when the program is over, people with Trachoma can visit community hospitals and from there they will be referred to the General hospital where there are people who has trained the TT surgeons who are able to carry out the procedure there if not they will refer you to Katsina I: what do you think should be done to ensure that these surgeries can be done on daily basis or more fequently ? R: This procedure is complex and there are shortage of staffs in the eye department not only in Katsina but it’s a nationwide challenge that is why the government must train and retrain personnel that can conduct this procedure. We have shortage of staff and its not every hospital that even has an Eye clinic up till now but with this TT there is no hospital in any local government that does not have a staff that has been trained on how to easily identify eye problem be it TT or other eye ailments. They all have been trained I: How will you feel if this ailment is eliminated in your community and the whole state at large? R: we will be grateful and appreciative to see that everyone has attained a healthy eyes status, that will be our greatest desire I: kindly tell us your name, occupation and age again R: My name is Dahiru Abdulkadir Karofi, I am 54 years and I have been working on eye for over 25 years in Katsina State. I: what hospital is this? END OF INTERVIEW