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September 24, 2017

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Afghanistan struggles with severe lack of eye care options

KABUL--Had they treated Nasaratullah sooner, the doctors might have been able to save the Afghan baby's eye, which was riddled with cancer.

Instead, the doctors at Noor Eye Hospital, a rundown facility in the Afghan capital overrun with 400 patients a day, had to remove it.

"Unfortunately, people come to us very late," Dr. Najib Osmani said looking up from the operating table where his tiny six-month-old patient, still anesthetized, rested in purple pajamas. "In early stages, this is curable. You can save the eyes, the sight — everything. Not in Afghanistan."

Eye care is a casualty of Afghanistan's tortured history. Eye clinics exist in only a few major Afghan cities. There are only six ophthalmologists for every 1 million Afghans. The country's lack of roads, mountainous terrain, extreme poverty and three decades of civil unrest are immense roadblocks to getting care — and giving it.

Roughly 1.5 million Afghans are visually impaired, according to the Ministry of Public Health. Every year, around 25,000 Afghans lose vision in one of their eyes.

Nasaratullah, a round-faced boy from eastern Afghanistan, has retinoblastoma, a rare cancerous tumor in his retina. After removing it, Osmani embedded a whitish glass ball, which later can be replaced with an artificial eye.

The infant's other eye appears healthy now, but there is a 40 percent chance that cancer will develop in it as well, the doctor said.

"I pray the other eye is OK," Osmani said. "At least we can refer him to neighboring countries for better treatment, radiation or chemotherapy."

Simpler vision problems can be easily treated in Afghanistan — if patients can get access to care.

Sixty percent of all blindness in Afghanistan is blamed on cataracts, which are removed in simple operations common in the developed world. But in Afghanistan, only 15,000 cataract surgeries are performed each year, not even enough to keep up with new cases and causing the huge backlog of cases — 200,000 by some estimates — to grow even more.

Babi Dukther, a 45-year-old woman from Kabul, is one of the lucky ones. On a hot day in the dusty capital, she walked barefoot into one of the hospital's operating rooms where a man was still swabbing the floor with a dirty mop.

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