Di Caelers
28 October 2002
Cape Town — DIABETIC Susan Martin, of Montana, is now almost totally blind because Groote Schuur Hospital cannot afford to replace a laser machine that could save her sight.
She is among 250 diabetics across the Peninsula facing this nightmare as they await treatment.
Frustrated ophthalmologists are going the surgical route to try to help patients, at huge extra cost, which they describe as a complete waste of resources.
This new controversy, which has left patients angry and devastated and their doctors frustrated, comes amid severe financial constraints in the Western Cape health sector.
Cuts are being made across the board as the province tries to cut projected overspending of more than R100 million for this financial year - and patients are suffering.
Because Groote Schuur's R370 000 eye laser machine cannot be replaced, a 30-minute procedure that could halt deteriorating eyesight associated with diabetes is not being done.
The situation has become so severe, according to consultant ophthalmologist Dr Emma Hurley, that they are no longer even screening diabetics, because they cannot offer them any treatment.
So patients like Susan Martin will simply go blind. And once her eyesight is lost, there is no way it can be regained.
Martin, who has severe diabetes, was blind in her right eye, but that didn't stop her from running her home and cooking for husband Henry.
When her left eye started failing too, ophthalmologists couldn't help her because their argon laser was in for repairs, leaving her destined for total blindness.
Today, she said, she can no longer cook at all.
"I can't even get her out of the house on to our stoep," Henry Martin said.
"I am so disappointed.
All my life we have looked to Groote Schuur for answers and now they cannot help us."
"I am very disappointed," Martin said, tears falling from her sightless eyes.
Diabetic Kamrodien Mohedien of Retreat has a similar story.
He had a cataract removed from his right eye early last year.
His eyes were then lasered, and Mohedien said the result was so good he could get back behind the wheel of his car.
He started having laser treatment to his deteriorating left eye but half-way through, the machine "conked out".
Last week Hurley operated on the eye for two-and-a-half hours to try to save his vision and although anatomically the result is good, she cannot make any predictions about whether he will lose his sight.
"He had a lot of scarring at the back of his eye and it was pulling the retina off.
We re-attached the retina but we don't yet know how many of the nerves are still functioning," Hurley said.
Mohedien said he felt extremely frustrated because of the excellent result he had got from his laser treatment.
"But then the machine went haywire and now they have to do a big operation like this instead, which is a big effort for the doctors. Everything is being delayed, so people who could have been helped early on are having to wait and wait as their eyes get worse."
Hurley said the argon laser worked on a different process to lasers that restore vision.
The Groote Schuur one had prevented further vision loss in eyes already affected, which is common in diabetics and particularly in South Africa, where diabetes is not well controlled.
Here, more than a quarter of all diabetics require laser treatment to save their sight.
Groote Schuur's machine is eight years old, but because it is used so much, today it is beyond repair.
"For the past two years, it has not worked 50% of the time. For the past six months it has been totally out of operation," Hurley said.
At least 250 people desperately in need of laser treatment are on the waiting list.
"We have tried to get help from Tygerberg Hospital, but they have similar problems with breakdowns.
The only other laser in the state sector in the Western Cape is in George, but that is broken too.
"We have also tried to form partnerships with the private sector and although we have persuaded ophthalmologists to do the treatment free, patients need at least R560 for each session on the machine, and they can't afford it," she said.
Patients need between three and four half-hour sessions.
Pointing to the cost of blindness to families and the state, Hurley cites figures from the US, which spends $500 million a year supporting diabetic patients who have gone blind.
And many of the local patients are aged between 30 and 60, when they should be able to work and support themselves and their families.
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