Sight for Cameroon: Tissue donation as a last chance

Bafoussam, Cameroon / Hannover, Germany: Nine Cameroonians receive a new cornea from the network of the non-profit German Society for Tissue Transplantation (DGFG) as part of a humanitarian mission. An interdisciplinary team of doctors and technicians from Greifswald/Germany traveled to Bafoussam in the west of the country for this purpose. The DGFG accompanied the trip with a documentary.

Documentary of the trip to Cameroon

Tissue donation as an altruistic act without borders

Dr. Eric Njikam, Augenarzt in Bafoussam, Kamerun

“Here in Cameroon, there is currently neither tissue nor organ donation,” explains ophthalmologist Dr. Eric Njikam. The Kenyan-trained ophthalmologist recently opened his “Clair Vision” eye clinic in Bafoussam, located in the country’s western plateau.

More than 200 patients suffering from corneal disease had been seen by the German doctors and technicians who are friends of his by the time of the week of the operation. The fact that such a donation can save from blindness is largely unknown to the local population. Njikam clarifies in the patient discussions: “The majority of the population is Catholic. They therefore recognize the selfless donation of a deceased person as an act of charity and are insanely grateful to the donor families.”

Impressions from Cameroon

Transplantation of a cornea decides on livelihoods in Cameroon

Many of the patients suffer from severe eye injuries at work, the consequence is a deeply scarred cornea. The congenital pathological clouding of the cornea (dystrophy) is also very common, probably also due to marriages in the family. Precarious hygienic conditions favor a corneal inflammation (keratitis) caused by bacteria or viruses. These forms of the disease affect all layers of the cornea, which is why a full transplantation, a so-called penetrating keratoplasty, is necessary to save the eyesight. Unlike in Germany, relatively young people visit Dr. Njikam’s clinic because of corneal disease. Among them are children a few months old, teenagers and young parents. The restoration of sight through a transplantation decides on livelihoods here – social security in case of disability is unthinkable.

Combating preventable blindness worldwide

Professor Wilhelm is responsible for one of a total of 12 tissue banks in the DGFG network in Schwerin, which, with hundreds of donation clinics and transplantation programs, is Germany’s largest and only tissue facility of its kind. Patients can usually be provided with a corneal transplant within a few weeks – in 2021 there were 4,145 distributed corneal transplants [1]. In Cameroon, on the other hand, people simply have to surrender to the “fate of blindness”. Currently, an estimated 4.2 million people worldwide lose their vision due to corneal opacity [2].

“We want to contribute to a fairer access to ophthalmic care and see the fight against avoidable blindness detached from national borders” emphasizes DGFG Managing Director Martin Börgel.

[2] World report on vision, WHO (2021)

Ophthalmology and tissue medicine in the most adverse conditions

The DGFG therefore supports the ophthalmological aid project under Professor Wilhelm and the German Committee for the Prevention of Blindness once again. Due to Corona, the otherwise annual visits had to pause since 2018. In addition, political instability, conflicts between Anglophone and Francophone citizens, and terrorist groups active in the border regions are increasingly limiting the country’s medical progress. Compared to many East African countries, Cameroon in West Africa is hardly developed for tourism. The lack of an economic factor is evident, among other things, in the inadequate infrastructure: The road network is rudimentary, and the power supply in the cities regularly breaks down. In rural areas, electricity and running water are the exception. “Hopelessness is the biggest problem here. We have many young people who can’t find work despite vocational training. Poverty is growing and with it the number of needy patients” explains Dr. Njikam.

Tissue donation must be self-sustaining

Dr. Njikam wants to help his country sustainably. To achieve this, a self-sustaining tissue donation structure must be created and ophthalmological treatment expanded. Up to now, ophthalmologists have concentrated on urban areas. This is where more affluent patients tend to be waiting. Patients in need outside the city sometimes have to travel up to seven hours and incur high costs. Meticulous aftercare by transplant recipients and doctors is crucial for successful healing. Dr. Njikam uses telemedicine here: consultation via messenger service on the smartphone. His vision: to anchor tissue and organ donation in law and to make it possible for transplants to be processed in the patient’s own banks.

“The patients transplanted here last week hopefully signal to the public as well as the government how important tissue donation is. We must carry out intensive educational work, especially in rural areas. Where access to basic things like education and medicine are most lacking.”