It’s 9am in Samrong, in the Oddar Meanchey province of Cambodia. Children are riding their oversized bikes along the highway on their way to school. The girls wear white shirts with navy skirts – and boys wear the same white shirts, with neat little navy ties. Two young figures walk in the opposite direction.
One is eight-year-old Thas and the other is her 13 year-old brother Jay. They both drag a large, woven plastic bag behind them, half full of bottles and cans. They’ll collect rubbish from the side of the street until their bags are full. “That’s around 20c worth,” we’re told. ”And they’ll keep doing this for another three hours or so until they can make around $1.”
Children fighting to survive
Thas collects rubbish as though it’s a game. There is a playful spring in her step when she spots a plastic or glass bottle worth picking up. But this isn’t a game. This is her life. This is her survival.
Meanwhile, over the other side of town, Thas and Jay’s 17- year-old brother Chang is standing on the edge of a nearly dry river with a fishing net in his hand. He’s trying to catch a fish or two for his family to add to the boiled rice they’re lucky to eat each day.
For the past year Chang has been the head of his household, responsible for his family’s financial survival. His youthful face bares the stresses of a man twice his age. He fondly remembers his only year of school and says if life were kinder, he’d like to be an engineer. But life hasn’t been kind - and education was a luxury his family simply couldn’t afford. He casts his net out into the brown, murky water and then jumps in after it.
He finally re-emerges, pulling his net up as quickly as possible. He unravels the net, but finds just one tiny crab. He casts out over and over for about an hour, but eventually becomes dejected. He knows he will now have to travel to the rice fields and work for several days to make up for today’s empty pickings.
The children’s mother Thol sits idly on a raised wooden platform inside her home, which is only about 3x3 metres. There are no walls in her home, just straw tied to sticks covering about a third of the space where walls should be. Eight thin bamboo poles hold up a collection of tin scraps forming a roof.
Reliant and helpless
She is helpless – marooned on her platform - unable to move without the eyes and guidance of her children. The 46-year-old has been totally blind for a year and a half. Her cataracts
are like tiny, white sequins in her eyes, blocking out her surrounds. Her husband didn’t want a blind wife, so he left her when she was pregnant with Cheet. He took all the family’s money.
During three months of the wet season, her home sometimes floods up to her knees, making the raised bed platform more isolated than it already is. She worries all day that her youngest child will crawl off the platform into the water. Although she’s never seen Cheet’s face, she knows every inch of his body and reaches out for any part of him to hold onto.
When the rain is really heavy, everyone gets wet. It pours through the open home on an angle and leaks through one of the many gaps in the roof. Thol and her family huddle close together and cover themselves with a large piece of plastic.
A vulnerable situation
Young Thas is now at a vulnerable age. This is a part of Cambodia
where child trafficking is a threat. There are signs around everywhere pointing out this terrible fact. Thol arranges her children on the platform at night to protect her daughter. The two boys lay on the outside of the platform closest to the edge. If anyone accosted their fragile home, they would need to fight past the boys to reach their younger sister.
Thas and Jay arrive home with their full bags of bottles and cans. They place them in the corner of the home and dash off to play. Thol explains she hasn’t had her eyes fixed because she didn’t know her condition could be treated.
Even if Thol had known her cataracts could be removed, services in Oddar Meanchey Province are frighteningly few. There are no ophthalmologists here.
Finding an eye doctor is not easy
Eye services only really began in 2011, when The Fred Hollows Foundation renovated the local hospital, donated some essential equipment and began conducting outreach eye camps. These eye health shortages aren’t unique to Oddar Meanchey - in fact in a country of over 15 million people, there are just 34 practicing ophthalmologists.
To get your eyes fixed in Cambodia the first thing you need to do is find an eye doctor and in Oddar Meanchey, you need to wait for The Foundation to bring that eye doctor to you.
Thol is lucky that Dr Sarath and his surgical team are in town. The first thing you notice about Dr Sarath is his beaming, youthful smile. At just 32, he represents a new generation of Cambodian professionals in a country that tragically lost an entire generation.
Her situation looks brighter
Last year, with The Foundation’s support, Dr Sarath attended the Tilganga Institute of Ophthalmology in Nepal to study under the tutelage of world-renowned surgeon, Dr Sanduk Ruit
. It was a learning experience that he treasures. He was born in the capital Phnom Penh, but now lives in the coastal town of Sihanoukville. It’s Cambodia’s eye doctor shortage that brings Dr Sarath all the way to Oddar Meanchey. Fred Hollows would love the fact that a Cambodian is doing the surgery – but he would equally hate that the nearest eye surgeon lives so far away.
It’s the day of Thol’s surgery and she is sitting on her platform as usual. Chang has already left for the rice fields and will be gone for several days. The other children are excited to be going on a trip today – even if it is just to the hospital about 10 minutes away. When it’s time to go, Thas and Jay grab a sandal each and place them on their mother’s feet.
The surgery begins
Thas guides Thol for about 20 metres before she stops. She’s forgotten something and quickly runs back to the home leaving Thol on her own. That’s when we see how helpless Thol is. She feels around in the air for anything to touch to guide herself with. She finally finds a small washing line and grabs onto it. Without her daughter, she is stranded. Before too long Thas is back and takes her mother’s right hand. The relief is instant.
At the hospital, Thol sits with around 20 other patients. They’re all here with the same condition – cataract blindness. It’s a condition familiar to the elderly in the developed world, but today the ages appearing on the patient list highlight the inequities of our world.
Thol is the youngest at 46 – but there’s also a 48-year-old man and a 50-year-old woman. Most of the patients are in their early 60s – far too young by modern standards. In Cambodia, and in most other developing countries, cataract is the leading cause of blindness. In fact, four out of five cases are avoidable – and cataract, a condition that can be corrected in some countries for as little as $25, is by far the greatest contributor.
The children disappear into the corridors of the hospital, exploring their new playground. Thol is led into the operating theatre that has been designated to the eye care team for the next few days. With just a local anesthetic, Dr Sarath makes a small incision in Thol’s right eye. He plans on doing one eye today – and if everything goes to plan, the other eye tomorrow. It’s the most conservative approach he can take in a region so devoid of services. He first removes the cataract-affected lens. He then replaces it with an intraocular lens produced by one of the factories Fred Hollows helped establish in Nepal and Eritrea.
Over in less than 15 minutes
In less than 15 minutes, the operation is over. Thol sits up assisted by the nurses. In an incredible gesture of gratitude, she places her hands together to thank the staff before she’s even left the table. Years of misery are close to an end for Thol, but Dr Sarath barely pauses before taking on his next case. Today, he will restore sight another 20 times.
The next morning, Thol is whisked back to the hospital on the back of a motor scooter. She’s wedged between the driver and Jay who stands at the back to make sure she doesn’t fall off. She prefers a motorbike to the car, which made her feel ill yesterday on just a 10-minute ride. One by one Dr Sarath removes the eye patches of the patients he operated on yesterday. Soon, it’s Thol’s turn.
Seeing her baby for the first time
The children gather around her hoping to be the first one that Thol sees. Dr Sarath slowly removes her bandage.
There’s a pause for a moment as Thol’s first reaction is to keep her eyes shut. But then she opens them and almost instantly comes to life in a bursting smile. All the other patients cheer. She thanks the doctor again and then turns to face her children and counts them one by one.
She reaches out to touch baby Cheet’s face as if to match what she can now see, with what she’s always been able to feel. She’s asked what Cheet looks like and she says, happily, ”He’s fat!” After the second operation to fix her left eye, Thol’s vision was completely restored. It was hard to tell if she was laughing or crying.
We can't stop now
As bad as her family’s living situation has been, Thol’s never actually been able to see it with her own eyes. Now, it’s clear to her how vulnerable they are and it scares her.
Thol tells us again how happy she is, but then she says she's sad because of her family’s circumstances, especially their home.
The leader of the community hosts a tea ceremony to thank The Fred Hollows Foundation for bringing Thol home with new found hope. Thol notices an older lady next to her is uncomfortable, so she reaches across and begins massaging her leg. For so long she’s needed to be cared for, but now she is doing the caring.
These days, Thol is able to make a living growing and selling vegetables, and the kids no longer have to fend for themselves. Through a relatively straightforward operation, their mother has been liberated from the darkness. She’s been given back opportunities that were once taken away so cruelly. Giving people that chance, that choice – that independence and dignity, is exactly why the work of The Fred Hollows Foundation matters so much.