When the Zimba Eye Clinic Encounters Mercy  

From Jeffrey P Colquhoun

Mercy’s story is typical in that she is one of many who have suffered with severe eye disease due to limited access to eye care in Zambia.  What is unique, however, is the extent that our eye team from Michigan has been drawn to Mercy in a personal and comprehensive manner.

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In 2009, Mercy was living with her husband, Isaac, a pastor in Kazungula (photo 1) , a village near the border of Zambia and Botswanna, near Livingstone, Zambia.  They had three children – Blessings, Patience and Isaac, Jr.  I first met Mercy in 2009 when she was presented to the Zimba Eye Clinic with a diagnosis of acute Stevens Johnson’s Syndrome after being treated with Trimethoprim/Sulfamethoxazole for a Urinary Tract Infection (photo 2).  She had moderate conjunctival injection and symblepharon OU.  I performed symblepharon release, amniograft placement and treatment with steroids (see photo).  Over the course of a year, and two additional procedures, Mercy worsened to complete symblepharon (Photo 3), and extreme corneal exposure secondary to cicatrization.  This left her with Hand Motion vision OU. Tragically, in 2010, Isaac died of cancer while Mercy was undergoing ART treatment for HIV/ AIDS, as she found herself legally blind, unemployed and unable to take care of her children.

As there was little more that our visiting eye teams could do for Mercy in Zambia, I decided to pursue her receiving a Keratoprosthesis in the US.  After extensive research including a cautionary discussion with the developer of the Boston Keratoprosthesis (KPro) device, Dr. Claes Dohlman (MD, PhD), it appeared that Massachusetts Eye & Ear Infirmary was the best choice.  Eventually, Dr. James Chodish agreed to do the procedure with his team at no cost to Mercy! 

More complicated was establishing all of the logistics for Mercy to get to the US: flights, visa, medical clearance in Zambia to assure adequate HIV control - CD4 count, HIV RNA viral load, etc.  Also, Mercy needed a travel escort and a caretaker in Boston.  One of the Zimba Clinic interpreters, Charity, agreed to travel with Mercy to act as her “good Samaritan.”  An acquaintance of mine, Maggie Alexander (a single mom with 2 children), agreed to house and help transport Mercy and Charity in Boston.  Mercy needed to remain around Boston for nearly 2 months for the pre- and post-op care.  

On July 10, 2011, Mercy had her surgery with Dr. Chodish (photo 4) and his team at the Harvard Massachusetts Eye & Ear Infirmary.  I flew out from Michigan to watch the team, and pray with Mercy, Charity, and Maggie prior to the surgery.  The surgery was unlike any procedure a typical comprehensive Ophthalmologist in the US would perform – with a team of 8 different surgeons.  First, an anterior segment surgeon and fellow released adhesions.  Then, the glaucoma team put an Ahmed shunt in place.  That was followed by the cornea surgeon placing temporary corneal tissue so the retinal team could remove the lens and do the pars plana vitrectomy.  Next, the temporary cornea was removed; the KPro II device (Photo 5) was fit into the new corneal tissue with anterior/posterior plates and then sutured near the recipient corneal limbus (Photo 6).  Finally the oculoplastics team fit the Keratoprosthesis anterior button thru the eyelid and performed a permanent tarsorrhaphy. 

Although in immediate post-op (Photo 7), most patients have vitreous hemorrhage, miraculously when Mercy’s patch came off, she could see 20/70.   Her media was completely clear.  Potential complications include glaucoma, retroprosthetic fibrosis, infection, erosion of the external optic as well as rejection. The 5-year prognosis is guarded for KPro II devices, as approximately 50% maintain 20/200 vision.  In the first few months, post-op Mercy was 20/70 uncorrected; with a -1.50 sphere, she could see 20/20.   I just saw Mercy and Charity a couple of months ago in Zambia (Photo 8&9).  She reported excellent vision; without correction at distance; 20/200 and J1 at near!  She could see 20/25 with -4.00 sphere. 

Mercy has been back to work part time, is planning on completing her schooling to become a social worker, and she is now engaged to be married in April (this month).  My family has committed to helping Mercy’s children get thru school in Livingstone.  I cannot explain exactly why we reached out in an extraordinary way for Mercy; however, perhaps her name pleads for the hand of God to be placed on her. 

A diverse group of people have come to help restore her vision and her life. Perhaps Matthew, the gospel writer of the first book of the New Testament summed it up best.  In Matthew 10:7-8, Jesus charged His disciples to proclaim, ‘The kingdom of heaven is at hand.’ Heal the sick, raise the dead, cleanse those who have leprosy, drive out demons.  Freely you have received; freely give.” 

If you would like to learn more about the Zimba Eye Clinic or find out how you can help Jeff and his team, please contact him at jcolquhoun5@yahoo.com.  They need additional teams to keep a consistent presence at the clinic.

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Mercy's Prayer

Here is Mercy’s Prayer prior to her surgery.  You will be encouraged by it and it will give some insight into why Jeff and his team were drawn to her.

For Dr.Jeff to read prior to the surgery:

I call upon you Lord in times of trouble like this and this is my prayer: Lord Jesus I invite you to do the surgery to me through the capable hands of those who will carry it out.  Our Father God, I bring myself before you on the operation table spreading the blood of Jesus Christ upon the instruments that are going to be used in this surgical room. God I pray for all the doctors and their assistants, those you have chosen as vessels to do this surgery on me, to work as instruments of blessing in accordance to your work that you are going to bless the works of their hands and that without you Lord their work is in vain.  I also pray that after the surgery we are going to confess your name as Lord because of the miracle that you are about to perform, may the tissues and veins in my eyes line up with your word, for nothing is impossible with You and in You I put my trust, now in the name of Jesus Christ, Amen.

(Luke 1:37) For in you God I put my trust in Jesus’ name. Amen.