Giving the gift of sight in rural Mpumalanga

There are few things more rewarding than watching a line of patients, in their heavily strapped eyepatches, waiting with an air of expectation, followed by their collective shouts of joy as, one by one, their eyepatches are removed to let in the world that had been covered in a mist of grey. 

These are not people with easy or regular access to healthcare. Instead, they live in the rural poverty of northern Mpumalanga and my fiancée, Dr Amy Tiri,  and I were blessed to watch their lives (and many others) transformed during the six months we spent working as volunteers with the Tshemba Foundation at Tintswalo Hospital, a 423-bed public hospital located in Acornhoek, Mpumalanga.

Each one of these patients represented a ripple. One more grandchild who could go to school instead of caring for their blind grandparent. One more adult who could earn a wage and lift their family out of poverty. Ripples that would stretch out through the community.

These particular cataract surgeries were conducted by a whole team of ophthalmology surgeons from one hospital in Pretoria who volunteered with Tshemba as part of a particularly powerful team-building exercise.

At around 8am on the second day of the team’s visit, a blind lady in her 80s was brought to the eye clinic by the gate security team. She was alone and spoke no English. After a brief translation, it transpired that she had heard that there were some doctors who could make her see again and she had travelled for three hours on four separate buses, with only a cane to guide her way, to see if this was true. The next morning, we had made good on that promise, and she walked away, the cane now repurposed as a walking stick with a grin that could warm the brutal Atlantic currents that course past Cape Town.

The gift of sight

The Tshemba Foundation works to recruit volunteers from around South Africa and the world to support the provision of rural healthcare in this most challenging of situations. Some are generalists who come to muck into the general running of the hospital and offer different perspectives. However, Tshemba is also devoted to bringing specialists with advanced skill sets to bring high-quality care to the people who need it most.

The flagship programme of the foundation is the ophthalmology service, where visiting surgeons arrive for short visits to perform cataract surgeries at the eye clinic that Tshemba helped to construct and outfit.

The clinic houses a dedicated team of nurses and an ophthalmology specialist nurse. Together, they offer a service that is very rare in the setting of rural healthcare. The local clinics identify and refer patients to the eye clinic, which means the existence of the clinic has made an incredible impact on the local community.

Getting involved where we’re needed most

Even though my fiancé and I are both generalists, we were able to get involved in several ophthalmology-related programmes. We kept the whole process moving, ensuring the specialists could perform at the speed they were used to rather than having to devote resources to the peripheral tasks. It was a real learning experience.

The dedicated and very well-stocked cupboard full of ophthalmology consumables, along with the top-quality microscopes and operative equipment available, allow the surgeons to deliver the same gold standard care they would if the patient had travelled to a clinic in Johannesburg.

This attention to small details, while being aware of the larger implication of the actions taken, speaks to the vision of those like Tshemba and the volunteers who join the programme who are working hard to take rural medicine in South Africa to the next level.

It’s a long and never-ending vocation. As one of the ophthalmologists remarked to us during one particularly memorable visit, “We could move up here, do ten cataracts a day for a month and not even be close to running out of work!”

The foundation is working towards making these trips a monthly occurrence with this in mind and I’ve seen first-hand how rewarding the experience is for the surgeons involved.

Pay it forward

We are forever indebted to the wonderful folks at the Tshemba Foundation who gave us such a wonderful range of opportunities (not just those detailed above!). We have made some friends for life and had some experiences that we will carry forward for many years to come. 

Anyone who is interested in a “leave of purpose” with this fabulous non-profit organisation should check out About Tshemba ( A range of skill levels and sets would be considered, and international volunteers are encouraged to stay for at least three months to get out and give back the best – although even a weekend can make a huge difference.

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George Crawshaw
Dr George Crawshaw is a medical trainee from Newcastle upon Tyne in the UK with an interest in elderly care. He and his fiancée, Dr Amy Tiri, a general physician with an ENT focus, both have a passion for global health. They volunteered with the Tshemba Foundation, providing care to underserved communities in Mpumalanga for six months this year.

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