Retinoblastoma

The baby seen above had a grapefruit sized tumor of his left eye and a shrunken, phthisical right eye from presumed bilateral retinoblastoma. He was found in the bush by a missionary and brought in to see us in Jos. An extenteration had been planned for the left eye, but the baby started doing quite poorly from a medical point of view and it was not felt safe to take him to the OR. (Keeping in mind, that the ICU does not have ventilators, or running water for that matter).

Retinoblastoma has a cure rate of greater than 90% in the Western World. Even at the King Khaled Eye Specialist Hospital in Saudi Arabia (where I worked for nearly a decade), we had a cure rate approaching 90%.

I was quite excited on my initial trip to Nigeria last year to do some tumor work, as I was initimately involved in our biweekly retinoblastoma clinic in Saudi.

However, in Nigeria (and much of subSaharan Africa) it is very rare to see a patient early enough to save the eye. In fact, in the majority of cases the child will die within a year due to extraocular spread/metastasis. Even if the tumor is caught early, most parents cannot afford the workup (CT/MRI scan) and/or the treatment (chemotherapy/radiation etc...). The other huge problem is that there is a lack of basic equipment for the doctors--indirect ophthalmoscopes, cryotherapy units, lasers...

As Bono sings in "Crumbs from Your Table":
(fromU2's latest album, "How to Dismantle an Atomic Bomb)

"Where you live should not decide
Whether you live or whether you die"

Link:http://radio.terra.com.br/busca/musicas.php?musica=Crumbs%20From%20Your%20Table