“I’m so happy I can see my grandfather again!”

Mary is a typical 10-year-old: she loves learning, playing and spending time with her family. But her freedom and ability to enjoy life were severely limited by cataracts.

We travelled to Neno, a district in southern Malawi, to meet Mary and her family. By the time she was diagnosed with bilateral cataracts, her vision had been deteriorating for the past year. She was struggling at school, finding it difficult to do tasks at home and had been socially excluded by her siblings and peers.

For children with cataracts, timely treatment is essential: the condition can cause permanent sight loss if left untreated when the brain is still developing. Luckily for Mary, she was referred for surgery at her local hospital to restore her vision.

We visited Mary at her home to learn more about her, and were able to return after the operation to see how her life had changed.

On our first visit to Mary’s village, we were greeted by her grandfather Williyamu, with whom she has a close bond. He showed us to the family home, where we met Mary, her mother and her siblings. Mary was shy and withdrawn as we observed her daily routine, which included helping with the dishes and collecting water.

Mary was aware of her surroundings and could find the things she needed, but she was unable to focus on the tasks. She frequently squinted and experienced pain and weeping in her eyes. As she could no longer help with cooking and gardening, she often stayed at home with her younger sister while the rest of her siblings worked and played together outside.

Cataracts also severely affected Mary’s education, which had been a major worry for her mother, Martha. Her teachers didn’t realise that she had been experiencing vision loss until her family informed the school, but they were very supportive and tried to ensure that she could continue learning by inviting her to sit at the front of the class.

Martha explained why she was eager for her daughter to have surgery: “All I wanted was some assistance and a diagnosis so that she could regain her sight. I’m very hopeful that she’ll be able to see again. I look forward to her operation and her regaining her sight. I hope that she’ll be able to read and work towards becoming a teacher or a doctor.”

Unfortunately, Mary has experienced bullying both at home and at school. Sitting at the front of the classroom led to teasing from her classmates and her siblings mocked her when she was unable to do household tasks. Some of the children in the village also refused to play with her. This was distressing for Mary and Martha, who had to intervene and speak to other parents about the bullying.

On the day of her surgery, we joined Mary and her family at Lions Sight First Hospital, where Dr Gerald Msukwa performed the operation. In Malawi, a country of 19 million people, Dr Msukwa is the only surgeon who can do child cataract operations, highlighting the urgent need for additional funding to train more surgeons and ensure that eye health is fully integrated into local health systems.

Community screenings are a vital aspect of Sightsavers’ work in Malawi and help to identify eye issues in people who don’t have the means to travel to a hospital due to age, cost or location. Health care teams also work closely with rural communities to challenge myths about surgery and provide education on common eye conditions and treatments.