When Dr. Levi Kandeke decided to leave his promising career as a glaucoma specialist in Europe and return to his home country of Burundi, he shared with Megan Webber, Co-Founder of KnowTheGlow, that he was initially filled with fear. Trained in Switzerland and with experience working in Paris, Dr. Kandeke faced the daunting reality of returning to a nation with no ophthalmologists and limited medical infrastructure. “There was nothing there,” he recalls. “I knew I would have to start from the beginning.”
In 2007, encouraged by a senior doctor who told him that he was more needed in Burundi than in Europe, Dr. Kandeke took the bold step of setting up the country’s first operating room for eye surgeries. In partnership with organizations like the Kilimanjaro Centre for Community Ophthalmology (KCCO) in Tanzania, he began by performing cataract surgeries. However, establishing eye care services in the world’s poorest country proved to be a monumental challenge.
Burundi’s government at that time, overwhelmed by more urgent health concerns like HIV and other communicable diseases, had little interest in supporting eye care. The financial landscape was equally bleak, with doctors earning as little as $50 per month. In response, Dr. Kandeke created a private group to help ophthalmologists earn a sustainable income while also dedicating time to treat patients in need.
Initially, Dr. Kandeke’s practice focused solely on adults, as the prevailing belief was that children did not suffer from eye problems. But as word spread, parents began bringing their children for treatment, often with advanced, complex cases. Pediatric eye surgery is particularly challenging, requiring general anesthesia, expensive implants, and specialized skills. This need spurred Dr. Kandeke to establish the Centre Tertiaire pour les Soins Oculaires de l’Enfant (CTSOE), a non-governmental organization designed to unite public and private resources to deliver comprehensive eye care.
The CTSOE has grown significantly under Dr. Kandeke’s leadership. In partnership with organizations like SEVA Canada, which provides financial support and training for staff and management, the organization has become a cornerstone of pediatric eye care in Burundi. Despite the success, the journey has not been without difficulties. Many children arrive with extraocular disease, having been brought for treatment only after the condition has severely progressed. Yet, when Dr. Kandeke sees the telltale “glow” in a child’s eye, he feels a surge of relief, knowing that he still has a chance to save their vision.
One of the most alarming trends Dr. Kandeke has observed is the prevalence of congenital cataracts among children in very poor populations. Tragically, many of these children die before the age of five, likely due to a combination of malnutrition and neglect. Families, overwhelmed by the burden of caring for a blind child, often do not know how to provide for them. These children are frequently smaller and less developed than their siblings, but after successful cataract surgery, they begin to grow and thrive, highlighting the life-saving impact of early intervention.
To address this, Dr. Kandeke and his team have placed a strong emphasis on awareness campaigns, seeking to detect these children as early as two to six months old to maximize their visual potential. The team’s outreach efforts have significantly reduced the average age of children receiving treatment, from six to four years old in just two years. “The surgery is the easiest part,” says Dr. Kandeke. “The hard part is finding these children early enough to make a greater impact and ensuring they receive the follow-up care they need.”
The importance of outreach was further underscored by a small study Dr. Kandeke conducted, revealing that the primary reason families delayed seeking treatment was not primarily financial but, above all, simply a lack of awareness. Burundi, with its population of 12 million and relatively good road access to rural areas, offers a unique opportunity for immediate impact through awareness campaigns and screenings. However, these efforts have required innovative solutions. For example, while the CTSOE initially struggled solely to fund the treatment of children, SEVA Foundation stepped in to sponsor treatments for adults, allowing the organization to screen both adults and children and subsequently reduce the average age of pediatric patients.
Today, Dr. Kandeke leads a dedicated team of ophthalmologists, including a colleague who is set to travel to India for specialized training in oncology. The hospital from which they operate in Bujumbura collaborates with another hospital built with the support of American donors located in Gitega, specifically in Kibuye, which is now equipped to offer chemotherapy for retinoblastoma, a once-impossible feat in Burundi. While the hospital currently focuses solely on retinoblastoma, Dr. Kandeke ensures that 10% of funds from private donations are allocated to treat children with other ocular tumors, ensuring that no child is left behind.
The work at CTSOE is demanding, but it is driven by a model of sustainability. The ophthalmologists volunteering with CTSOE also work at the Clinique de l’Oeil, where they are compensated for their time, allowing them to continue their vital work with CTSOE. This hybrid model ensures that the hospital’s equipment is maintained, and the ophthalmologists can continue their mission of saving sight.
Dr. Levi Kandeke’s story is one of resilience, hope, and an unwavering commitment to his people. From starting with nothing to building one of the busiest pediatric eye hospitals in East Africa, his journey is a testament to the power of returning home, facing fears, and building something extraordinary. His work is not just restoring sight—it’s giving countless children a chance at life, and in doing so, bringing light to a nation long in the shadows.
