Interview with Dr. Michael Gichangi

Head of Ophthalmic Services Unit, Ministry of Health-Kenya

In the heart of rural Kenya, Dr. Michael Gichangi’s journey began, navigating illnesses that frequently led him to the local hospital. This early exposure sparked his interest in the medical world, experiencing both sides as a patient and caregiver. Though he was good in Physics, he chose to take biologo for  his schooling that would eventually lead to training at the University. After Postgraduate studies, Dr. Gichangi enjoyed clinical practice in rural Kenya (Nyeri).

His struggle with diagnosing eye issues during patient encounters became a personal challenge, steering him toward a deeper understanding of ophthalmology. Meeting with Dr. Khaki Kimani in med school sparked a lifelong friendship. Postgraduate studies, including a Master’s in Global Health Studies for both doctors, followed, and their collective efforts for Kenyan families have spanned nearly four decades.

After post-graduate studies at the London School for Tropical Medicine, Dr. Gichangi enjoyed a clinical practice in Nairobi. However, he soon recognized the breadth of the challenges in vision care, leading to a remarkable 17-year journey in policy-level work for Kenya. His involvement in a trachoma study paved the way for evaluating eye care strategies to enhance accessibility and focus on vision care nationwide.

Dr. Gichangi and his team continue to grow, and they are collectively ushering positive changes in Kenya. Collaborating with WHO’s Vision 2020 initiative and championing the IPCEC (Integrated People-Centered Eye Care) program, they’re ensuring higher coordination of services, emphasizing prevention and early detection of vision challenges.

Their leadership in early intervention and coordinated efforts has significantly reduced lag times between detection and treatment. With Dr. Kimani and Kenya’s other regional teams, the survival rate for children with Retinoblastoma has surged from 25% to 69% in a decade, with aspirations to reach 80-90% in the coming years. Lessons from reaching the unreachable through technology like that of COVID-inspired messaging, coupled with tools like the ArcLight, aim to educate front-line caregivers and communities at large.

Dr. Kimani’s training programs and fellowships transform doctors into change-makers in their countries. Dr. Gichangi extolls her as extraordinary, recognizing the impact of training, education, and innovative tools in reducing preventable childhood blindness.

Kenya’s strategic framework for eye health, complete with goals and a roadmap, is gaining traction. Investments and resources are streamlining their strategic plan, showing improvements in adult and childhood eye care, particularly in cataracts and refractive errors.

While childhood blindness incidents are low in numbers, the burden of care for the country makes it the second leading cause of blindness in Kenya. The toll on education, productivity, intervention, and treatment is high, placing it second to age-related blindness in the country. Early intervention in school-aged children holds immense potential, with the public health approach bridging the gap between detection and diagnosis.

In Kenya, thanks to the efforts of Dr. Kimani and Dr. Gichangi, mother/child health booklets, including information on infant eye health, are distributed, and every child undergoes a simple eye check before being released from the hospital. This has increased patient visits, especially for severe eye conditions. Swift referrals from primary to tertiary care and education for community healthcare workers are making a significant impact.

They’re expanding their reach by leveraging social media, visuals, and tools like WhatsApp. Posters and training for medical students, nurses, and frontline healthcare workers have the potential to elevate vision care information in medical schools further. Despite ophthalmology’s usual low priority, simple awareness has the ability to make a monumental difference.

IPCEC is gaining momentum, emphasizing the need for education and information. Programs like those surrounding World Sight Day in cities like Nairobi and Meru are paving the way for a positive change in Kenya, with hopes of a ripple effect on a global scale.  KTG hopes to continue to find ways to be additive to the programs and education channels in the country, knowing that together, we can make a world of difference right in Kenya…and then watch Kenya make a difference worldwide!