Dr. Furahini Godfrey Mndeme, a Pediatric Ophthalmologist and strabismus surgeon at Kilimanjaro Christian Medical Center (KCMC) and senior lecturer in the Department of Ophthalmology-Kilimanjaro Christian Medical University College (KCMUCo) in Tanzania. Dr. Mndeme was awarded his first degree- Bachelor of Science with honors from the University of Dar-es-Salaam, Tanzania. He then graduated from Muhimbili Medical School -University of Dar-es-Salaam, Tanzania. He completed his Ophthalmology residency at Kilimanjaro Christian Medical College-Tumaini University, Tanzania. He completed his fellowship in pediatric ophthalmology and strabismus surgery at Kilimanjaro Christian Medical College under the mentorship of Dr. Lee Woodward from Texas, United States, and from Dr. Joe Abbot, Dr. John Answorth and Dr. Manoj Parulekar at Birmingham Children’s Hospital- UK. He received his PhD from the University of London (LSHTM) in the Prevention of Childhood Blindness and Primary Eye Care for Children and has led several studies on child eye health. His Ph.D. program not only treats many blind children but also sets an essential base for developing a sustainable system to prevent childhood blindness in Tanzania and elsewhere in Sub-Saharan Africa.
Dr Mndeme is also a Fellow of the College of Ophthalmology of East Central and Southern Africa (FCOphth.ECSA) and was Vice President of the Tanzania Ophthalmological Society (TOS). Dr. Mndeme is currently performing his Clinical duties at Kilimanjaro Christian Medical Centre, one of the high-volume pediatric ophthalmology clinical units in Tanzania. He also provides pediatric ophthalmology fellowship training, which has attracted candidates from different parts of Africa, including Togo, Benin, Ethiopia, Uganda, Botswana, Mozambique, and Cameroon.
Dr. Mndeme was initially inspired to become a doctor by watching his father, a general practitioner. However, it was witnessing his uncle’s struggle with blindness in both eyes that planted the seeds of his future career as an eye specialist during his Five years in medical school plus one year of internship. He received only four weeks of training in ophthalmology, which left him desperately wanting to understand the mystery of his dear uncle’s vision loss. He was systematic and meticulous with his note-taking in all of his ophthalmology classes and created a personal manual of eye care references. Despite his passion for eyesight, he remained uncertain about which medical field to pursue. A serendipitous turn of events occurred when he accompanied a classmate to apply for a scholarship in ophthalmology. Although he had yet to plan to apply for the scholarship himself, the head of the department (Dr. Anton Hall) assumed he was there to do so. Before Dr. Mndeme knew it, he was scheduled for an interview and was ultimately awarded the scholarship. This marked the beginning of his journey in a profession that aligned with his childhood intrigue in finding the root cause of his uncle’s blindness (which he later discovered was due to corneal scarring from an early bout with measles, for which at the time, there was no cure).
Speaking recently with Megan Webber and Helene Dameris from KnowTheGlow, the two recognize the immense fortune of the children in and around the rural areas of Kilimanjaro, Tanzania, due to Dr. Mndeme’s tireless work to ensure pediatric screenings for sight-robbing diseases and conditions. Dr. Mndeme regularly sees many children in his practice. Still, when he first started, he noticed that most of the patients arriving with cataracts and retinoblastoma presented with highly advanced stages of disease. This revelation made him realize that his role was not just about addressing the eye issues in these children; he was essentially preserving their lives. In some cases, the retinoblastoma had progressed to such an extent that it had become extraocular, sometimes even reaching the brain. Dr. Mndeme shared with Megan his deep sorrow in witnessing some of these children succumb to the disease, believing that earlier detection could have made a significant difference. He explained that in Tanzania, there are reproductive and child health clinics that children regularly visit for various health check-ups, such as weight, growth, and nutritional needs. To his disappointment, no program was in place for checking children’s eyes. Dr. Mndeme would ask the parents how they had initially identified issues with their child’s eyes. Many parents reported that when they had noticed something amiss and sought the advice of a health professional, they were often told that their child was too young for surgery or that the problem would likely resolve itself. Mndeme recognized that the issue was primarily rooted in a lack of knowledge and knew that something crucial was being overlooked.
This realization prompted Dr. Mndeme to take action. He sought to train healthcare workers who routinely examined children at reproductive and child health clinics also to assess their eyes. He faced a dilemma, however, when it came to choosing the right tool for this purpose. Direct ophthalmoscopes were too expensive, and he couldn’t simply provide healthcare nurses with a “crystal ball.” It was then that he discovered the Arclight Scope. Dr. Mndeme conducted a small study to determine if these community healthcare nurses could learn how to use the Arclight Scope and identify abnormal reflexes. He organized a workshop, selected participants from the areas where he worked, provided training, and conducted practical sessions at the hospital. Much to his satisfaction, the healthcare workers quickly adapted to the Arclight Scope and successfully identified abnormal reflexes.
Dr. Mndeme has applied for another grant and plans to continue training and testing the use of the Arclight Scope in an additional 20 districts, hoping to promote its widespread use in primary health care facilities throughout Tanzania. Dr. Mndeme also shared with Megan his goal of incorporating eye care into the Integrated Management of Childhood Illness (IMCI). He pointed out that the IMCI addresses various diseases that can be fatal to children, yet it fails to mention eye-related conditions. He aspires to include fundal reflex examinations in the IMCI and further train IMCI nurses to detect conditions like retinoblastoma, cataract, Coats Disease, and other vision impairments.
Moreover, Dr. Mndeme emphasized that this initiative should extend beyond healthcare facilities and reach into communities, involving caretakers and family members. He believed that everyone should be made aware of the “Glow,” a term used to describe the reflection observed in the eyes of a child with a leukocoria-related eye condition.
Megan and Mndeme both recognized that his mission and KnowTheGlow’s awareness campaign complement each other, dovetailing to help parents quickly identify problems and seek professional assistance. KnowTheGlow looks forward to monitoring Dr. Mndeme’s progress over time and commends his dedication to increasing early screening for eye conditions in young children guiding them toward early intervention and necessary treatment. With this visionary leading the charge there is great hope for the children of tomorrow in Tanzania.
