When Susan Lewallen and Paul Courtright married in 1988, they shared a dream of making a difference in the world while living, working and raising a family overseas.
Both are doctors. An ophthalmologist, Lewallen treats individual patients for eye conditions and performs surgeries.
An ocular epidemiologist, Courtright does not treat patients. Instead, he researches and applies his research to medical delivery systems and policies.
“We have always considered ourselves a team,” Lewallen said. “We look at things differently but are compatible. We learn from each other.”
Shortly after they were married, the couple decided to move from the U.S. to Africa and help address rampant blindness.
About 80 percent of blindness could be prevented with medical care. The leading cause of blindness was cataracts, a condition that is routinely cured through surgery in America.
By 1990, the couple was living in the African nation of Malawi where Lewallen was the only ophthalmologist for 5 million people.
“You would think I would be very busy,” she said. “But I wasn’t.”
Many patients refused to seek medical care for cataracts and other conditions, such as trachoma, a bacterial eye infection that can lead to blindness when left untreated.
After spending time in the villages, Courtright concluded that fear, gender issues and traditional healers were the main obstacles.
“They feared myths such as one that had surgeons removing eyes and replacing them with goat eyes,” he said. “Women would not seek medical care without their husbands’ consent, which was often withheld.
“We needed to get their confidence.”
Traditional healers were particularly difficult. They were influential, and they felt threatened by modern medicine. Moreover, they often worsened eye conditions by applying unknown substances to eyes.
It took three years, but eventually Malawi communities began accepting modern eye care. The turning point was when an elderly traditional healer failed in treating his own cataracts and was becoming blind.
Courtright persuaded him to consult with Lewallen, who then successfully performed the first cataract surgery on a traditional healer. The healer returned to his village and word spread of her work.
That was the beginning of trust.
Having experienced some success, the couple decided to expand their efforts. In 2001, they established Kilimanjaro Centre for Community Ophthalmology in Moshi, Tanzania.
It trains locals from various African nations to conduct outreach in their respective countries similar to what Courtright and Lewallen did in Malawi. It also trains local ophthalmologists in modern medical techniques.
The trainees return to their countries and train others on outreach and medical techniques, similar in concept to a pyramid organization.
“Each community has its own obstacles, whether it be traditional healers, myths or other reasons. We have to address them all,” Courtright said. “The best way is to have locals carry the messages. We train them and give them .”
Kilimanjaro Centre began working out of a converted storage room in 2001 with Lewallen, Courtright and an assistant. During the ensuing 23 years, it has grown through partnerships with medical facilities and ever-increasing numbers of outreach trainees.
Today, Kilimanjaro Centre reaches 14 African countries where medical facility partners annually perform thousands of cataract surgeries. Its goal is to further expand so that “all Africans can access high quality, patient-centered eye care, provided by Africans in well-functioning systems.”
Lewallen and Courtright, now 70, are semi-retired living in Rancho Bernardo. They have two adult sons who were raised in Africa, a daughter-in-law and a grandson, all currently living in Africa.
Between them, they have authored 450 scientific papers and three books. They remain on Kilimanjaro Centre’s board of directors, although locals primarily manage it now. They both are on the University of Cape Town, South Africa, faculty and often travel to Africa.
In 2008, they received the prestigious “International Blindness Prevention Award” from the American Academy of Ophthalmology.
It was the only time in 30 years that the award was given to co-winners, a fitting honor for two doctors who realized a dream.
