Comm Eye Health Vol. 15 No. 41 2002 pp 15. Published online 01 March 2002.

A study of patients attending for eye surgery at a rural hospital in the Republic of Benin

Andrew R Potter MRCOphth DTM&H

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Over a 14-week period from 27 June-4 October 2000 all patients discharged from our eye unit after surgery were asked to complete a verbally administered questionnaire.

The St Jean de Dieu Hospital is situated 15 km north of Parakou, the major town in northern Benin (pop. 100,000+). The eye unit is staffed by one expatriate surgeon, three national nurses and one clerk.

One hundred and fifty-six questionnaires were completed. The age range of patients was from 2-90 years. Ninety-nine (63.5%) were over 65 years. Ninety-two were male, 64 were female (male:female 1.4:1)

Distance travelled and means of transport

  • 14% travelled less than 20 km
  • 20% travelled 20-100 km
  • 66% travelled over 100 km.

The means of transport used were:

  • Car taxi (communal) 72%
  • Motorbike taxi 10%
  • Train 6.7%
  • Personal/family car 5%
  • Family motorbike 4.5%
  • Other car 1.9%.

Pathology

Of the 156 patients, 66% were operated for cataract and 16% for glaucoma. Other pathology included pterygium (4) and entropion (3). When asked how many understood their pathology, 60% said they did not.

Occupation

The patients’ occupations were: 37% housewives (who usually work just as hard in the fields, as do their husbands); 29% subsistence farmers and 10% cattle herders. Six were children under 15 years (only one of whom attended school) and five patients were officially retired and in receipt of a pension.

Cost of surgery

We asked each patient who had paid the cost of their operation: 42% were self-financed; 38.5%were paid by patient’s children; 9% were paid by a parent and a further 9% by the patient’s wider family. The vast majority (98.7%) did not consider the consultation cost (US$2) too expensive. The price of surgery was acceptable to 95.5% (US$28 for cataract surgery with either an implant or aphakic spectacles).

On discharge from the hospital, usually 7 days after their operation, 135 (86.5%) said that their vision had improved, 17 (11%) said it was worse. Each patient was asked if they experienced too much pain either during or after the operation. Whilst 131 (84%) did not experience too much pain, 23 (15%) did. Two patients made no comment.

General comments

Finally, patients were asked for any additional comments. Sixty-seven patients volunteered 80 comments

  • Satisfaction (18)
  • Wished for a better result (16)
  • Thankful to staff (7)
  • Need for hospital to be cleaner (4)
  • Experienced too much pain (3)
  • Will pray for the staff (3)
  • Will tell others to come (3)
  • Other comments (26).

Note: The eye service at St Jean de Dieu Hospital is supported by Christian Blind Mission International.

Table 1. How patients knew about the eye clinic

How informed? No. (%)
Another patient 54 (34.5)
Outreach clinic 46 (29.5)
Radio 35 (22.5)
Family 7 (4.5)
Friends 6 (3.8)
Other 8 (5.1)

Table 2. Emotions experienced by hospital patients

Emotions No. (%)
Confidence in the doctor 27 (17.3)
Fear 26 (16.6)
Uncertainty 24 (15.4)
Confusion 9 (5.8)
Confidence 6
Confidence in God 2
Satisfaction 1

Table 3. Evaluation by patients of their stay in hospital

Emotions Satisfactory Fair Unsatisfactory
Check-in desk 156 0 0
Nurse 153 1 2
Doctor 131 19 6
Consultation 152 1 3
Operation 129 20 6
Post-operative care 152 1 3

Published courtesy of: Tropical Doctor 2002; 32: 17-19