Don't crush the Queen's hand, please

Wearing your first pair of shoes in Form One means meeting Queen Elizabeth II is not even among your wildest dreams.

And not when the soles of your feet are so cracked "a 50-cent coin could easily fit in them," jokes Dr Hillary Rono, an ophthalmologist.

But meet the Queen, he did at Buckingham Palace in 2019.

Dr Rono had then been working at the Eye Unit of Kitale District Hospital since 2015 covering Trans Nzoia, West Pokot and Turkana, but had travelled to the UK for a workshop related to ophthalmology.

See, his PhD project was based on the Peek Vision and had been funded by Queen Elizabeth II Diamond Jubilee Trust.

On a material day, he didn't know he was going to meet the Queen as "there were two invitation cards to Buckingham Palace; one white, the other blue. I had the white one" and at the entrance, cardholders guided to separate rooms.

His white card took him to the Holding Room inside Buckingham Palace where guests were issued with etiquette protocols, how to behave in front of the monarch.

"This involved simple things like how to greet her, just lightly unlike the firm handshakes that we are used to, how to take a bow, how to correctly address her as Ma'am," recalls Dr Rono.

He also remembered the guests were cautioned against saying unnecessary things "maybe they thought we would start saying how we have come from a poverty-stricken country or something close to 'serikali saidia.'"

Though nervous, Dr Rono realised the Queen was very humble and quite engaging, and in their one minute interaction, she asked about eye care in Kenya.

"At 93 years, she was very clear and articulate and as we spoke, she wanted to know how much we had achieved in terms of eye care, to know how the fund was being utilized and the benefits it had brought in the country."

Queen Elizabeth II Jubilee Diamond Trust Fund bankrolls trachoma projects in over 10 counties in Kenya. Set up in 2012, its programmes commemorated Her Majesty's Service to Commonwealth and were earmarked to end two years ago.

"In Kenya we had two programmes; the scholarship programme for PhD in which I benefitted and the technical one on sustainable eye care projects to eliminate avoidable blindness," explains Dr Rono whose PhD project focused on how Peek, a smartphone-based eye screening system carries out vision tests to identify vision impairment.

This system was pioneered in Trans Nzoia, West Pokot and Turkana counties, which had the largest burden of trachoma in Kenya and has since been rolled out in other countries across the world.

Turkana, he says, had a prevalence of 42 percent of trachoma meaning for every two children between one and nine years, one had active trachoma.

Through the programme, they implemented the SAFE strategy; Surgery, Antibiotic Therapy, Facial cleanliness, and Environmental improvement in those areas whereby the first survey was done in 2010. Data from the second survey in 2017 indicated the prevalence had gone down to below 10 percent.

Dr Rono was then the eye health coordinator and led the baseline surveys in the three counties besides working as a consultant for the Ministry of Health.

Using the peek community technology, they doubled adherence to hospital services and school going children.

Dr Rono says identification of potential victims was not done by health workers, but by non-eye care workers like teachers in school or community health volunteers. This gave health workers time to offer other health services.

"That proved the system was capable of improving health services and was therefore rolled out in ten other countries," says Dr Rono.

"Last month we celebrated one million people who have been linked to health services using the technology and the reason I was invited to Buckingham Palace in 2019."

Although his initial interest was in obstetrics/gynaecology, his passion for eye care grew during a medical camp organised by The Christian Union during his medical school days at Moi University in 1995.

Over 50 percent of attendees had eye problems and "we only had tetracycline eye ointment to manage all the eye conditions and later. When I was doing my ophthalmology class at the University of Nairobi, I learned that was trachoma."

After graduation, Dr Rono was posted to Eldama Ravine for his internship. Having had to travel to Nakuru after an eye injury was what heightened his passion which grew when he realised the biggest problem in those areas was preventable blindness.

That meant people needed awareness on primary hygiene which saw him studying public health.

"I was based in Kitale, but would do outreaches in Turkana and people came to me, blind and crying for help and I would go back home to cry too," recalls Dr Rono.

His dreams of being a medical doctor was planted at five years when his father, a teacher, developed abdominal pains, was taken to the hospital by some priests, but returned in a coffin.

Dr Rono recalls how "being young, we didn't know what had happened. Nobody told us. We peeped inside and saw someone lying there, and two or three years down the line was when it hit us the person in that coffin was our father."

Thoughts why his father had abdominal pains and what happened in the hospital for him not to return home, drove him and his brother, a gastroenterologist, into medicine.

The dream was further incubated by his brother who "believed we would set up a big hospital to help people, and I am still waiting to see that dream materialize."

Seeing the priests escorting his father to hospital, presiding over his funeral, also got him toying with the idea of joining the priesthood.

"I think my soul was willing but my body was weak so that is how I later got married and had children," he laughs.

According to Dr Rono, one of his greatest achievements is the thousands of patients who have passed through his hands.

"Being the first ophthalmologist in the North Rift, I was operating from a small room and through friends from Canada, they built an ultramodern facility in Kitale, seeing around five thousand people in a year," he recalls.

"Now we are into 30,000 a year and in ten years of practice, 300, 000 looks good."

He has managed to grow the human resource in the three counties by mentoring more ophthalmologists to work and help, the effect of service to humanity he learnt during his high school years at Starehe Boys' Centre.