Cataract blindness: Poverty, fear leave thousands frustrated in Niger

When Asabe Mahmud, 40, of Mariga Local Government Area of Niger State began losing her sight, the consequences extended beyond her eyes. Her worsening vision affected her independence and disrupted her daughter Maryam’s education.

Maryam was eight when she stopped attending school.

Now 10, she has spent about two years out of classroom as her mother struggled with cataracts in both eyes.

A government intervention on October 8 eventually enabled Asabe Mahmud to undergo surgery and regain her sight.

She is now working towards getting Maryam back to school.

Their experience illustrates how a treatable eye condition can disrupt an entire household when treatment is beyond reach.

Across Niger State, thousands of people are believed to need cataract treatment. While some cannot afford surgery, others face long journeys to health facilities or fear that an operation could leave them worse off.

For people who depend on their sight to earn a living, care for relatives or manage daily activities, untreated cataracts can gradually take away their independence.

Thousands still need treatment

Dr Halima Isah Umar, a consultant ophthalmologist, Chairperson of the Niger State Eye Care Programme and Head of the Eye Centre at General Hospital, Minna, estimates that about 14,000 people in the state are blind from untreated cataracts.

The figure is an estimate based on applying findings from Nigeria’s national blindness survey to the state’s population and geographical context.

It is not a verified count of individual patients, but Umar considers it a conservative indication of the scale of the problem.

She also estimates that about 5,000 new cataract cases arise annually in the state, adding to the existing backlog.

Cataracts develop when the eye’s natural lens becomes cloudy, causing blurred or dim vision that can worsen over time. Surgery involves removing the cloudy lens and replacing it with an artificial one.

Umar estimates that cataracts account for 50 to 60 per cent of blindness cases in Niger State.

The problem extends beyond the state.

Nigeria’s National Eye Health Strategic Development Plan 2024–2028 estimates that more than two million people nationwide need cataract surgery, with over 70 per cent living in rural areas.

The plan projects that 612,941 Nigerians were blind from cataracts in 2023.

This is a modelled estimate, not a register of individually confirmed patients.

Financial constraints have long affected access to treatment.

An analysis of Nigeria’s National Blindness and Visual Impairment Survey found that 36 per cent of people who were blind from cataracts and had not undergone surgery said they could not afford it.

The analysis also reported cataract surgical coverage of 38.3 per cent, falling to 25.3 per cent among women in poor households.

The underlying survey was conducted between 2005 and 2007, so these figures reflect historical access, not current national coverage.

Muhammad Abubakar Enagi, Executive Director of the Empowerment Initiative of Persons with Disability in Niger State, said untreated cataracts could place severe pressure on patients and their families.

According to him, “When someone loses their sight because of cataracts and cannot afford treatment, life becomes very difficult for both the individual and the family. It can lead to hunger, poverty and hardship.”

Enagi identified limited information about available services, transport costs, distance to hospitals, fear and inadequate outreach as barriers facing rural residents.

He, however, said his organisation does not yet have a comprehensive, verified statewide record of people living with untreated cataracts because it is still building its capacity.

When fear keeps patients away

Even when treatment is available, some people remain reluctant to undergo surgery because they fear losing the sight they still have.

Bako has chosen to avoid medical treatment, relying instead on local remedies because he worries an operation could leave him completely blind.

“Nothing will make me go for treatment. I have been treating it locally, and since I can manage to see, though no longer clearly, I will not go for them to spoil what I have left of my sight.

“I have heard of people who went for treatment but did not regain their sight, so I decided it was better to stay away,” he stated.

His decision reflects how fear and accounts of unsuccessful treatment can influence patients’ choices, even when their vision is deteriorating.

Malam Adamu’s experience illustrates the consequences of prolonged delay.

According to his son, Aminu, the family urged him to seek medical attention about 10 years ago, but he continued relying on local herbs and refusing hospital treatment. He eventually lost his sight.

Dr Abdullahi Imam, Permanent Secretary in the Niger State Ministry of Health and a consultant ophthalmologist, warned against using eye drops and medicines bought online or through social media as supposed cures for cataracts.

He also warned that ordinary eye drops and unverified medicines cannot clear a cataract. Surgery remains the established treatment when the condition significantly affects vision.

For patients who fear surgery, reliable information and consultations with qualified eye-care professionals may help address their concerns.

But reassurance alone cannot resolve the problem for those unable to afford treatment.

The cost of regaining sight

For some patients, the cost of treatment is a major obstacle. Others have regained their sight after receiving financial assistance.

Baba Manko, a 65-year-old trader at Kasuwan Gwari Market in Minna, lived with cataracts in both eyes for about three years before undergoing surgery in January through the intervention of a non-governmental organisation.

He estimated that treatment would otherwise have cost him more than N60,000, an amount that could have been difficult to raise from his trading income.

Manko said about 15 other people also benefited from the intervention.

Paul, another patient, told DAILY POST that he paid more than N100,000 for cataract treatment about three years ago. His surgery was successful, and his sight was restored.

His experience demonstrates the benefits of treatment but also illustrates the financial burden facing patients who must pay for it themselves.

For rural farmers, market traders and older people who depend on relatives, the cost of surgery, transport and hospital visits can make treatment difficult to access.

Maimuna Isah, who benefited from an earlier government intervention, said restoring her sight helped her regain her independence.

“I was among those who benefited from one of the government interventions last time, and today I am okay, Alhamdulillah.

“I no longer need to depend on my children for help. But before then, living in a state where I was almost blind was hard for me,” she said.

Her experience shows how restoring sight can enable patients to resume daily activities and reduce their dependence on relatives.

Nine ophthalmologists for seven million people

The availability and distribution of specialists also affect access to treatment in Niger State.

Imam said nine ophthalmologists serve a state with a population of about seven million people.

Although specialists are distributed across secondary health facilities, services remain concentrated in major centres, including Minna and Bida.

Residents of remote communities may therefore have to travel long distances to receive specialist care, adding to the difficulties faced by people with deteriorating vision. Expanding the eye-care workforce and distributing specialists more evenly could bring treatment closer to underserved communities.

Primary healthcare centres and outreach programmes could also identify patients earlier and refer them for appropriate care.

The World Health Organization reported in February 2026 that three in every four people in its African Region who needed cataract surgery remained untreated.

The WHO identified shortages and unequal distribution of eye-care professionals, high out-of-pocket costs, long waiting times and limited awareness as major barriers.

These challenges reflect the experiences of patients in Niger, where fear, financial constraints and distance can prevent people from obtaining treatment.

Government interventions offer relief

The Niger State Government at some point organised eye-care interventions to help residents who cannot afford treatment.

During activities marking World Sight Day on October 8, 2026, at the Eye Centre of General Hospital, Minna, the state provided free cataract surgeries, eye screening, treatment for common eye conditions, reading glasses and counselling for vulnerable residents.

Dr Murtala Muhammad Bagana, the state’s Commissioner for Health, announced that 30 free cataract surgeries would be provided during the programme. Umar later said 32 surgeries were performed.

Bagana also referred to an earlier state eye camp during which more than 200 cataract surgeries were carried out and over 1,000 reading glasses distributed.

Aside from that, he disclosed that another programme was planned for November, with a target of reaching 1,000 beneficiaries.

The interventions have helped patients such as Asabe and Maimuna regain their sight and independence.

However, the estimated backlog of 14,000 people in Niger State and Umar’s projection of 5,000 new cases annually raise questions about whether occasional eye camps can meet the continuing demand.

The Federal Government has also set a target of providing 25,000 free cataract surgeries nationwide by the end of 2027 under the Renewed Hope Health Connect initiative.

Announcing the target on October 8, 2026, the government said it had trained more than 3,000 healthcare workers across 16 states and activated over 1,400 primary healthcare centres to provide primary eye-care services.

The national target must be considered against the eye-health plan’s estimate of more than two million people needing cataract surgery.

Sustained implementation and transparent reporting will be needed to show how many patients receive treatment and whether underserved communities are being reached.

Reaching people before sight is lost

For Enagi, addressing untreated cataracts requires reaching people in rural communities rather than waiting for them to arrive at hospitals.

Community-based screening and outreach could identify people whose vision is deteriorating, particularly older residents and those who have lived with the condition for years.

Such programmes could also provide reliable information about cataracts and the dangers of relying on unverified remedies.

But identifying patients is only part of the solution.

Those unable to afford treatment also need services that are financially and geographically accessible.

For families like Asabe’s, the consequences of untreated cataracts extend beyond the person losing sight.

A child may leave school to help at home, while a parent who can no longer work may struggle to provide for the household.

Asabe’s recovery shows what treatment can make possible. Manko and Maimuna’s experiences demonstrate how restored sight can help people regain their independence, while Malam Adamu’s story highlights the consequences of prolonged delay.

For Niger State, the challenge is to move beyond occasional interventions towards a sustained system that identifies patients early, expands access to specialists and ensures that people who need surgery can receive it.