Building a Retina Surgery Program in Sierra Leone

A mission team reflects on surgical innovation, logistical challenges, and the long-term goal of building sustainable vitreoretinal care in West Africa.

By
Sean J. Jin, MD
Tedi Begaj, MD
Lloyd Harrison-Williams, MBBS
Steven Yeh, MD
Grant A. Justin, MD
July 1, 2026
11 min

Retinal Physician

Objective:

To develop sustainable vitreoretinal care in West Africa, particularly in Sierra Leone, in the context of significant logistical challenges and resource limitations faced during the Ebola outbreak and beyond.

Approach:

Mission Team Collaboration: A surgical team, including Dr. Steven Yeh and local ophthalmologist Dr. Lloyd Harrison-Williams, initiated efforts to establish vitreoretinal surgical capacity in Sierra Leone, building on their collaboration that began in 2015.
Surgical Procedures: The team performed approximately 400 vitrectomies and 100 corneal transplants, demonstrating the feasibility of delivering complex ophthalmic care in resource-limited settings.
Training and Sustainability: The initiative focused on training local ophthalmic surgeons to ensure the establishment of a sustainable vitreoretinal surgery program.

Key Findings:

The cost of supplies for complex retinal surgeries is significantly higher than for cataract surgeries, raising questions about resource allocation.
Logistical challenges include disrupted supply chains and environmental threats to equipment.
Sustainable care requires affordable systems and stronger international partnerships.

Interpretation:

The mission illustrates the complexities of establishing advanced surgical care in resource-limited settings.

Limitations:

Resource scarcity limits the availability of essential surgical supplies and equipment, impacting surgical outcomes.
Environmental factors, such as humidity and electrical outages, pose risks to surgical machinery.