She Saw the Hills Again: One Woman's Journey Through Cataract Treatment in Rwanda

By RWAMREC | Faces of Change | Musanze District, Rwanda

"After they removed the bandage, I immediately saw the hills of my home area. It had been a long time since I had seen." — Velediana Ntahorutaba, 77, Musanze District

A Life Slowly Dimming

For Velediana Ntahorutaba, the world did not go dark all at once. It faded — slowly, quietly, the way dusk settles over the hills of Musanze. Shapes became shadows. Faces became blurs. The fields she had worked her whole life became places she could no longer navigate alone.

Velediana is 77 years old. She lives in Gahanga Village, Rugeshi Cell, Nkotsi Sector, in the heart of Musanze District in northern Rwanda. Like many older people in her community, she had been living with deteriorating vision for years — not because treatment was unavailable, but because no one had ever told her that what she was experiencing was not simply the inevitable consequence of growing old.

She could not see the faces of people standing right in front of her. She could not farm. She could not fully participate in the life of her community. And yet, for a long time, she waited.

The Day Everything Changed

When Velediana finally went for treatment at Shyira Hospital, surgeons performed cataract surgery on one of her eyes. She does not describe the procedure in complicated terms. What she remembers — what she will never forget — is the moment the bandage came off.

After they removed the bandage, I immediately saw the hills of my home area.

For most people, seeing a hill is unremarkable. For Velediana, after years of blindness, it was everything. The rolling green landscape of Musanze — the same hills she had known her entire life — came flooding back in one overwhelming moment of clarity.

She went home. She returned to her farm. She began to live again.

A Ripple Through the Community

What happened next is perhaps just as remarkable as Velediana's own recovery.

Her neighbors — women and men her own age, people who had watched her struggle and then witnessed her transformation — came to see for themselves. They needed to confirm with their own eyes that she had truly recovered. That it was real. That it was possible.

And then, one by one, they followed her.

Many of them have come here to the campaign so that they can also get treatment for eye diseases,

Velediana says with quiet pride.

This is how change travels in a community — not through posters or announcements, but through the living testimony of someone you trust. Velediana did not set out to be an advocate. She simply got better. And in getting better, she became the most powerful argument her community had ever seen for seeking care.

Coming Back for More

Today, Velediana has returned to the outreach and screening campaign in Nkotsi Sector — not for herself alone, but also for her second eye, which is also affected by cataracts.

She is not afraid. She has seen what is possible.

she says.

I have confidence that the second eye will also heal. Before, I could not farm. But now I am able to. Going to the hospital is important.

She repeats it like a message she wants to make sure the world hears: going to the hospital is important. It is the kind of sentence that sounds simple until you understand everything that stood in the way of her saying it — and believing it — for so many years.

The Barrier Behind the Blindness

Velediana's story is deeply personal. It is also deeply common.

Across Rwanda, cataracts are one of the leading causes of preventable blindness — a condition that is fully treatable with a straightforward surgical procedure, yet one that thousands of people live with untreated for years. The reason is rarely a lack of hospitals or surgeons. The reason is everything that happens before a person decides to walk through the door of a health center.

Cultural beliefs tell people that failing eyesight is simply part of aging — something you accept, not something you treat. Traditional remedies are tried first, sometimes for years, sometimes making conditions worse. For women, the barriers are layered: they may lack the financial independence to seek care, the decision-making power to go without permission, or the time to prioritize their own health over the needs of their family. For men, the pressure to appear strong and self-sufficient can make admitting to a health problem feel like a sign of weakness.

These are not medical barriers. They are social ones. And they require social solutions.

The Project Changing How Communities See Eye Health

This is the challenge that RWAMREC's Health System Strengthening for Eye Health project was designed to address.

Funded by the Fred Hollows Foundation, in partnership with LDSC and Australian Aid, the project operates in Musanze and Karongi districts with a clear and ambitious goal: to promote gender equity and inclusion in eye health by changing the attitudes and behaviors that stop people from seeking care in the first place.

Rather than relying on top-down health messaging, the project takes a gender-transformative, community-led approach — building a chain of trusted people within communities who can carry the message where it matters most.

How it works

The project trains community health workers (CHWs), local and religious leaders, healthcare providers, and members of Men Engage clubs on three interconnected themes: eye health, gender equality, and disability inclusion. These individuals then carry that knowledge back into their communities — through home visits, church gatherings, community meetings, school outreach, and one-on-one conversations with neighbors.

The idea is simple but powerful: people are far more likely to seek care when they hear about it from someone they already trust.

Outreach campaigns bring eye health services directly into communities, with on-site screenings conducted by ophthalmologists from Ruhengeri and Kibuye referral hospitals. Radio dramas — developed in collaboration with Urunana DC and broadcast on RC Musanze — reach audiences who may never attend a campaign in person. Information, education, and communication (IEC) materials developed through co-creation workshops ensure that messages are culturally grounded and community-owned.

The results after one year

In just its first year of implementation (July 2024 – June 2025), the project reached:

• Over 276,000 people through awareness campaigns, home visits, and outreach events in Musanze and Karongi districts

• More than 1,000 cataract cases identified and referred for treatment

• 2,000+ community health workers, leaders, and club members trained on eye health and gender norms

• A threefold increase in monthly eye consultations at some health centers — from 50 to over 150 patients per month

Behind every one of those numbers is a person. A neighbor who finally went to the clinic. A father who admitted his vision was failing. A grandmother who came back for her second eye.

Why Gender Equity Is Central to Eye Health

RWAMREC's approach is rooted in a foundational insight: you cannot solve a health access problem with medical solutions alone.

For women like Velediana, gender inequality shapes every step of the health-seeking journey — from whether she feels entitled to prioritize her own health, to whether she has the resources and freedom to act on that decision. For men in her community, the same cultural norms that pressure them to appear invulnerable quietly stop them from seeking treatment for conditions that are entirely curable.

By engaging men as allies rather than bystanders — and by training community leaders to actively challenge these norms — the project creates an environment in which seeking care becomes not just acceptable, but expected. It becomes what responsible, caring community members do.

This is what makes Velediana's story so powerful. She did not just recover her sight. She became, without intending to, a living rebuke to every cultural belief that had kept her and her neighbors from seeking help. Her recovery was the proof her community needed.

A Future Where No One Has to Wait

RWAMREC's vision for this project is ambitious and clear: a community that no longer needs to be told to seek eye care — one that simply does.

That kind of lasting change does not happen overnight. It requires sustained engagement, trusted relationships, and a community that has internalized the belief that their health — every member's health — is worth fighting for. It requires more Veledianas: people whose recoveries become living testimonies that ripple outward through families, through neighborhoods, through generations.

Year two of the project will expand these efforts to additional districts, deepen partnerships with schools and religious networks, and continue building the community infrastructure that will sustain this change long after the intervention ends.

Velediana's Message

Before leaving the campaign in Nkotsi, Velediana has one thing she wants people to know.

She has said it to her neighbors. She says it to anyone who will listen. She will say it again now, clearly and without hesitation:

Going to the hospital is important.

It is a sentence that cost her years to learn. It is a sentence that, thanks to the community health workers, local leaders, and outreach teams who showed up in her village, more and more people in Musanze and Karongi are finally hearing — and believing.

Velediana Ntahorutaba lives in Gahanga Village, Nkotsi Sector, Musanze District, Rwanda. Her testimony was collected during the RWAMREC outreach and cataract screening campaign in Nkotsi as part of the Health System Strengthening for Eye Health project, 2024–2025.

To learn more about RWAMREC's work on gender equity and health, visit rwamrec.org.