A Vision of Equity

Picture of a child at an eye hospital

ORBIS Flying Eye Hospital Programme – Addis Ababa, Ethiopia – October 2012

Lene Øverland, CEO, Orbis Africa (and 10GA programme partner) writes on the need for eye care for children.

The second a child is born, their eyes encounter the outside world for the first time – a world beyond the warm home of the mother’s uterus.

In South Africa, in that same second, that baby’s future is – for better or worse – often mapped out by the dire inequality that still plagues us more than twenty years after the first democratic election.

This affects every single aspect of life from education, to nutrition, to housing, to protection, to health (to name but a few).

Our unenviable label as “the most unequal society on earth” is a heavy burden to carry – with many left asking that overwhelming question: where do we begin?

Sometimes, the best way to begin is to find that one thing which alone could change people’s lives, and then let it have a positive domino effect on everything else.

That ‘one thing’ can, in fact, be sight.

What few people know is that 50% of cases of childhood blindness were in fact preventable and in many cases, treatable.

Across the world, there are an estimated 1.4 million blind children, many of whom are from low income countries and 320 000 of whom live in sub-Saharan Africa (with many more suffering from lesser forms of visual impairment).

In South Africa, there are just over 100 000 blind children.

People often make an assumption that blindness isn’t a cause worth fighting for because “it’s too late to do anything about it”.

This misguided notion is especially true in South Africa when there are so many competing causes in our country beset with problems.

But, poverty itself is both a cause and consequence of childhood blindness and the real problem underlying the statistic of 50% of child eye health cases being preventable and treatment is to do with access to quality health services.

Such services are inaccessible to many, and at the same time, blindness feeds the cycle of poverty, poor health, and underdevelopment.

Imagine, for example, a child in a wealthier milieu whose family uses private healthcare.

It is very likely that any visual impairment, or the diseases that can lead to blindness, will be detected very early on because of access to quality screening.

Then, if a problem is found, that same child will have access to whatever is needed to try rectify the problem.

A child from a lower income setting is firstly more likely to get the serious health conditions that lead to blindness. They are then less likely to access the right services. And now, left in a world of darkness or blurriness, their chance of having a comfortable life is marred even further.

That’s because blindness compromises a child’s development.

This translates into a lifetime of costs for the child, his or her family and society.

Those children are later not the only adults who, through lack of universal health coverage, suffer from not being able to see. There are many conditions – also preventable and treatable – that only hit later in life.

But, until there is equitable distribution of access to eye care services, and until universal health coverage includes eye health for all, many more people in our country will be “punished further” by a system that didn’t regard the eyes of that newborn baby as something worth fighting for right from the beginning.

Eye health through the gender lens

An African lady at an eye screening

Helen White, Director of Communications & Fundraising, Orbis Africa (and 10GA programme partner) writes on the role gender plays when it comes to eye health in Africa.

It is true that blindness can stalk anyone regardless of race or gender or age.

That’s if you view the eyes simply as an organ of the body devoid of any context in the real world and if you ignore all statistics.

The moment you see sight in context, all that changes.

Firstly, people in poorer communities are far more likely to become needlessly impaired, and when one considers that 80% of blindness could have been stopped if it was treated in time, this is a tragedy.

Then add into the mix that hottest topic of all: the gender-divide.

Like with many things, being a girl child or a woman immediately puts you in the ‘back row’ when it comes to who can and who can’t access services.

Did you know that on our continent, two thirds of blind and visually impaired people are women?

That’s because treatment and prevention come down to accessing services, and that is harder for women.

When it comes to cataract, there is another highly worrying statistic to consider: men are 1.7 times more likely to receive cataract surgery than women.

If that were to change, and women in Africa received surgery at the same rate as men, cataract blindness would be reduced by a whopping 12%.

A closer look at social factors reveals the unfair load placed on women who lose their sight: In countries such as South Africa, women bear the overwhelming burden of household responsibilities and child rearing, even when they have experienced debilitating sight loss.

Research in the KwaZulu-Natal province found that men were often able to seek financial and personal support from wives or daughters when they suffered visual loss or impairment.

Women, on the other hand, carried the burden of cleaning, cooking, and child rearing as well as contributing financially to the household – even when blind!.

Both men and women are faced with barriers preventing them from accessing the services they need, but women often experience debilitating challenges when sight loss is coupled with gendered economic, social and cultural expectations.

However, this bleak picture is of no use to those of us who can make a difference if we choose to turn our own ‘blind eye’ to the situation.

Put simply, a little innovation – through government, communities, non-profits and households – goes a long way.

Studies have shown that when women’s access to transport, money and social support improves, cataract (the primary cause of blindness) is reduced.

When existing social and traditional structures are used to train women to reach other female community members, an incredibly strong network of support is the result.

When girl children are sent off to school at the same rate as boy children, there is more chance that a problem with their sight will be picked up.

The earlier the detection the better: children with congenital eye disease need to be treated as quickly as possible to prevent permanent blindness.

A girl child who goes blind permanently becomes a woman carrying the same burdens as the ones described above.

Just remember: Blindness impedes education, can prevent people from finding employment or a life partner, and can lead to a lonely life in poverty.

Ask yourself if there is anything you can do about this – in your personal, professional or financial capacity.

We owe it to our country – because that is also our community.

Opening Ceremony

10GA_newsletterCard

The 10GA Opening Ceremony: A high-profile start to the premier event on blindness prevention

With over 1000 delegates witnessing the event, the IAPB 10GA will begin on the 27th with a spectacular Opening Ceremony. The highlight, of course, will be Dr Ellen Johnson Sirleaf, the President of Liberia and Nobel Prize laureate, speaking on her government’s tireless efforts to help establish strong health systems, with integrated, good-quality eye care services, in Liberia. Following in her wake will be Dr Aaron Motsoaledi, the South African Minister of Health, along with key dignitaries from IAPB. The ceremony will include a glittering achievement that IAPB is very proud of: the launch of the IAPB Vision Atlas. IAPB President Bob McMullan will then be presenting the IAPB Awards.

Just before the Opening Ceremony Dr Motsoaledi will be a part of a high-level panel discussion on the interface between civil society and governments, along with Peter Ackland, IAPB CEO and other members of politics and academia. The evening will close with the Welcome Reception—a beach-themed extravaganza at the Durban ICC.

Over three days of symposia, courses and plenaries, 10GA will have over 200 renowned speakers covering every aspect of eye care and public policy. These include speakers like Dr Matshidiso Moeti, the Regional Director of the World Health Organization (WHO) Africa region and Mr Tim Evans, Senior Director of Health, Nutrition and Population at the World Bank, among others.

10GA Opening Programme

High-Level Panel

16:15-17:10
ICC HALL 1

How Civil Society Can Interface with the Government

  • Identify enabling factors and challenges in the relationship
  • Key ingredients for appropriate and effective partnerships
  • Mechanisms and processes to facilitate multi-sectoral cooperation

Speakers

  • Dr. Aaron Motsoaledi, National Minister of Health
  • Deputy Minister Bogopane-Zulu, Dept. of Social Development South Africa l Mr Thembinkosi Willies
  • Mchunu, Premier KwaZulu Natal Province (TBC)
  • Peter Ackland, IAPB CEO, Representing Civil Society
  • Representative from The Liberian Government
  • Professor Hoosen Coovadia

Opening Ceremony

17:30-19:00
ICC HALL 1

  • Opening and Welcome IAPB Address – Bob McMullan, IAPB President
  • IAPB Africa Chair & Chair: Organising Committee Address – Professor Kovin Naidoo l Provincial Address –
  • Mr W Mchunu, Premier, Kwazulu-Natal
  • National Address – Dr. Aaron Motsoaledi, MP, Minister of Health
  • Keynote Address – President EJ Sirleaf, President of Liberia
  • Launch of Vision Atlas – Peter Ackland, IAPB CEO
  • Presentation of IAPB Awards and Close – Bob McMullan

Welcome Reception

19:00-21:00
ICC HALLS 5/6

Experience the vibrant spirit of the fabulous Durban beaches brought to life

 Shuttle buses depart to event hotels every 15 minutes from 20:00-22:00

Improving eye care service delivery through mentoring: 10GA Course

Dr. Suzanne S Gilbert

Suzanne Gilbert, Senior Director of Seva Foundation’s Innovation & Sight Program, our 10GA Eye Health Investor, writes about her upcoming course, Improving eye care service delivery through mentoring.

A great investment of 90 minutes!

Welcome to Durban! During the past several months, I have worked with an international team of partners to create a course that addresses priority needs relevant to any eye care programme. Join in on Friday 28 October, at 14.00 in Meeting Room 11 if you can.

Course 9: Improving  eye care service delivery through mentoring tells the story of comprehensive service programme strengthening. The presenter team from FIVE continents addresses: What is mentoring? How does it promote programme improvement? What are priority intervention points? How do we nurture leadership? What about engaging with the community? What strategies are recommended to improve clinical performance? What about financial viability of programmes? Once improvements are made, how do we sustain them? And the big question: what sustainability strategies are important for reducing the environmental impact of our work?

The presenters have devoted many years to systematic efforts to improve eye care service delivery within their own institutions and also through the Global Sight Initiative mentoring network. Start your Friday afternoon with this engaging and enlightening session!

This is my eighth IAPB General Assembly. As Senior Director of Seva Foundation’s Innovation & Sight Program,  Co-Chair of the IAPB Human Resource in Eye Health Working Group and incoming Chair of the IAPB North America Region, I bring a special enthusiasm for all the 10GA has to offer. Make Course 9 part of your plan!

You can also catch Seva Foundation’s Heidi Chase (Associate Director, Innovation and Sight Programs) and Katie Judson (Global Sight Initiative and Program Learning Manager, Innovation and Sight Programs) speaking on Strategic Partnerships to Scale Quality, Sustainable Eye Service Worldwide and Financial Strategies for Accelerating Service Delivery respectively on October 30 at the Pavilion.

7 Reasons to Become a Lion!

Lions volunteers

Lions Clubs International Foundation, our 10GA Eye Health Investor will be hosting Catalysts of Change: The Role of Volunteer Service in Eye Health, a breakfast session designed to highlight the broader impact of volunteer service organizations, on eye health promotions. We re-share a post from them on how volunteering can be an enriching experience.

People considering joining their local Lions club often ask, “Why should I become a Lion?” Here are just a handful of reasons:

1. Serve the community.

Lions are committed to partnering with local leaders and organizations, identifying the unique needs of their communities and surrounding areas, and planning service projects that address those needs. From community clean-up projects to food drives to fundraisers, Lions help people in need who are close to home. We serve!

2. Make a difference in the world.

A small act like collecting recycled glasses may not seem like much at first, but when those glasses are distributed around the world through Lions sight missions that change lives, you’ll soon discover that Lions are making a big impact. Lions are everywhere: teaching children to read, responding to disaster, fighting measles, providing clean water and so much more.

3. Enjoy a rewarding experience.

There is no greater feeling than making a positive impact on someone’s life. Lions are doing good – for others and for themselves.

4. Make new friends.

Joining a local Lions club is a great way to connect with other people in your community and make new friends. Find a Special Interest club that involves people with the same interests, hobbies and passions. Or consider starting your own club! Serving together can help build relationships that last a lifetime.

5. Learn, grow and share.

Through volunteer work and community service, Lions are learning new things and developing leadership skills every day. Learn how to plan a food drive and feed the hungry. Learn about the risks of diabetes, and share your knowledge with community members to help them lead healthier lifestyles.

6. Grow as a family.

Lions clubs offer opportunities for families to volunteer together. Become a Lion with your spouse, children, grandchildren and siblings, and start spending quality time together while serving the community.

7. Develop young leaders.

By engaging youth, Lions are helping to develop strong leaders for the future. Leo clubs provide youth volunteer opportunities that allow young adults to become involved in community service and begin learning about the impact they can have around the world.

Be a part of the session on 30 October.

This post originally appeared here.

Photo Credit: Dan Morris

HKI helps streamline vision screenings for people with Diabetes in Indonesia

Diabetic Retinopathy screening

This is a post from Helen Keller International, our 10GA Eye Health Investor, on their work in Indonesia tackling diabetic retinopathy.

Annual eye exams for people with diabetes is not routine practice in Indonesia (like it is in countries like the United States), and the process to access care is time-consuming and convoluted. In 2000, the number of people with diabetes in Indonesia was estimated at 8.4 million; with this number expected to almost triple by 2030.1

Typically, people with diabetes make monthly visits to a primary health centre where vital signs are checked, blood is drawn, and a general practitioner is consulted. If concerns are raised, the GP refers the patient to a district hospital for a consultation with an endocrinologist. If an ocular condition is suspected, the person is referred to an ophthalmologist. But at district hospitals, ophthalmologists don’t often have access to retinal cameras, so patients may be referred to a third hospital for a definitive diagnosis before then being sent back to a district hospital for laser treatment.

In this system, patients only reach the point of diagnosis if something obvious is wrong. But early diabetic retinopathy—when the disease is most treatable—shows no symptoms. This system means less than 20% of people with diabetes were seen by an ophthalmologist.

Helen Keller International saw a need for change.

“As many as one in three people with diabetes may develop diabetic retinopathy, which would lead to a public health emergency in Indonesia,” says Country Director Prateek Gupta. “We saw an opportunity to work with the government and the hospitals to update systems to reduce preventable blindness.”

In 2009, a hospital-based screening programme was established in Jakarta. People with diabetes visiting the endocrinology clinic would have retinal photographs taken, and the images would then be transferred to the ophthalmology department. Any patients with diabetic retinopathy would be referred to an eye clinic for care. The process was then replicated in Bandung and Yogyakarta, two cities believed to have many people with diabetes.

In an effort to reach more patients and raise awareness, a new model was tested in Jakarta that revealed valuable information. In some primary health centres, fundus cameras were used for screening. Retinal photographs were taken that helped identify the presence of diabetic retinopathy or other undetected conditions; the images that were unclear or raised concerns earned patients referrals to a district hospital. In other primary health centres, education was provided.

Surveys revealed a lack of awareness about the need for eye care among the patients following both efforts. The first method proved more effective, as the fundus cameras enabled greater patient screening at the earliest point of contact. HKI also learned that patients simply told to visit a hospital were unlikely to follow through, but written referrals enabled reimbursement.

Since HKI began working with the government to address diabetic retinopathy, 10,000 patients have been screened and almost 2,000 treated. Perhaps more importantly, by building the capacity of the healthcare system and the professionals working in it, these efforts have set the stage for more effective care to come.

“We look forward to working with our partners in the Indonesian government and at the health facilities to identify new models for screening and treatment and expanding access to vision-saving care,” says Gupta.

Don’t miss the pavilion session by HKI, on their other work in Indonesia, Lessons learned from a school-based refractive error screening program in Jakarta, Indonesia, on 28th October.

 

 

10GA: Top-10 Safety Tips

hashtag safety with 10GA logo
Remember, your safety is strongly dependent upon you, no matter where you are visiting. Always be aware and always know where you are going. Be particularly vigilant on the beach-front and to the North of Durban. With that in mind, please note some safety tips for when you travel to Durban next week.

  1. When in a car fasten your seat-belt, lock your doors and only leave your windows open about 5cm
  2. Never pick up strangers and do not stop along the road at deserted areas
  3. Never display your valuables in the car, e.g. handbags, clothes, mobile phones
  4. Beware of your surroundings when you stop at a roundabout or stop sign
  5. Consumption of alcohol in public places constitutes a criminal offence
  6. Use reputable exchange bureaux or banks to exchange money or travellers cheques
  7. All tap water in South Africa is safe to drink
  8. Just like anywhere else in the world, please do not leave your luggage unattended
  9. Keep your room door locked, whether you‘re in or out
  10. If someone knocks on your door, check who it is before allowing them to enter

On the street:

  1. Please keep your valuables, e.g. jewellery, camera, cell-phones, out of sight
  2. Do not carry your passport. Secure in safety deposit box at your hotel
  3. Use credit cards or, if not possible, carry only small amounts of cash
  4. At night, avoid isolated, dark places
  5. If you require any information, policemen or tourism information officers will gladly assist you
  6. Do not wear backpacks
  7. Taxis are highly recommended and are a good, safe way to travel, especially in areas you are unfamiliar with; your hotel can help with booking a taxi
  8. Obtain advice from your hotel prior to embarking on foot
  9. If embarking on a tour use a registered tour guide
  10. Store valuables in the safety deposit box at your hotel’s reception

The 10GA welcome desk can advise on these or any other questions you may have. Keep the 10GA app handy in case you need to get in touch with us.

General Emergency Telephone numbers:

  • In the event of an emergency: 10111
  • Vodacom, Cell C and MTN cell-phone users: 112
  • This is a 24-hour emergency number, throughout South Africa, Swaziland and Lesotho: 082 911
  • Durban Metro Police Control Room: +27 (0) 31 361 0000
  • South African Police Service Delivery Line: 080 000 0596
  • Ambulance: 10177
  • Fire Brigade: +27 (0) 31 361 0000
  • Business Against Crime: +27 (0) 31 332 0437
  • Tourism KwaZulu-Natal: +27 (0) 31 366 7500; +27 (0) 86 010 1099
  • Airport: +27 (0) 32 436 0031
  • Travel Doctor: +27 (0) 31 360 1122

BOOSTing surgical outcomes: Pavilion Presentation

Man after cataract surgery

 

This is a post from Nathan Congdon, on BOOST, an app created to boost surgical outcomes.

Un-operated cataract remains the world’s leading cause of blindness. Training new surgeons to perform high-quality operations is critical to managing the problem, but it is impossible to improve quality without being able to measure it. And the low rates of follow-up after cataract surgery in many low-resource areas makes measurement of outcomes challenging.

Consequently, a group of non-governmental organizations (NGOs) are working with Aravind Eye Hospital, one of the largest eyecare facilities in the world, to create an app leading users in Low and Middle Income Countries (LMICs) through data collection protocols validated in an earlier study called PRECOG.

An informal market survey of 90 hospitals in LMICs showed strong demand for user-friendly software allowing users to measure and benchmark their surgical results against other practitioners in a cloud-based database, while also providing simple advice on improving outcomes.

Based on this feedback, our app, called BOOST (Better Operative Outcomes Software Technology), steps the user through two rounds of data collection: First, uncorrected (without glasses) visual acuity the day after surgery is measured for 60 consecutive patients.  This allows outcome quality (proportion of patients with good [>= 6/18] and bad [<= 6/60] visual acuity) to be benchmarked, initially against the PRECOG database, and subsequently against other BOOST users.

Secondly, users choose from among three reasons for poor vision outcomes (refractive problems, surgical mis-adventure, presence of ocular co-morbidity) for each of 20 consecutive patients returning >= 6 weeks after surgery with presenting vision <= 6/60.

The app then suggests changes in practice to remediate the most common cause of poor vision identified for a user. At this point, programmers at Aravind have completed a Windows version of the software, which has been field-tested at facilities participating in the initial market survey.

We are using support from the Standard Chartered Bank Seeing Is Believing Global Innovation Fund to complete an Android version of BOOST, V1.0 of which should be available for testing by the time of 10GA in Durban. The app will be made freely available on websites of supporting NGOs, eye hospitals and national ophthalmic organizations.

We hope in this way to transform our research result into a practical tool to improve cataract surgical quality in areas of limited resources.

To learn more, be a part Course 32: Assessing and Delivering Quality in Cataract Surgical Training and Service by Nathan Congdon, or attend the BOOST session at the pavilion.

Photo: Submission from Lindsay Hampejskova for the #StrongerTogether Photo Competition.

SightFirst Brings Clearer Vision to Timor Leste

10GA blog_LCIF

This is a post from Lions Clubs International Foundation, an Eye Health Investor at the 10GA, on their work in Timor Leste through their SightFirst programme.

Timor Leste is a small country located to the southeast of Indonesia and northwest of Australia. It has a population of just over a million people, half of whom are under the age of 18, with a majority living in rural areas. Timor Leste’s infrastructure was almost completely destroyed in the violence that followed the vote for independence in 1999, which also left the country without a viable health care workforce. The country continues to rely heavily on visiting teams from other countries while slowly trying to build its local health care capacity.

The Lions of Australia have a long history of support to Timor Leste, including leading teams to repair and build hospitals and schools, supplying medical aid and spectacles, and supporting the eye care and transportation of patients in remote areas.

When the Lions of Australia decided to apply for a SightFirst grant from Lions Clubs International Foundation (LCIF), a national eye health survey had found that 91 percent of people had reported a previous or current eye or vision problem, yet only 34 percent of these had ever sought out care. Many people did not know treatment was available or were not able to get to a doctor. The survey indicated that approximately 47,000 people over the age of 40 had some sort of visual impairment. It was determined that nearly all of these conditions are preventable or treatable.

The Lions undertook this project to build the country’s overall eye care capacity by strengthening the existing eye care human resources and improving the infrastructure at the district level. Infrastructure upgrades include providing ophthalmic equipment to five eye clinics and establishing a prosthetic eye lab.

This project is a collaboration between the Lions of Timor Leste, District 201-Q4, Lions Recycle for Sight Australia, the Ministry of Health and the RACS Timor Leste Eye Program.

Attend the session by Lions Club International Foundation on SightFirst funding opportunities at the Pavilion on 29 October from 15:30-16:00.

 

A guide to the 10GA

Picture of Durban Botanic Garden

The 10th General Assembly is less than a month away and there are many micro details that are not part of the event but are still fairly important.

We have put together almost all the questions you had about the venue, the transport, the programmes and much more.

The 10GA App

10GA_app

The 10GA app is available for download in the App Store & Google Play, and it allows you to plan, organise and communicate with fellow attendees. Everything you need, from live activity streams to the full programme of courses, Breakfast Sessions, speakers and sponsors is all available in the palm of your hand.

Safety and Security

Do read up on the safety and security instructions before you make travel plans.

Accommodation

Delegates are responsible for their own accommodations. However please note that the standard time at all hotels for check in is 15:00 and for check out is 12:00.

For any accommodation support or accommodation confirmation letters contact: Denese Govender (+27 (0)31 764 0143 / deneseg.letsgo@galileosa.co.za).

Shuttle Buses

For delegates attending the GA, the shuttle buses will be running from the airport to the official hotels and from the hotels to the Assembly venue / Opening Ceremony/ Gala Dinner venue. The information on departure times and dates can be checked out here.

If you require support on transfers outside of the above hours please contact: AquaTours bookings@aquatours.co.za  / +27 (0) 31 563 5003 or use an Uber.

Travel Safety Guidelines

The delegates intending to travel in and around Durban can go through the Travellers Tips & Safety Advice Booklet  provided by the Durban Convention Bureau.

10GA Events and Guidelines

Registration / Name Badges

  • All the delegates are required to wear badges during the entire event. The registration for the delegates will open at 14:00 on Thursday 27th October (exhibitors will be let in 12:00-14:00).
  • The badges shall feature the information entered during registration.
  • Name on badge: from system
  • Organisation on badge: from system
  • The above will be displayed unless you advise alternatively before 13 October by emailing iapb10ga@myt.uk.com
  • Delegates who have registered but have not processed outstanding payments before 14th October will automatically be transferred to on onsite rates.
  • Providing the passport details are a must, pending which the entry to the 10GA on the 27 October cannot be guaranteed.

For any query regarding registrations please email: Eva Natcheva at iapb10ga@myt.uk.com.

WiFi at the Venue

The Durban ICC offers complimentary WIFI throughout the centre and the WIFI password is: durban1cc. Since it is a public Wi-Fi service, the speed could vary depending on the number of users.

CPD

CPD and CET

The 10GA includes opportunities for delegates to earn Continuing Professional Development (CPD) points valid for optometry professionals in the United Kingdom and South Africa – please read more here

  • The Professional Registration number provided during your registration will appear on the badge (it will appear empty if no number provided).
  • If you would like to add/amend your number, please log back into your registration using the details below:
  • 10GA Modify Registration Website
  • Reference number: from system
  • Email address: from system

Social Programmes

For the opening ceremony taking place on the 27th October there will be a security check and the dress code is business casual.

The gala dinner on the 28th October will be held at the Durban Botanic Gardens. The theme is ‘Elegant Africa’ so delegates are encouraged to dress accordingly. Consequently, beaded jewellery can be purchased in the 10GA Exhibition hall during the conference dates. In terms of travel, there will be transfers organised to and from the venue that can be seen here.

Information at the 10GA

10GA_helpdesk

Maximize Your Time (MYT Events) will be at the 10GA assisting with any logistical questions.

They can be contacted on the Help Desk on Thursday 27th October (located close to the main entrance and registration area) and the Information Desk on Friday 28th – Sunday 30th (located just outside the Exhibitor area).