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.