23 June 2011
Collaborating to save children's sight in sub-Saharan Africa
Ten paediatric eye-care clinics in ten years - that was the commitment from multinational sight-saving organisation ORBIS, announced at a recent conference they hosted in Cape Town, when eye-care NGOs, ophthalmologists, health department officials and academics from around the world gathered to strategise on how to prevent children from going needlessly blind in sub-Saharan Africa.
With a direct link between the incidence of blindness and poverty, sub-Saharan Africa carries the heaviest burden - 23% of the world's blind (India has 19% and China 13%). “In terms of global blindness alleviation Southern Africa is a priority region,” said Lene Øverland, Director of Programme for ORBIS Europe, Middle East and Africa.
It seems that the poorer the community, the lower the chances of children surviving blindness. The World Health Organisation estimates that up to 60% of infants die within two years of becoming blind. “With a one hour procedure you can not only make a huge difference to a life, you can save it,” said Dr Hunter Cherwek, Medical Director of ORBIS, one of speakers at the meeting.
“Fifty percent of childhood blindness in Africa is avoidable,” said Professor Colin Cook, Head of Ophthalmology at the University of Cape Town, Groote Schuur Hospital and Red Cross War Memorial Children's Hospital. “Early intervention is very important both in the community and at a tertiary level.”
At the meeting Øverland challenged other stakeholders to embrace and add on to ORBIS' pledge of a one million dollar (R6.7-million) paediatric eye care clinic each year, over the next ten years. “There are fewer paediatric ophthalmologists and paediatric eye centres in Africa than anywhere else in the world. Correcting the tragedy of preventable blindness in the region is an urgent public health priority.”
According to WHO recommendations, one paediatric ophthalmic centre is necessary per 10 million people. Sub-Saharan Africa is grossly under-catered for with just 11 centres across the 47 countries: South Africa only has one dedicated children's facility at Red Cross War Memorial Children's Hospital in Cape Town, and many countries in the region do not even have a paediatric ophthalmologist.
Funding consortiums and resource mobilisation to finance improved paediatric eye care services was one topic addressed. “Fundraising is just one of the challenges,” said Dr Daniel Etya'ale, Executive Director for Africa for the International Agency for the Prevention of Blindness. “The vast geography and scattering of rural and impoverished communities over an enormous area complicates the delivery of regular and sustainable eye care services.”
Far from being a luxury, the experts concurred that paediatric eye care gives a significant return to society; childhood blindness is estimated to account for a third of the total economic cost of blindness. “Restoring a child's sight offers you one of the best returns on medical investment,” said Dr Cherwek. “It is one of the most cost-effective procedures of all medicine if you consider the years of use subsequent to treatment. Saving one child's sight can be the same as operating on 10 elderly people with cataracts in terms of blind years saved.”
Training of specialist eye care professionals was another key issue that arose. “If you are the only paediatric ophthalmologist in the country it is extremely difficult to go overseas for months at a time to do specialist training,” said Cherwek. “The ORBIS Cyber-Sight programme - which connects medical professionals around the world via the Internet – is one way African doctors and nurses can receive mentoring, consultations and expert input from their peers without having to leave their places of work.”
Dr Etya'ale described the meeting as “historical” but warned that the next step is to make sure the plan is implemented. “Every child that can be treated is a chance given to them to go to school and be productive, and realise their potential simply because they can see.”
More about ORBIS:
ORBIS is a non-profit organisation committed to saving sight worldwide. It has been active in 88 countries since its inception in 1982. ORBIS uses flagship tools such as the ORBIS Flying Eye Hospital, a mobile ophthalmic training hospital on-board a DC-10 airplane; Cyber-Sight, an award-winning online telemedicine mentoring and teaching resource; and over 450 expert medical volunteers, to bring quality eye care and training to its partners in developing countries. To date ORBIS has enhanced the skill of over 260,000 health care professionals and helped establish services that have provided quality eye care to more than 12 million people.
ORBIS opened its first Africa programme office in Ethiopia in 1999 and its Southern Africa office in Cape Town in late 2010. The ORBIS Flying Eye Hospital has visited numerous African countries including Ethiopia, Uganda, Ghana, Cameroon, Tanzania, Mali, Malawi, Botswana, Kenya and very recently Nigeria. Since 2010 ORBIS has been working in Zambia and South Africa to develop dedicated children's eye clinics and is currently poised to inject R3.5-million into establishing a new paediatric eye-care clinic in South Africa. Upgrading of facilities and training has also begun at Kitwe Central Hospital in Zambia. ORBIS is working closely with the Red Cross War Memorial Children's Hospital in Cape Town to share knowledge and skills as well as develop training opportunities for African doctors throughout the continent.