Sustainable eye care in Africa

Kate Coleman

Consultant eye surgeon

Executive chairperson/founder Right to Sight.

‘Needless’ Blindness

New technology and therapeutics mean more than 90% blindness in Africa can be

PREVENTED or TREATED

Solutions are available worldwide

AFRICA : 9 million needlessly BLIND!

Eye care?

Cataract

Glaucoma

Glasses

Children

INSPECTION OF THE AUTO REFRACTOMETER

VISION SCREENING AT RUAL CAMP ; VILLAGE BONAMOUTONGO

EYE TESTING FOR THE INDIGENT POOR AT THE RUAL CAMP

EYE EXAMINATION FOR TEAHCERS

Past interventions....no sustainable providers

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Why Right To Sight exists...

* Other causes include untreated refraction, alien bodies, trachoma, glaucoma

Dr Godelieve, CHUK, Rwanda

Nkhoma Eye Hospital, Malawi

A blind patient being led by his granddaughter - Gondar, Ethiopia

Dr Fitsum with his patients - Tigray, EthiopiaThis is a crisis . . .we can solve it

90% of blindness in the developing world is preventable – a needless waste

More people are needlessly blind than have HIV (37m globally vs. 32m)

Eye CARE

SUSTAINABLE

AFFORDABLE

ACCESSIBLE

First Day – 9 cataract surgeries; ALL regained Good Vision

2006

• Affordable SOLUTION to most causes of traditional blindness!

Why can these children not have their glasses???

Why is this 46yo healthy man still blind?

0 10 20 30 40 50

D.R. Congo

Africa

Malaysia

Philippines

Vietnam

India

Singapore

China

Lat. Americ.

Korea

E.U

Opthalmologists per million population

22

Right to Sight works in in 8 African countries and India

November 2009

n

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The sustainability process

0

1,000

2,000

4,000

8,000

25% 50% 75% 100%

• Increase surgical output, and

• Improve cost recovery

Cataract Surgeries per annum (#)

• Increase surgical output,•Maintain cost recovery

• Maintain surgical output, • Improve cost recovery

Self-sustainability (cost recovery %)

• Start position

16,000

500

250

Surgery every 5 minutes...

Public vs Private

• 12 private NOT for Profit

• 13 government hospitals

Nkhoma Mission Eye HospitalRTS Involvement • Needs Assessment - March, 2007• Onsite support-Ideas and Strategies• Vision Building and Strategic Planning-

LAICO Feb 2008• Staff skill development training – LAICO

Feb 2008

RTS Cost • $50,000

RTS Objectives • Increase capacity of surgery to 5,000 and

out-patients to 50,000 per annum • Expand training of key staff to allow

Ophthalmologists to focus on surgery • To introduce cross subsidy programmes

with a view to long term sustainability

OCO trained as a cataract surgeon

•

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Mahatma Gandhi Memorial Hospital (MGMH)

Dr. Abdi with the two newly trained

Ophthalmic Nurses at MGMH

Dr. Abdi from Right to Sight supervises as the Registrar from UKZN undertakes her first surgery using the new more cost effective Small Incision Cataract Surgery technique

(SICS), as the newly trained nurse assists (left)

Dr. Abdi performing SICS surgery on a

blind patient at the newly opened

MGMH eye unit

A total of 56 surgeries have been completed at MGMH since the unit opened in Aug 09’

First Day – 9 cataract surgeries; ALL regained Good Vision

Glaucoma

30% blindness over 50yr age in Africa

NO DROPS!!!!

80 cataract surgeries in one day

Prevent Needless blindness

• Early diagnosis and awareness

• Early treatment