Conrad Gweru Features  Correspondent
Blindness brings with it  an inescapable cycle of disability and extreme poverty – hunger, malnutrition and limited access to health, education, water and sanitation services the world over. Globally, there is an estimated 285 million people with visual impairment, 90 percent of these live in developing countries while 82 percent of the blind are aged 50 years and above.
Following the realisation that avoidable blindness is contributing significantly to poverty throughout the world, the World Health Organisation and the International Agency for the Prevention of Blindness launched a joint initiative known as V2020.

This is a global initiative for the elimination of avoidable blindness with an overarching vision in which no one is needlessly visually impaired, where those with unavoidable vision loss can achieve their full potential, pinned around universal access to comprehensive eye care services.

In Zimbabwe alone, eye health experts estimate that 10 percent of the population is blind with the major causes of blindness being cataracts, glaucoma, trauma, diabetes complication – (diabetic retinopathy) and refractive errors.

While the burden of eye health is high in Zimbabwe, inadequate funding and lack of adequate human resources is weighing down the implementation of eye health projects. During commemorations to mark World Sight Day in Chirumhanzu recently, an official from the Ministry of Health and Child Care indicated that poverty rooted on avoidable blindness will continue to be Zimbabwe’s number one problem as witnessed by a huge cataract surgical backlog of 60 000 accumulating each year.

“Zimbabwe is estimated to have an annual cataract surgery backlog of 60 000. This backlog is attributed to lack of cataract surgical equipment, consumables and inadequate qualified personnel (ophthalmic trained nurses, optometrists, eye health equipment technicians, cataract surgeons and ophthalmologists) in the rural provinces coupled with high cost of cataract surgery in the private sector.

“In order to clear this backlog and cater for the incidences by 2020, the country needs to conduct at least 30 000 cataract surgeries per year,” indicated Mrs Lilian Muchena, Non Communicable Diseases Manager in the Ministry of Health and Child Care.

She further indicated that the number of blind people in Zimbabwe is expected to rise due to an increase in the number of old people. Blindness due to cataracts is more common among the 50+ age group throughout the world.

“With an older persons population of 4,7 percent in 2012, and projected to increase, the number of people developing blindness and visual impairment in Zimbabwe is expected to increase as is the situation in most countries,” she said.

Zimbabwe has 23 ophthalmologists with about 16 of them being in public service. The World Health Organisation postulates that a country the size of Zimbabwe should have 24 ophthalmologists in public service with each one of them conducting at least 2 500 cataract surgeries each year. An insignificant number of operations have been carried out in 2012 and 2013 against a potential of close to 60 000 surgeries.

“Due to limited funding and resources to conduct surgery, each one of them is only able to conduct approximately 600 cataract surgeries each year. In 2012, a total of 7 395 surgeries were conducted while approximately 12 000 were conducted in 2013,” further indicated Mrs Muchena.

The world body also recommends that for eye health services to improve, Zimbabwe should have 120 ophthalmic nurses, 48 optometrists and

1  200 primary eye care trained nurses.
“To date, Zimbabwe has trained more than the required 120 ophthalmic nurses, and an insignificant number of primary care nurses. There are no optometrists in public service at the moment, all the 46 optometrists in the country are in private sector”, indicated a policy brief developed by the Zimbabwe Eye Health Advocacy Coalition.

The policy brief notes that a number of these eye health experts are spread out thinly across the country with most of them based mainly in Harare and Bulawayo were there are functional eye units and a few at provincial eye units.

In order to lessen the burden of eye health Non-Governmental organisations, churches and the private sector have been conducting eye camps in an effort to reduce the cataract surgical backlog.

One of the country’s distinguished ophthalmologist Dr Solomon Guramatunhu through his organisation, Eyes for Africa, has been working hand in glove with government in an effort to improve access to eye health services to the rural folk.

Eyes for Africa holds eye camps in rural areas to try reach the rural folk.
This idea is meant to address the major challenges in eye health delivery are which include lack of adequate manpower, lack of resources, eg microscopes, micro-surgical instruments, consumables and also transport or mobility challenges for patients to health centres where they can access treatment.

To clear the cataract backlog, we need to provide resources, develop cataract surgery centres in every province and in some districts then invite even other surgeons from abroad to conduct constant, high quality, high volume cataract safaris.

Unfortunately eye diseases are perceived to be not life threatening like HIV/AIDS, therefore health planners do not highly prioritise eye care.”

In a lesson learned in eye health programming document produced by Sightsavers International, the organisation puts forward that countries should allocate more resources towards integration of primary eye care into the overall primary health care system.

“It is believed that greater focus on integration of eye health into primary health care will improve access to eye care services at community and primary level, particularly addressing gaps in prevention and promotion aspects of services. This would result in improvement in overall management of eye conditions at primary level and more appropriate referrals to secondary and tertiary services.
Ultimately, this would contribute to the Vision 2020 goal of eliminating avoidable blindness and visual impairment by the year 2020”, states the document.

While funding is affecting programme implementation, Government has recognised the increasing burden of eye diseases and has taken steps to improve access to eye health care services in the country.

Recently Government launched an eye strategy with plans to increase eye health medical staff, and mobilising resources for eye health. In line with the plans to reduce burden of eye problems, two optometry training schools will be set up in the country, one in Bindura and the other at Sekuru Kaguvi eye unit in Harare.

 

You Might Also Like

Comments

Take our Survey

We value your opinion! Take a moment to complete our survey