ORBIS’s Comprehensive Rural Eye Care in Ethiopia
Ethiopia faces huge challenges in meeting the healthcare needs of its urban and rural populations. Although there have been improvements in eye health status, with a population of 82 million people and only one ophthalmologist for every 3 million people, the country still struggles to provide quality eye care services, especially in rural areas. In Ethiopia, approximately 1.2 million people are blind and more than 2.8 million have low vision. Ethiopia is especially impacted by a high prevalence of trachoma—a highly contagious but completely preventable eye disease that can result in blindness after years of repeated infection.
ORBIS has been working in Ethiopia since 1998 to reduce the burden of avoidable blindness and visual impairment. One of the ways we do this is by developing comprehensive rural eye care services for the millions of Ethiopians who live in remote, rural areas and find it difficult to access services. Our rural work has focused geographically on the Southern Nations, Nationalities and People’s Region (SNNPR) where we are working to tackle the leading causes of unnecessary blindness - trachoma, cataract and uncorrected refractive error.
In 2011, through 8 ORBIS projects:
- More than3,500 doctors and other eye care staff received training
- Over 132,000 adults and children received eye examinations/screenings
- Over 480,000 adults and children received medical/optical treatments
- More than 15,700 eye surgeries/lasers were performed on adults and children
ORBIS’s model for comprehensive rural eye care
Over the past 12 years ORBIS has developed a tried and tested framework for providing comprehensive eye care services in rural Ethiopia. ORBIS has a longstanding partnership with the Ministry of Health, through which we work to develop the capacity of existing government health providers to provide eye care services at primary, secondary and tertiary level to reduce the number of people losing their sight to cataract, trachomachildhood blindness and other eye diseases.
ORBIS builds the capacity of local health services to provide eye care by training both community and health care workers in many aspects of eye care, from awareness of services, identification, diagnosis, referral and treatment. We also supply equipment and consumables to the secondary and primary units. Our rural programmes focus on strengthening primary and secondary eye care services, and on building effective referral networks between primary, secondary and tertiary services to ensure that people are appropriately treated at the right level of the healthcare system to maximise their potential visual recovery. We also ensure that followup services are available. As such, responsibility for community eye health is integrated within the wider health care strategy and therefore various tasks within blindness prevention are disseminated to specific levels of the system:
Community and Primary Units
- General screenings and eye health checks
- Training of cataract and trichiasis case detectors
- Distribution of Zithromax
- Support Integrated Eye Care Workers’ outreach activity for trichiasis surgery (reversing in turned eyelids resulting from repeated trachoma infection)
- Conduct community awareness campaigns
- Refractive error services – delivered through partners
Secondary Level or Secondary Eye Care Units
- Adult cataract surgery
- Referral of complex eye disease such as glaucoma, corneal disease and childhood blindness
- Treatment of complex eye disease such as glaucoma, corneal disease and childhood blindness
Trachoma Elimination and World Health Organisation’s SAFE strategy
Trachoma is a huge healthcare challenge in Ethiopia with an estimated infection rate of 2 out of 5 children in SNNPR. ORBIS therefore anchors our trachoma elimination strategy within our comprehensive rural eye care framework. ORBIS implements the WHO’s SAFE strategy for eliminating trachoma:
||training of local health care professionals to right the eyelids which have turned inside out to stop the eye lashes scratching the cornea and causing permanent sight loss.
||can be distributed to prevent the infection but is only effective if all members of the community take them and if other strategy elements are in place, so infection cannot take hold again.
||informing communities how best to wash their faces and hands to prevent infection from spreading
improving sanitary conditions and providing clean water prevents bacteria from breeding.
ORBIS focuses on the distribution of Zithromax – the trachoma fighting antibiotic. ORBIS distributed Zithromax to 1.9 million people in 2010 alone. We train nurses to perform trichiasis surgeries at primary healthcare units. We build awareness and teach community health workers, teachers, local women’s group leaders and community leaders about eye health and environmental improvements to reduce the risk of trachoma. ORBIS also works with partners to deliver the ‘F’ and ‘E’ components of the strategy.
Through our long-term commitment to Ethiopia, ORBIS has developed high quality programmes to meet the challenges of avoidable blindness head on. With your support we can roll out our model of rural comprehensive rural eye in more regions in Ethiopia to ensure that no one goes blind from causes that are preventable, treatable or avoidable.