Overview of
Operation Eyesight and
Scope for Partnership
Dr. Santosh MosesCountry Manager - India
• We have been in existence for 52 years!• Couple of years ago we celebrated our
50th anniversary!
• We decided to go around and find out how effective we have been..
• We asked our partners: Have your eliminated avoidable blindness from your service areas?
No! Our partner hospitals deliver quality eye
care services to the poor free of cost!! Then why??
• This year we did the same
• We asked our partners: Have your eliminated avoidable blindness from your service areas?
Yes in many villages! I have been told Operation Eyesight is the only
INGO that has been able to achieve this Vision 2020 India has awarded us this year for
declaring a village blindness free on WSD So how do we do it?
Beginnings
Inspired by Dr. Ben Gullison, a Canadian doctor
Founded in 1963 by Art Jenkyns, a Calgary businessman
First program partner: Arogyavaram Eye Hospital, Andhra Pradesh
Original focus: cataract elimination in developing countries
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Who are we?
BEN GULLISON
ART JENKYNS
Who are we?
OUR VISION: For all the world to see.
OUR MISSION: To eliminate avoidable blindness.
Our work in India is centered on two key thematic areas:
Hospital Based Community Eye Health Programme
Hospital Improvement Programme
Operation Eyesight’s interventions in India
Hospital Based Community Eye Health Programme
Through this programme in service areas of partner hospitals we:
Establish Vision Centers at the community level and link them up with secondary and tertiary eye hospitals
Empower target communities to take responsibility for their eye health Deliver blindness free villages on a sustainable basis within 4 to 5 years Eliminate Vitamin A blindness among under 5 children Achieve full immunization coverage and ensure all women undergo ante-natal
care and post – natal care leading to reduced maternal and infant mortality rates
Ensure malnourished children access services available at the Anganwadi centers leading to reduced child mortality rates
Hospital Improvement Programme
Through this programme we:
Establish/ strengthen secondary eye hospitals Improve quality of eye care services:
• Build capacities of medical and non-medical staff• Introduce/ strengthen protocols and standards
Treat poor patients free of cost including surgeries:• Introduce/ strengthen cross subsidy financial management system that
ensures completely free treatment for the poor (average 52% of patients surgically treated free of cost)
Make hospitals self sustaining• Promote optical • Promote pharmaceutical shops
Reaching out to the marginalized
In 2013 we have:
Screened over 3 million for potentially blinding
conditions
Surgically treated over 120,000 (Over 50% of
them totally free) many of whom who would
have gone needlessly blind
Dispensed spectacles to over 128,000
Intervening in very remote areas
In the Aravalli Desert Hills of Rajasthan
In the riverine island of Majuli, Assam
In the tea gardens of West Bengal
In the Marathawada region of
Maharashtra
In the far North East in Meghalaya
Key achievements in the last 51 years
Developed/ supported over 100 eye hospitals across India to deliver quality eye care services
Built capacities of over 2,000 medical and para-medical staff 1st INGO to venture into urban slum eye health programmes Focused on quality over quantity and the shift to development Promoted financial sustainability through the cross subsidy model
and through establishment of optical shops and pharmacy stores Launched an innovative community eye health approach which
targets the root causes of avoidable blindness leading to promotion of sustainable blindness free villages
Developed a new model of partnerships (NFTP)
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Operation Eyesight in India
OE India Programme Partners
• 46 partners
• 60 projects
• Over 600 Women
Community Health Workers
• Covering 12.5 million people
• Screening 3 million annually
• Surgically treating over
125,000 annually
Impact of our work
Increased knowledge and positive behavioral change towards eye health in over 85% of the target population
Strong linkages between target community, vision centers and the secondary center
Integrated primary eye care services into primary health care system leading to decreased infant and maternal mortality rates
Improved quality of life – 85% of the those treated for blindness return to their livelihood activities, 90% of those treated for blindness perform their daily duties independently
Blindness free villages a reality in upto 90% of the areas where HBCEHPs are implemented
Paradigm shift: Non-financial Technical Partnerships
No more fund driven but knowledge driven• Hospital partners implement our model (HBCEHP) with
their own resources• We provide full fledged technical support – from
conceptualization to recruitment to capacity building to execution to evaluation
• We provide limited financial support to select hospitals that are remotely located for capacity building and establishment of vision centers
We are different and unique – The only INGO which is sought for its technical expertise
How does NFTP work
We have a five year strategy• Community Eye Health• Hospital Improvement
We and the partner hospital jointly agree on the objectives, outcomes and reporting requirements of a program
We do not provide financial assistance; instead, the partner invests its own resources to implement the project
How does NFTP work We provide technical support to our partners in the following
areas:• Community Eye Health and Primary Health - select geographical
areas, conduct assessment, launch and sustain Hospital Based Community Eye Health projects in the partner hospital’s service area
• Hospital Improvement - conduct quality assessment, provide clinical and related services such as infrastructural development and restructuring; developing and strengthening systems and protocols; human resource development and capacity building; and strengthening planning, review and reporting systems
• Organizational development – strengthen governance, financial and human resource management
• Programme development – strategic and operational planning, proposal development, monitoring and evaluation systems
North East India
Comprises:
• Seven sister states – Assam, Arunachal
Pradesh, Meghalaya, Manipur, Tripura,
Mizoram and Nagaland
• Sikkim
• Parts of North Bengal (Districts of Darjeeling,
Jalpaiguri and Alipurduar & Cooch Behar)
More than 2,000 km of boundary is shared
with other countries: including Nepal, China,
Bhutan, Burma and Bangladesh.
North East India – Health Profile Key Indicators National Averages Assam Arunachal Pradesh
50+ population 13% of total population 12% 0.11%
Children (< 16 years) 36% of total population 29% 38%
Poverty level(% of people living below poverty line) 23.6% of total population 36% 33%
Blindness Prevalence (<6/60) 1.1.% 3.05% 3%
CSR (Cataract Surgical Rate) 450/ lakh - -
CSC (Cataract Surgical Coverage) 70% 25% 20%
MMR 450 per 1 lakh 400 400 IMR per 1000 live births 57 66 61U5MR 74 85 87
Immunization coverage (BCG,DPT, Polio & Measles) 43.50% 31% 28%
Gr 111 Malnutrition (% of u5 weight/ age criteria) 15.80% 11.1% 11.4%
Indicators of utilization of ICDS services (% of children u5 who utilized any service)
33% 30% 15%
% of children with diarrhea who received ORS 26% 13% 13%
% of Children between 6 - 35 months who are anemic
79% 77% 77%
% of Pregnant women between 15-49 years who were anemic
58% 72% 72%
North East India – Health Profile
State Arunachal Pradesh Tamil Nadu
Eye Surgeons 0.8 per lakh population (7) 2 per lakh population (1,200)
PMOA’S 12 600
Medical Colleges 0 22
Regional Institutes of Ophthalmology 0 1
District Hospitals 10 26
NGO Eye Hospitals 1 >100
Comparison of infrastructure and human resources status
RANKING AND MAPPING OF DISTRICTS BASED ON SOCIO-ECONOMIC AND DEMOGRAPHIC INDICATORS
Fort AguadaFort Aguada
Operation Eyesight’s intervention in the NE
Started exploratory visits in 2010
Mapped regions of high need and
existing eye hospitals
1st partner in 2011
• Chandra Prabha Eye Hospital,
Jorhat
Partnered to implement a
HBCEHP in arguably the most
difficult region in the NE
Majuli Island, Assam
Home to around 150,000 people.
Populated mainly by the MISHING
tribes
Dependent mainly on agriculture
primarily cultivation of rice
Majuli is battered by floods for
atleast 3 months in a year
Health status - Majuli
Transportation to the main land is
only through a ferry twice a day
Poor access to the main land and
with very limited medical facilities
on the island have resulted in poor
health care delivery
Absolutely no eye care facilities at
all
Operation Eyesight & Chandra Prabha Eye Hospital, Jorhat
We launched a Hospital Based Community Eye Health Project (HBCEHP) in Majuli in
2011
HBCEHP Majuli – Women Community Health Workers
(WCHWs) 10 Women Community Health
Workers were recruited and trained by Operation Eyesight team for over 25 days
These WCHWs conduct door to door survey, eye and general health education events, liaise with Government Primary Health Care personnel, Organize screening programmes and ensure patients undergo treatment
HBCEHP Majuli – Door to door survey
A comprehensive door to door survey was conducted over 3 months in all houses on the island covering a population of 123,000 people
Results of the survey: 6% of the total population
identified with cataracts 6% of the population identified
with other blinding conditions 2% of the population are blind
because of preventable causes
HBCEHP, Majuli – Screening Programmes
Screening programmes are conducted by the hospital’s clinical team once a week at various parts of the village.
Persons identified by the WCHWs during the survey are motivated to attend the screening programmes
After ensuring that all patients from suffering from blinding conditions are treated, screening programmes will be phased out
HBCEHP, Majuli – Vision Centers
1 Vision Center has been established on the Island to ensure that permanent eye care facilities are available on the Island
1 more in the other end of the Island will be established by end of this year
Average opd is 15
HBCEHP, Majuli – Chandra Prabha Eye Hospital
First and final link in the project Provides surgical treatment of
the highest quality for all patients from Majuli Island free of cost
An affiliate hospital of L.V.Prasad Eye Institute
In two year since it’s launch:
• Blindness prevalence of 2.23%
• 13,090 persons screened by hospital’s medical team
• 3,400 surgeries performed
• 1,623 spectacles dispensed
• Immunization coverage increased from 43 to 54%
Scaling up
Assam
• Implementing HBCEHP in 6 Districts
• Supported establishment of 4 Vision Centers
• Partnering with SSN, Guwathi; CPEH, Jorhat and Tezpur Eye Hospital, Tezpur
• Built capacities of 12 hospital staff and 52 CHWs
Scaling up
Meghalaya
• Implementing HBCEHP in 2 Districts including an urban slum
• MEHP in Shillong City
• Partnering with Bansara Eye Center, Shillong through the Government of Meghalaya
• 42 CHWs trained
Scaling up
• Proposed to implement a District Blindness Prevention Project in Papum Pare District
• In partnership with RK Mission Hospital, Itanagar
Arunachal Pradesh
Scaling up
North Bengal
• Implementing HBCEHP in 6 Districts
• Supported establishment of 4 Vision Centers
• Partnering with SGLEH, Siliguri; TSSK, Malda and Alipurduar LEH, Alipurduar
• Built capacities of over 60 hospital staff and 32 CHWs
Key Learning
• Blindness prevalence is 1.3-1.5% in North Bengal and over 2.2% in Assam
• There are good eye hospitals to partner with in the region• Focus should be on expanding their
areas of work both vertically and horizontally
• Utilize existing resources – HR, Public Health System etc.
• Local community participation is critical• Similar results can be achieved if the
methodology/ approach is sound and all stakeholders are committed
Challenges still to be addressed
• Other areas of eye health still need support:
• Sub-specialty care
• Pediatrics
• Cornea
• Low Vision and Rehab
• Partnership with Governments and North East Council
• Partnership with NGOs and INGOs in other sectors of development
• Insurgency affected states
So what is in it for us??
We have a vested interest
• We want to have a greater presence in this region of the country
• The need is great in this region
• We can together make a difference
Our relationship with Lions
Our Lions Partners
• Greater Lions, Siliguri
• ALEH, Alipurduar
• OEU Lions, Shreeramnagar
• ULEH, Udgir
• DSKEI, Latur
• TSSK, Malda
• RRLEH, Nidadavole
I look at you as potential partners
Thank you
No region is too difficult to deliver. If there is a will there is a way
Dr. Santosh Moses
91-8008500550
If we travel alone we can travel fasterIf we travel together we can travel further