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Meeting patients’ eye care needs in remote communities

In a hot, dusty shanty town in the Indian city of Kolkata, a group of barefoot ‘street children’ rush to greet an ambulance.

It’s no ordinary ambulance. This specially equipped mobile eye clinic offers the children a chance of treatment for a range of conditions that could threaten their eyesight.

The vehicle represents an opportunity for destitute children who normally have no access to healthcare, in a country with the highest incidence of youth blindness in the world.

The mobile clinic is one of 16 projects that have secured funding from the eXcellence in Ophthalmology Vision Awards (XOVA), an annual Novartis Pharmaceuticals and Alcon program to support independent eye care initiatives worldwide via grant funding, including some in the world’s most remote areas and deprived communities.

XOVA funding has helped to set up eye care clinics in the Republic of the Congo and Guinea-Bissau, train pediatric eye doctors in Cambodia and Laos, and provide internet consultations (or ‘teleophthalmology’) in Timor-Leste, also known as East Timor.

In Kolkata the need to provide eye care for some of the 100,000 children who live on the streets of India’s third-largest city was clear to Professor Himadri Datta from the Regional Institute of Ophthalmology.

Many of the children suffer from simple eye problems like short-sightedness that can be corrected with glasses. Others have more serious conditions such as glaucoma which, left untreated, could ultimately lead to blindness.

Professor Datta said: “It’s vital that eye problems are identified at an early age, because when these children grow up they will need their health to be able to earn a living.”

He began the project on a small scale with one or two students, providing basic eye care to young people in the city’s ‘jhuggi jhopri’, or slum districts.

At that time they had no vehicle and little equipment. He found many so-called street children were not actually homeless, but with their parents working up to 12 hours a day in low-paid jobs such as street vending, rag-picking or rickshaw-pulling, they had to live by their wits on the street during the day.

“Even with free medical treatment, these people can’t afford to take time off work to take their children to a hospital, so it’s important for us to go to them,” Professor Datta said.

Patient referrals

A XOVA award in 2011 enabled them to buy an ambulance and fit it out with a range of eye testing and diagnostic equipment. Since then, more than 700 children have received treatment in 26 roadside sessions. Around 160 pairs of glasses have been given out, and patients with more serious conditions have been referred to hospital for treatment.

“The XOVA award made all this work possible,” said Professor Datta. “These are children who never thought they could have glasses, so when they get them it’s a godsend.”

Another XOVA award winner is New Sight in the Republic of the Congo, which provides surgery for common eye conditions such as cataracts. It is the first clinic of its kind in the northern part of this African country, which is almost the same size as Germany but has a population of less than five million.

The center was set up by Joyce Samoutou, a British doctor, and her husband Henri, a senior ophthalmic technician from Gabon in Central Africa. Their goal was to tackle the desperate lack of eye care in the neighboring Republic of the Congo.

Remote access

The XOVA funding has helped them establish an eye surgery center in the regional capital of Impfondo, a city so remote it has no road access. All the medical equipment and supplies – including a fragile operating microscope weighing 400kg (880 pounds) – had to be ferried in by river.

The Samoutous moved from the United Kingdom to Africa with their three children to run the clinic, which has treated more than 1,000 people in just over a year.

“Many people thought our move was a great idea, but kind of crazy,” said Joyce. “However, it has been an absolute privilege to help people to see again and to give them back their confidence, independence and dignity.”

One of their first patients was Boniface Bokouaka, whose eyesight was deteriorating due to cataract and glaucoma. The operation gave him two reasons to celebrate – he no longer had to give up his job in a government ministry, and he was able to see his wife again.

The XOVA awards began in 2010 and build on the long-standing commitment of Novartis to addressing patients’ needs wherever they may be.

Applications are invited for this year’s awards, which are run jointly by the Pharmaceuticals and Alcon divisions of Novartis. Grant funding of up to €50,000 are available for non-profit initiatives to the awarded organizations that provide innovative and sustainable eye care solutions.

Full details can be found on the XOVA website at http://www.xovaprogram.org/

Entries must be submitted by June 30 and will be judged by an independent committee of more than 30 international eye care specialists. The 2014 winners will be announced at a scientific congress later this year.