Charitable Organizations Dedicated to Preventing Blindness
The World Health Organization estimates that between 40 and 45 million individuals are blind and cannot get around without assistance. Unless public health action is taken, this figure is expected to double over the next 25 years.[1,2] Furthermore, 500,000 children become permanently blind each year, often because of poor nutrition (eg, they do not get enough vitamin A before the age of 6).
Part of the tragedy of these statistics is that with early detection and proper treatment, blindness could have been prevented in many of those afflicted. In fact, more than half of the estimated 45 million cases of blindness are reversible! Why, then, is the problem growing larger instead of smaller? Why is it that modern medicine and technology have enabled us to successfully treat many of the underlying causes of blindness (eg, vitamin A deficiency, trachoma, leprosy, and onchocerciasis), and yet, according to the Eye Center, 90% of those who are blind will never recover their vision?
The problem is cost. Many people cannot afford the expense of such treatment, especially if they are living in impoverished areas. Therefore, in order to tackle this problem, change must come about through a shift in government and public health priorities and through effective education and training.
There are many organizations that provide funding, education, and other assistance to the millions of blind people throughout the world. This column focuses on the efforts of 4 organizations that are dedicated to restoring sight and preventing blindness in underserved populations: the International Eye Foundation, Operation Eyesight Universal, The Eye Center, and Prevent Blindness America.
International Eye Foundation
The International Eye Foundation (IEF) has restored sight for hundreds of thousands of people in more than 60 countries in the developing world since 1961. Through its 3 charitable programs, SightReach Prevention, SightReach Surgical, and SightReach Management, IEF's staff and volunteers focus their efforts on preventing and treating cataract, trachoma, river blindness, and childhood blindness related to vitamin A deficiency -- the 4 conditions responsible for 80% of the world's blindness. In addition, they make ophthalmic supplies available at reduced costs through their Gifts in Kind program, which involves distribution of donated supplies, and they foster financial self-sufficiency of eye-care providers in economically disadvantaged regions through their SightReach Management program.
Recognizing how essential vitamin A is to healthy eyes and good vision -- and acting in response to the alarming statistic that more than half the children under age 5 who go blind from xerophthalmia die from complications within a year (eg, measles, acute respiratory diseases, and diarrheal disease) -- IEF programs in Bolivia, Eritrea, Ethiopia, Guatemala, Honduras, and Malawi have distributed vitamin A capsules to tens of thousands of children.
Since 1995, IEF's Seeing 2000 program, funded by the US Agency for International Development, has saved the sight of over 14,000 children in 13 countries on 5 continents, and has provided eye examinations and treatment to an additional 200,000 children. This program has been made possible by offering small grants to indigenous charity hospitals and eye care organizations.
In its battle against river blindness, IEF has been educating health officials and community leaders about how to prevent the disease and, with funding from the African Program for Onchocerciasis Control and the Lions SightFirst program, has distributed ivermectin (Mectizan) in Cameroon to more than 65,000 people.
Another IEF program that is achieving significant results is the S.A.F.E. strategy (Surgery, Antibiotics, Facial Cleanliness, and Environmental Hygiene), aimed at prevention and treatment of trachoma, the second leading cause of preventable blindness. These efforts have been concentrated in Malawi and Mozambique.
Operation Eyesight Universal
Operation Eyesight Universal (OEU), a Canadian charitable organization dedicated to eradicating blindness in developing countries since 1933, has made eye care services accessible to more than 30 million people and supports 41 comprehensive eye care programs in Africa, South America, and South Asia; these programs include vaccinations, medicines, training, equipment, and nutrition counseling.
OEU was officially founded in 1963, but its humble beginnings actually can be traced to 1933, when Dr. Ben Gullison and his wife, Evlyn, went to Sompeta, India, to operate a 2-room medical dispensary where they provided medical treatment to the local population. By 1939, they had expanded their dispensary and opened a small, general-purpose medical facility called the Arogya Varam Hospital. Because the number of patients presenting with eye ailments steadily increased (an estimated 200,000 people living in the areas around Sompeta at that time were curably blind), Dr. Gullison asked Dr. John Coapullai to join the staff, and the Arogya Varam Eye Hospital became an annex to the facility.
OEU's ophthalmic surgeons perform the necessary blindness-prevention procedures at hospitals or at eye-screening camps (free clinics that perform eye examinations) in rural areas. If a patient's condition cannot be treated on-site, OEU provides transportation to the base hospital for treatment.
During its 38 years in operation, OEU has examined more than 30 million people and treated approximately 24 million. It has funded programs in Bangladesh, India, Kenya, Malawi, Nepal, Pakistan, Peru, Sri Lanka, and Zambia. The organization has performed more than 1.7 million sight-restoring surgeries and has provided almost a million vitamin A treatments.
In addition, nearly 400,000 people have been fitted for eyeglasses -- OEU has provided eyeglasses free of charge in countries where the majority of the population cannot afford to purchase them. OEU's eyeglass collection program was launched in Calgary, Alberta, Canada, by Albert Jenkyns, a local business leader who, after meeting OEU's founder (Dr. Gullison) in 1962, dedicated himself to the cause of getting the word out about OEU. His program is still active throughout Canada today, and has coordinated the collection of thousands of pairs of donated eyeglasses. One of the most dramatic donations occurred in Calgary, when local Boy Scouts troops collected 21,000 pairs of eyeglasses in a single evening. Through OEU, used eyeglasses are recycled in Albania, Angola, Bolivia, Bosnia, Cuba, Guyana, Lithuania, Mexico, New Guinea, Nicaragua, the Philippines, Rwanda, Tanzania, and Uganda.
During the first few years of its existence, OEU concentrated its efforts solely in India, but by 1970, they were supporting hospitals in Bangladesh and Thailand, and purchased mobile eye units to help fight trachoma in Kenya. By 1976, donations to OEU had exceeded $1 million. The following year was a banner year for the organization, when Art Jenkyns became its first salaried employee as Director. That same year, the OEU Institute of Ophthalmology, a 40-bed eye hospital, was built at a medical college in Manipal, India. This hospital, as well as the one OEU opened later in Shreeramnagar, operates in cooperation with international service organizations such as Lions Clubs International and Rotary Clubs International and provides training facilities for Indian ophthalmologists.
Emergency relief efforts were provided by OEU after the Union Carbide disaster hit the central Indian city of Bhopal in December 1984. OEU donated $100,000 toward the establishment of an emergency clinic for the more than 2000 people who were temporarily blinded by toxic airborne chemicals from the pesticide plant.
Another way in which OEU has provided assistance is through its training program at Little Flower Hospital in Angamally, India, where ophthalmic nurses receive free education. After these students graduate and secure jobs, they repay the cost of their education so that the training fund is replenished.
Eye Center Missions
The Eye Center, a branch of Oregon Eye Associates that comprises 6 independently run clinics in Central and Western Oregon, believes that "those of us fortunate enough to live in the prosperous regions of our planet must not neglect our less fortunate neighbors." Since 1992, The Eye Center has committed its resources and personnel, on a voluntary basis, to fighting the world's vision crisis by reversing blindness in developing countries.
Each year, a team of ophthalmologists and other staff members of The Eye Center travel to a different region of the world to offer free surgical treatment to people whose disorders would cause blindness without surgical intervention, correcting such problems as cataract, conjunctivitis, glaucoma, pterygium, and strabismus. Their eye missions have brought them to Borneo, Bulgaria, Guyana, Malaysia, Mexico, St. Kitts/Nevis, and Thailand.
The organization's first eye mission was conducted in 1992 in the island nations of St. Kitts and Nevis. At a clinic that treated around 50 patients each day, the visiting specialists performed several surgical procedures and treated a variety of ophthalmic disorders. The Eye Center volunteers were provided with modest housing and a used car for touring the island. One of the most rewarding experiences from this trip was surgical correction of crossed eyes in a 3-year-old boy. According to the boy's mother, he spent the next 3 days "staring into a mirror and laughing gleefully."
A dramatic illustration of the urgent need for eye care in underdeveloped regions presented itself during the Eye Center's mission to Thiapas, Mexico. Some of the 160 candidates for surgical correction of glaucoma and cataract had walked through the mountains of Guatemala for 3 days to reach southern Mexico so they could receive corrective-vision surgery from the volunteer physicians.
Described as their "most primitive mission," the Eye Center's 1995 visit to Guyana was severely constrained by the conditions there. The volunteers were housed in a local church where they slept on cots, bathed in local streams, and performed their operations without the benefit of electricity because they could not carry a generator over the mountainous terrain. Despite this limitation, all 6 cataract surgeries performed in the remote village of Kato were successful. The Eye Center staff then traveled by sea-plane to the capital, Georgetown, where they performed corrective surgery on 55 people. Unfortunately, almost 400 candidates for surgery had to be turned away because of insufficient resources and equipment, so treatment was restricted to those whose vision impairment was so severe that they could only perceive light. A local ophthalmologist was trained by the visiting doctors in intraocular lens implant techniques so that he could apply these skills to the treatment of future patients.
Bulgarian ophthalmologists and medical students in the city of Plovdiv were trained by Eye Center doctors on phacoemulsification (ultrasound) techniques in 1996 and were amazed by the speedy recovery of patients who underwent this procedure -- never before had they witnessed a patient able to read the 20/20 line only 1 day after cataract surgery. To enable the Medical School of Plovdiv to continue performing such operations, the Surgical Eye Expeditions team donated a phacoemulsification unit and several other instruments to their facility.
In Thailand in the late '90s, The Eye Center performed 39 cataract operations at the McKean Leprosy Colony, with administrative assistance from SEE International and the Chiang-Mai Medical School and surgical assistance from Oregon Eye Associates. Leprosy, a very rare disease in the United States and other developed countries, can cause blindness in those who go untreated for many years. The Eye Center staff returned to Thailand the following year to speak about the advances of refractive surgery, with a special emphasis on LASIK.
And in Our Own Backyard...
It is not only in underdeveloped nations that people lose their sight needlessly. Even in the United States, blindness could be prevented in half of those who lose their sight. Every 11 minutes, another person in the United States goes blind, and quality of life suffers as the newly afflicted is forced to give up a certain degree of independence and mobility.
Prevent Blindness America (PBA), a volunteer eye health and safety organization founded in 1908, is dedicated to fighting blindness and saving sight in America. The approximately 35,000 volunteers who make up this national organization serve millions of people each year through public and professional education, community and patient services programs, and research. PBA has affiliates in 18 states, each of which has its own Web site.
A wealth of information is available on PBA's Web site, mostly in the form of "Frequently Asked Questions" for a variety of ophthalmic disorders. In addition, PBA launches a massive educational campaign by distributing brochures, newsletters, public service announcements, and videos to more than 220 million people each year. A catalog of these educational materials, which contain information about early detection of diseases and prevention of accidents that can threaten vision, is available from PBA.
PBA also publishes a 12-page newsletter, Prevent Blindness News, 3 times a year; it provides eye health and safety information. In partnership with the National Institute for Occupational Safety and Health (NIOSH), the International Safety Equipment Association, and the Occupational Safety and Health Administration, PBA published a brochure in response to the September 11th attacks entitled "Emergency Response and Disaster Recovery -- Eye Safety." The brochures were distributed by the Centers for Disease Control to rescue workers in New York City and in Arlington, Virginia.
The Team 20/20 group, organized by PBA, sponsors runs and walks to raise money for blindness prevention efforts and conducts training seminars to educate people about vision loss and proper eye care. Other programs coordinated by PBA are The Eye Patch Club, a support group for children with amblyopia and their parents, and Helping Kids See Their World, a nationwide fundraising program with a goal of $100,000, to be donated for in-school vision screenings during the 2001-2001 school year. The latter program is being cosponsored by eye-care company Bausch & Lomb and participating eye-care retailers.
This national health charity depends entirely on the contributions of individuals, corporations, and foundations. Discover how to donate cash, securities, real estate, or other assets on PBA's Web site. If you purchase something online from PBA's Shopping Village, at least 5% of the proceeds will be allocated to blindness-prevention efforts.
Global Initiatives to Prevent Blindness
Other organizations and initiatives are also actively addressing the goal of eradicating preventable blindness and can be studied in more detail via the related links listed below. They include the Carter Center's Global 2000 River Blindness Program; the National Cataract Blindness Control Project in India, sponsored by the World Bank; and Vision 20/20: the Right to Sight, a worldwide initiative to eliminate avoidable blindness by the year 2020.
The Carter Center initiative involves periodic mass treatment with ivermectin in endemic communities to prevent eye and dermal disease caused by onchocerciasis (river blindness), a disease that is widespread in Africa. As part of an international global partnership to control onchocerciasis, The Carter Center's Global 2000 River Blindness Program (GRBP) assists the ministries of health in 10 countries to distribute ivermectin (Mectizan, donated by Merck & Co.).
About Angels in Medicine
Angels in Medicine is a volunteer site dedicated to the humanitarians, heroes, angels, and bodhisattvas of medicine. The site features physicians, nurses, physician assistants and other healthcare workers and volunteers who reach people without the resources or opportunities for quality care, such as teens, the poor, the incarcerated, the elderly, or those living in poor or war-torn regions. Read their stories at www.medangel.org.