ST John Ophthalmic Week Sunday 6th – Saturday 12th October 2013

Jerusalem and the Crusades The exact date when the Order of the Hospital of St John in Jerusalem first came into being is unknown. Although in about 1070 a hospice was established in Jerusalem by monks from a neighbouring Benedictine abbey to care for the growing number of Christians traveling to the holy city. In the year 1113 the hospice developed into a hospital. Over the next 40 years it developed into a religious and military order, with its brothers and sisters (known as Hospitallers of St John or Knight Hospitallers) providing care to the poor and sick regardless of faith. Over the passing years, the Order of St John spread throughout Europe. In 1877 St John ambulance began to enable quick aid to people in Britain throughout the industrial revolution.

The modern Order There were originally three charitable Foundations of the modern Order. The St John Jerusalem Eye Hospital Foundation, established in 1882. The St John Ambulance Association, which predominately trained public first aid and was established in 1877. The St John Ambulance Brigade, which provided first aid care to the public. It started in 1873 and was established in 1887. The St John Ambulance Association and The St John Ambulance Brigade were amalgamated in 1974 to form the present St John Ambulance Foundation. There was a major re-structuring of the Order’s constitution in 1999. This introduced a Grand Council; removed restrictions as to nationality and religious belief on full membership of the Order; and established a new Priory to carry on the activities of the Order in England and the Islands.

St John in Australia People from the St John Ambulance Brigade came to Australia in 1883 and have since developed into the organisation that we are today. St John is a Royal Order of Chivalry with the Queen as its Sovereign Head. There are now well over 400,000 staff around the world. Humam Rishmawi, Consultant Ophthalmologist & winner of Magauran Cup 2007 – Priory of Canada Judith Musallam, Head Orthoptist – Knights Templar Hanan Zalan, Staff Nurse, Priory of Australia

Pictures The Original St John Ambulance ‘The Ashford Litter’ also known as “the St John Ambulance” from where our organisation takes its name. The Society's logo reflects its federal nature. Included on the logo are the Australian kangaroo and emu, the shield of the Australian Priory of the Most Venerable Order of St John and the armorial devices of each of the Australian States and Territories. 

St John eye hospital group The St John Eye Hospital in Jerusalem is the main hospital of the St John Eye Hospital Group. Treatment of eye disease is not always easy because of the restrictions on employment and general movement of both staff and patients in the region. Yet in 2012 they treated 44,238 thousand patients. The Jerusalem Hospital has a 49-bed capacity and is staffed predominantly by local specialist surgeons, doctors, nurses and paramedics. There is a large, modern Outpatients Department and very busy specialist Retinal, Corneal and Paediatric services.

Gaza The Gaza Strip is one of the most troubled and disadvantaged areas in the world. The small teams who work at our Clinic there are operating in what is really an emergency situation. Exacerbated by the on-going conflict in the area, the existing rate of blindness remains high (ten times higher than in the West).  In spite of the huge problems they face, the staff at our Gaza Clinic work hard to save the sight of local people.  The number of patients coming to the Clinic and the resulting operations is increasing and in 2012, we saw and treated 24,369 patients in Gaza.

Anabta The Anabta Clinic was the third St John Eye Hospital satellite centre. It opened in the spring of 2007 and on average 70-80 patients are seen each day. The Anabta clinic along with the Hebron clinic allows St John to reach almost all of the West Bank towns, villages and refugee camps. Anabta works in partnership with the Palestinian Red Crescent Society, focusing on the treatment and referral of diabetic patients, thereby intensifying efforts to control this preventable blinding eye disease in the region. In 2012, we treated 20,097 patients at Anabta-6,614 under the age of 18.

Hebron The Hebron Centre opened in November 2005 and since then the number of patients seen each day has doubled. Because of the need in the area, the then Chairman in 2008 upgraded the Clinic to a Hospital in its own right. The West Bank is subject to movement restrictions with a Separation Wall being built between Israel and Palestine and thus it is proving difficult for many people to reach the hospital. In 2012, our Hospital in Hebron treated 11,238 patients. Approximately 4,000 were under the age of 18. The presence of the Hospital benefits all residents of the Hebron Governorate, as well as the semi-nomadic Bedouins of the Negev Desert. 

Khaled Zuaiter Outreach Coordinator Sponsored by the Priory of Australia Khaled Zuaiter is sponsored by the Priory of Australia and is the Outreach Coordinator for our Outreach team. Khaled graduated in nursing at university level and currently manages two outreach teams which venture into remote villages and Bedouin camps offering free treatment, referrals and sight saving advice for patients. Khaled makes sure that the outreach clinics’ visits are well planned and communicated in advance to allow all inhabitants of hard to reach villages to seek treatment. “From the first moment I joined the hospital, I felt myself surrounded by my family and I was given all the support and training to improve my knowledge and skills. This increased my loyalty and has made me more proud to be a member of this hospital.”

Outreach Because movement is restricted for many people throughout Palestine and Israel, the outreach project that began in 1980 is a valuable asset for the people and for St John. The outreach van takes vital screening and treatment to patients living in remote, rural and impoverished towns and communities in the West Bank. This is predominately to patients who might be prohibited from coming to the St John Eye Hospital in Jerusalem.  Our Outreach team starts out at 7.30am four mornings per week and often returns after dark. In 2012, our Mobile Outreach Team saw 10,511 patients. 3,667 under the age of 18

Accomplishments All together the St John Jerusalem Eye Hospital group in 2012 cared for a total of 111,498 people. This achievement is no small feat as we have almost doubled the number of patients that walked through our doors back in 2006. The St John of Jerusalem Eye Hospital Group is delighted to announce that we have received a donation of $1 million towards the cost of developing our new Day Case Hospital in Gaza.

Accomplishments St John has been awarded the Joint Commission International (JCI) accreditation for quality and patient safety. The Joint commission is a US-based organisation that has established patient safety and quality service standards and goals for health service facilities. St John are the first in Palestine to achieve this award. The New Chairman, Nicholas Woolf has received the Ghandhi Peace award. Mr Woolf especially acknowledged the contribution and dedication of SJEHG staff working in dangerous areas. He was saying “…all had one thing in common.  Whether based in Jerusalem, Hebron, Anabta, Gaza or London, they are not doing what they do for credit or recognition.  They are doing what they do because they care about the Palestinian people – and want only to help make the region in which they work a better place.”

The Need Research shows that blindness causes poverty and that recovering lost vision can help families to once again look for work and contribute back into the economy. Our mission is to ensure that our patients are able to access poverty-relieving ophthalmic services regardless of race, ethnicity, economic status and where they live. Access to specialist healthcare in the region in limited.  Many ordinary people are unable to move freely and nearly half live below the poverty line.

Conditions Access to specialist healthcare in the region in limited.  Many ordinary people are unable to move freely and nearly half live below the poverty line. The rate of blindness is ten times higher than in developed countries. 30% of the population is under the age of ten and the incidence of conditions particularly affecting children such as squint, infantile glaucoma, cataract and trauma is high.  In adults cataract, glaucoma and the complications of diabetes are the main blinding conditions.

Conditions Diabetes is a pandemic medical and social scourge in the region.  At 12 to 15% of the population, sufferers are three times more prevalent than in the West.  Complications can damage the retina and lead to blindness. 

Partnerships SJEHG and the United Nations Relief and Works Agency for Palestinian Refugees (UNRWA) have been working in tandem since 1986. The two organisations came together in order to develop a referral mechanism whereby ophthalmic cases presenting at UNRWA clinics could be referred to SJEHG for screening and treatment. UNWRA then makes some contribution towards the costs of treatment. A quarter of the West Bank’s estimated 700,000 refugees live in 19 UNRWA refugee camps, while the Gaza Strip is home to more than 1.1 million registered refugees, of which more than half a million live in eight UNRWA refugee camps. By working in partnership with UNRWA, we have been able to treat many thousands of Palestinian refugees, whom we would probably not otherwise have seen. What’s more, we are able to treat these patients regardless of their ability to pay. In 2008, SJEHG began working in partnership with the Palestinian Red Crescent Society (PRCS), especially in Anabta, where we share premises with PRCS. We provide outreach primary eye care services at PRCS clinics all over the West Bank. By partnering with organisations on the ground in the oPt, we ensure that our services and reach reflect the true needs of the community in which we work. ‘Partnerships between The St John of Jerusalem Eye Hospital Group and hospitals and organisations with local knowledge and different expertise help us to reach and treat more visually impaired people.’ Rod Bull, previous CEO St John of Jerusalem Eye Hospital Group

Income The Hospital still relies on voluntary income as the major source of funding. During 2011, voluntary income of £4.513m constituted 59% of incoming resources; while £2.899m constituting 38% of total incoming resources came from the Hospital charitable activities. The remaining 3% of incoming resources were related to income from investments. £1.278m of the voluntary income was donated by the Priories of the Order of St John.

Use of funds The uses of funds were mainly related to cost of activities in furtherance of the charity’s objects. During 2011 expenditure on charitable activities amounted to £6.460m. This represents 92% of total resources expended. These costs include running our Hospitals in Jerusalem and Hebron, our Clinics in Gaza and Anabta and a Mobile Outreach Clinic across the West Bank.

quotes "St John’s focus on primary health care, especially amongst the poorest of the poor, and its capacity to tap the most generous and caring human impulses, gives it a special place in our hearts" Nelson Mandela, Bailiff Grand Cross of the Order of St John ‘The work done by the St John of Jerusalem Eye Hospital Group in the Palestinian territories – both in treating thousands of people with eye problems and in training local doctors and nurses – is absolutely crucial. The fact that they are multi denominational and help those in need, regardless of their ethnicity, religion, or ability to pay, is truly inspirational. They have been operating for well over a century now. I wish them well and hope that they continue to receive the support required to carry on providing their much needed services, inshaAllah.’ Her Royal Highness Princess Badiya bint El-Hassan of Jordan

Links To find out more about St John Jerusalem Eye Hospital, please go to: http://www.stjohneyehospital.org/ To find out more about what an intraocular lens implant is, what it is for and what it does some useful websites are: http://www.allaboutvision.com/conditions/iols.htm http://en.wikipedia.org/wiki/Intraocular_lens Pro Fide Pro Utilitate Hominum, 'For the Faith and in the Service of Humanity.‘

Oecussi

Oecussi St John has been providing assistance to Oecussi East Timor for several years as Oecussi is one of the poorest regions in the world. There are high fertility rates and 75% of the 60,000 people are under the age of 25. Oecussi is an isolated costal enclave and since 2006 St John have teamed up with the Australasian College of Surgeons and have helped to support the people of Oecussi by providing ophthalmic care in the form of eye surgery, optometric examinations and the provision of glasses and sunglasses. There are many issues affecting the development of Oecussi. These include: No business sector. Predominately unschooled population Poor transport Few Decent Roads. No sufficient electricity or water supply to the towns. High levels of illiteracy.

Supporting the People of Oecussi, East Timor The St John Ophthalmic national program provides support to the people of Oecussi in East Timor. This is a joint venture with the Royal Australasian College of Surgeons (RACs) which has been operating now for several years. St John has donated a microscope, surgical consumables and a number of first aid kits to the Oecussi community. As well as the partnership with the College over the last three years St John have also sent a team of volunteers who have been involved in providing first aid and related training to the hospital staff and other local people in Oecussi.

St John Trips Since 2006 St John have annually sent a team of people to Oecussi to help provide help in first aid training and Ophthalmic assistance to those in need. The 2013 annual Oecussi trip took place in July and was a great success. St John sponsored five people from the Royal Australasian College of Surgeons and three from St John Ambulance Australia to attend this trip.

Main Projects of the Oecussi Ophthalmic Project 2013 The St John and RACS team first met up in Darwin on Friday 12th of July. They then flew to Dili, Timor Leste and then flew onto Oecussi. Over in Oecussi the RACS and SJA group ran a few health and first aid workshops along with performing eye surgery on a number of patients. Much of the time was spent at the district hospital in Oecussi where the surgeons performed many eye operations for which the community was highly grateful. The Oecussi team also trained the police force in basic life support, wound care and had a question and answer time. It is vital for the police force to know how to manage emergency situations as they are often the first on scene for accidents.

Anneka Hyman’s experience “One of the best classes involved us instructing the local police force on basic life support. The lesson took place on the lawn out the front of the station with around 20 smartly dressed male and female officers performing CPR on dummies that we brought with us from Australia.” Anneka Hyman “It was encouraging to know that the basic skills that we were able to impart provided a chance of survival in circumstances where the nearest hospital was a days walk away and specialist care was a 12 hour boat trip away.” Anneka Hyman

2013 trip Improvements RACS completed 53 cases in 2013. Andrew Koch (RACS Optometrist) case load included 200+ assessments. Approximately ¼ of the assessments required surgical intervention. This is a huge improvement from last year. Over the last few years there have been considerable improvements in the up skilling of the local workforce. There have also been some good outreach eye health screenings conducted in surrounding communities.

DANIKA Crolla - Video “Photo of St John Volunteers with RACS and patients – Anneka Hyman, Danika Crolla and Aaron del Pino