Sustainable eye care in Africa Kate Coleman Consultant eye surgeon Executive chairperson/founder Right to Sight.

‘Needless’ Blindness New technology and therapeutics mean more than 90% blindness in Africa can be PREVENTED or TREATED

Solutions are available worldwide

Eye care? Cataract Glaucoma Glasses Children

INSPECTION OF THE AUTO REFRACTOMETER

VISION SCREENING AT RUAL CAMP ; VILLAGE BONAMOUTONGO

EYE TESTING FOR THE INDIGENT POOR AT THE RUAL CAMP

EYE EXAMINATION FOR TEAHCERS

Past interventions....no sustainable providers

14 Why Right To Sight exists... * Other causes include untreated refraction, alien bodies, trachoma, glaucoma Dr Godelieve, CHUK, Rwanda Nkhoma Eye Hospital, Malawi A blind patient being led by his granddaughter - Gondar, Ethiopia Dr Fitsum with his patients - Tigray, Ethiopia This is a crisis...we can solve it  90% of blindness in the developing world is preventable – a needless waste  More people are needlessly blind than have HIV ( 37m globally vs. 32m)

Eye CARE SUSTAINABLE AFFORDABLE ACCESSIBLE

First Day – 9 cataract surgeries; ALL regained Good Vision

2006 Affordable SOLUTION to most causes of traditional blindness!

Why can these children not have their glasses???

Why is this 46yo healthy man still blind?

22 Right to Sight works in in 8 African countries and India November 2009 n

23 The sustainability process 0 1,000 2,000 4,000 8,000 25% 50% 75% 100% Increase surgical output, and Improve cost recovery Cataract Surgeries per annum (#) Increase surgical output, Maintain cost recovery Maintain surgical output, Improve cost recovery Self-sustainability (cost recovery %) Start position 16,

Surgery every 5 minutes...

Public vs Private 12 private NOT for Profit 13 government hospitals

Nkhoma Mission Eye Hospital RTS Involvement Needs Assessment - March, 2007 Onsite support-Ideas and Strategies Vision Building and Strategic Planning- LAICO Feb 2008 Staff skill development training – LAICO Feb 2008 RTS Cost $50,000 RTS Objectives Increase capacity of surgery to 5,000 and out-patients to 50,000 per annum Expand training of key staff to allow Ophthalmologists to focus on surgery To introduce cross subsidy programmes with a view to long term sustainability

OCO trained as a cataract surgeon

28 Mahatma Gandhi Memorial Hospital (MGMH) Dr. Abdi with the two newly trained Ophthalmic Nurses at MGMH Dr. Abdi from Right to Sight supervises as the Registrar from UKZN undertakes her first surgery using the new more cost effective Small Incision Cataract Surgery technique (SICS), as the newly trained nurse assists (left) Dr. Abdi performing SICS surgery on a blind patient at the newly opened MGMH eye unit A total of 56 surgeries have been completed at MGMH since the unit opened in Aug 09’

First Day – 9 cataract surgeries; ALL regained Good Vision

Glaucoma 30% blindness over 50yr age in Africa NO DROPS!!!!

80 cataract surgeries in one day

Prevent Needless blindness Early diagnosis and awareness Early treatment