How to combat visual impairment

image-newsBlindness and visual impairment is considered to be a critical social and health problem in Bangladesh. Many children were deprived of necessary treatment due to lack of awareness and financial incapability of their parents and stigma surrounding visual impairment. Families of blind children often do not have access to the specialized resources they need to improve the quality of life of their children. The majority of the eye care facilities and rehabilitation services are located in the urban areas of Dhaka and Chittagong despite the fact that 80 percent of country’s population live in rural areas. This presents significant problem for children who are financially or physically unable to travel from their areas to the country’s urban centres to receive the services they need. There are several cross-cutting factors—lack of information, lack of knowledge, proximity, economic constraint and illiteracy, wrong belief, wrong treatment and unscientific interventions-which contribute to childhood blindness in our country. There are other problems, including lack of skilled eye doctors and necessary medical equipment at the district level, which hampered the treatment of eye patients. Child Sight Foundation (CSF), a NGO working for combating visual impairment, said many causes of childhood blindness are either preventable or treatable. Cataract is completely treatable with cost effective and safe surgery if we can intervene timely. With basic cost effective medication, all of these common and preventable eye diseases are easily treatable. In the absence of treatment, however, many children face stigma within their communities and place a financial burden on their families due to medical costs and their inability to help in the home. According to a research conducted by the CSF and London-based International Center for Eye Health, 40,000 children in Bangladesh are visually impaired and out of them 12,000 children are impaired due to cataract. They can be socially rehabilitated by providing treatment and rehabilitation. About 285 million people are visually impaired worldwide. Among them, 39 million are blind and 246 million have low vision (severe or moderate visual impairment). In Bangladesh, 750,000 people are blind and, of them, 650,000 are due to cataract, said CSF. CSF, in their another study, found that about 10,000 children on per million population have more or less visual impairment. Most of these children can see only by using spectacle. Blindness in children is often preventable if communities and parents become aware of the causes. Without early intervention for cataract blindness children may go blind permanently. Blinding conditions increase child mortality – 50 per cent of children who become blind die within two years. Many people treat blindness as fate. They do not know that blindness in our country is largely treatable or preventable. Dr. MA Muhit, eminent eye specialist and also honorary Executive Director of CSF, said many people accept blindness as fate and most of them do not know that blindness in our country is largely treatable or preventable. This is why, raising awareness level is one of the key factors that can help reduce the intensity. He mentioned that over six million blind people need vision correction by spectacles and other means and approximately 150,000 are irreversible blind which need to be rehabilitated in the society. “About 80 percent blindness in our country can be preventable and avoidable if surgery is carried out on cataract patients and glasses are provided to people with low vision”, claimed renowned eye expert Dr. Muhit. Cataract can affect babies and children although most of us think it as a disease of the elderly. According to CSF, cataract may be developed in the eyes of children and it may gradually impair the visual power of children if it is not treated timely. Cataract is treatable disease and only a simple operation can restore the visual power of many children. Parents should go to physicians immediately for cataract operation. The cataract does not need to mature. If treatment is delayed there is a risk of amblyopia (partial blindness), leading to blindness. According to physicians, factors that may speed up cataract formation are: Diabetes, eye inflammation, eye injury, family history of cataracts, malnutrition, long-term use of corticosteroids (taken by mouth) or certain other medications, radiation exposure, smoking, surgery for another eye problem and too much exposure to ultraviolet light (sunlight). Many of us do not know that the treatments available for prevention and cure for blindness are one of the cheapest and most cost effective healthcare interventions, especially when measured against the cost in lost productivity lifelong that is associated with the loss of sight. There is good example of projects in different parts of Asian region, which needs to be shared, synthesised and documented so that more effective and large scale programme can be developed in Asian countries to tackle childhood cataract and to eliminate childhood blindness from this cause. In our society, visually impaired people are deprived of getting medical facilities and proper rehabilitation due superstition surrounding the disability. Mass media, which include television, radio, advertising, movies, the Internet, newspapers, magazines, and so forth, can reach a large audience and can bring positive change by making people aware of the visual impairment and dispelling stigma and misconception surrounding the disability. There is no other strong tool than mass media in shaping the people’s perception and brining a positive change regarding visual impairment and establishing the rights of the visually impaired people. Inter-personnel communication can also be utilised in launching the awareness raising activities. In a bid to raise awareness among people for combating visual impairment, CSF with the assistance of The Fred Hollows Foundation took up a programme involving journalists. As part of the initiative, journalists from both print and electronic media were involved in the activities and they published and broadcast reports on visual impairment through their respective media houses. Of them, six journalists—three from print and three others from electronic media—were awarded for their best reporting on the issue at a ceremony titled ‘CSF-The Fred Hollows Journalist Fellowship Award’ in the Dhaka city. Organized by CSF, the award giving ceremony ‘CSF-The Fred Hollows Journalist Fellowship Award-2013’ was held at MA Matin auditorium at the University of South Asia recently. Besides, the results of a research titled ‘Rapid Assessment Avoidable Blindness’ were published at the programme. Prof. AH Saidur Rahman, president of CSF, eminent ophthalmologist Prof. Dr MA Muhit, executive director of CSF, Dr. Zerin Khair, country manager of Fred Hollows Foundation, Golam Kibria, country director of Sight Savers International, among others, spoke at the function. Speaking on the occasion, speakers called for making health services for eye patients easily available across the country and raising awareness for preventing visual impairment and establishing the rights of the visually impaired people so that they can live with dignity. They underscored the role of mass media, saying that mass media should play an important role in achieving those objectives. They expect the journalists would continue support the issue of visual impairment with the objective of ensuring the rights of the visually impaired people in the country where everyone can live with dignity free from all kinds of discrimination and stigma.

Awarding gold medal to DR. M A Muhit

Awarding gold medal to DR. M A Muhit for his great contribution on the field of research of childhood eye diseases on behalf of the Ophthalmological Society of Bangladesh (OSB).

Ophthalmological Society of Bangladesh (OSB) is happy to announce that the society is going to award a gold medal to Dr. M A Muhit for his great contribution on the field of research of childhood eye diseases in its 36th annual national conference on Wednesday, the 18th March, 2009.The conference held in BCPS Complex auditorium, Mohakhali, Dhaka. Dr. M A Muhit, in his career, is in teaching in the University of London, U.K for long 10 years. He is involved in research regarding the childhood blindness of the children of different countries of the world. Prof. Tasmima Matin, mother of Dr. M A Muhit, gives her consent to receive the award on behalf of her son as Dr. Muhit is staying abroad.

Dr. M A Muhit has invented Key Informant Method (KIM) through his long time research and his observation through research is that there are 40,000 (forty thousand ) children who are the victim of childhood blindness in Bangladesh. Out of them, 12,000 (twelve thousand) children are blind due to avoidable cataract problem. In the light of VISION 2020 global campaign, he has established Child Sight Foundation (CSF) to restore the eye sight of cataract blind children of our country. Now this organization has been detecting blind children and referring cataract blind for operation at free of cost. Besides this, the organization has been working for inclusive education and rehabilitation of the blind children.

Messages from ICEH

Clare-GilbertDespite being a relatively new NGO, and a new player in the field of blindness prevention in Bangladesh, the Child Sight Foundation has been doing truly excellent and innovative work over the last few years. One of the strengths of CSF is that the staff come from a range of backgrounds, and they bring their expertise and experience to bear on how activities are planned and organized, coming up with new and innovative ideas and solutions. The staff now have a wide range of skills, ranging from interviewing the parents of children who are blind and the blind children themselves, conducting house to house surveys to identify children who are blind, training key informants, networking with an extremely wide range of organizations, agencies and service providers, running national workshops, using qualitative information to develop and field test health education materials, and maintaining a database of the blind children they have identified. Indeed, developing and refining the key informant method for finding blind children in the community (and training other organizations in use of the method) is CSF�s the main achievement, and over the two years covered by this report CSF identified 2,846 blind children. Many of these children were referred to partner eye hospitals for sight restoring surgery – the vast majority of these children would have remained blind without the tireless and committed work of CSF staff.

I wish CSF all the very best as they continue in their excellent work, and I am sure that when the time comes to the next report in 2 years time that they will have even more new initiatives to report!

Clare Gilbert MBChB, FRCOphth, MD, MSc
Acting Head, International Centre for Eye Health
Reader in International Eye Health
International Centre for Eye Health,
London School of Hygiene and Tropical Medicine, London.

Messages from CSF President

A-H-Syedur-RahmanIt is with immense pleasure that I write this report as the President of Child Sight Foundation, a role that I am very honoured to carry out. The undertaking of this report highlights the organisation’s commitment to its stakeholders and transparency. It is also an opportunity for CSF to inform people about its achievements and future plans.

CSF has achieved outstanding results in its short three year life span. It gained registration with the NGO Affairs Bureau in October of 2004 and has been able to serve blind children on a broader platform.

The main aim of the organisation is to serve the estimated 40,000 blind children in the country, to provide them with treatment and where this is not possible, rehabilitation. The aim is to encourage them to be independent and full members of society. The organisation also seeks to assist the primary care givers of blind children by listening to them and operating in ways, which are conducive to best serving the needs of these two primary stakeholder groups. The organisation is currently in the process of developing a comprehensive programme for blind children, a model in one district, which will address their needs and hopefully be replicated in other parts of the world.

I would like to take this opportunity to congratulate the Executive Committee, the management team and staffs who contributed greatly to the continuous growth and success of CSF.

I am also grateful to the various regulatory bodies such as the Social Welfare Ministry, NGO Affairs Bureau, government and non-government organizations and local and international donors for their support, which has contributed to the success of the organisation.

I sincerely pray to the Almighty Allah to grace us with His blessings in our continued efforts in achieving success in the future.

Prof. A H Syedur Rahman
President
Child Sight Foundation

Messages from Founder President

M-A-MuhitIt was a privilege for me to be closely involved in the formation of this unique organization in 2002. Along with my friends, well wishers, professional colleagues and a committed team of young people (the CBPB team) we wanted to change the situation of blind children in Bangladesh and establish the rights of blind children to treatment, education and other essential services to participate as equal citizens of this country.

We, as a small team in CSF, started with a vision of a new world where no child is denied his or her human rights because of blindness, but we were soon challenged by the limitation of resources, by the needs for capacity building and most importantly by the fact that very little is actually known and documented on the situation of blind children in Bangladesh. There was a widespread denial among policy makers and service providers even about the mere existence of blind children � no data were available even on essential facts like �how many children are blind in Bangladesh?

Our work actually started in April 2000; it is now five years since I came to Bangladesh after undertaking my Clinical Ophthalmology training in Glasgow and Bristol and Community Eye Health training in London. The purpose of my two month visit in 2000 was to undertake a feasibility study for the International Centre for Eye Health (ICEH) in London so that the First National Study on Childhood Blindness in Bangladesh could be planned and implemented to inform policy makers about the number and causes of childhood blindness in the country.

During this long journey over the last five years, I had the opportunity to work with the CBPB and CSF teams, to visit every district of Bangladesh and to personally meet over 2,000 blind children. I was motivated and encouraged by many social and community workers, government officials, NGO staffs, ophthalmologists and policy makers who were keen to work for blind children in Bangladesh.

The journey of CSF taught us that the social capital in Bangladesh is well developed. We strongly believe that with this enormous social capital, motivating leadership and faith in the ability (not disability) of every citizen in this country- Bangladesh can create a wonderful example for many developing countries that are struggling to establish the rights of children (with or without blindness and disability). CSF strives to be at the forefront of the global movement against avoidable blindness-the VISION 2020 initiative, as well as in the movement to establish child rights.

Dr M A Muhit
Founder President
Child Sight Foundation and
Clinical Research Fellow
International Centre for Eye Health,
London School of Hygiene and Tropical Medicine.

District Blindness Control Program with BEH

Bangladesh Eye Hospital, Bank Asia

January 06- January 2007

Cataract case detection and referral for surgeries.

To identify the blind children from their community and to provide high quality surgery and postoperative treatment to the cataract child patients referred by CSF to Department of Pediatric Ophthalmology, Bangladesh Eye Hospital.

To detect about 430 blind children and refer approx. 135 for cataract surgeries including follow-up treatment in remote Chapai Nawabgonj district.

To develop a database of identified and examined blind children at the CSF.

To use this blind and cured children database for their future treatment, follow-up and case study.

Bangladesh Childhood Blindness Campaign (BCBC)

International Centre for Eye Health, London and Muslim Aid UK

3 years, July 2006 to June 2009

Comprehensive Community-based Rehabilitation (CBR) Programme to ensure early detection, prevention, treatment, rehabilitation, education and self help activities to control blindness and to establish the rights of blind children

240 blind children and their families will receive rehabilitation support.
600 blind children traced from rural communities by the trained key informants.

1,200 visually impaired children will be helped through eye examination and treatment. 200 blind children will receive sight restoring surgery 4,800 children with common eye diseases will be treated with eye drops, spectacles and other necessary treatments.

60 schoolteachers trained in inclusive education for blind children. 240 blind children will be educated in the mainstream schools through inclusive education. Model school practice in 10 schools will be developed, supported and sustained Localized advocacy among Parents, community and decision makers for education, rehabilitation, and rights of visually impaired children. 200 self-help group members trained through training programmes. 60 Trainers will be trained on Primary Eye care through Training of the Trainers programme. 1,800 volunteers trained in Primary Eye Care for Children’s Eye. 800 key informants trained in finding blind children from rural communities. 4,000 health education materials will be distributed. 4 district partnership workshops organized for childhood blindness control.

Childhood Cataract Health Communication Project (CCHCP)

ICEH, Christoffel- Blinden Mission (CBM), Development Cooperation Ireland (DCI), Muslim Aid, UK

January 06- January 2007

Health Communication materials development and dissemination, training and advocacy

To develop a health communication strategy, and to design, pilot, produce and disseminate health education materials to reduce cataract blindness in children in Bangladesh.

Development, piloting and dissemination of health communication materials (production of video/TV documentary, radio spots, posters, newspaper articles and training materials for primary health workers, community members and medical students) related to cataract blindness in children.

Training of primary health care trainers (TOT), community members and medical students on how to identify a blind child from the local community and where to refer them for treatment.

Partnership workshop of local service providers (both NGO and government) to facilitate sustained use of childhood cataract health communication materials in their outreach programmes.