ICEE Where we work - South Africa

Creating a sustainable spectacle delivery solution - Haydom Project

Globally today there are 37 million blind people and a further 124 million people with serious visual impairment. Of these, uncorrected refractive error - the need for a pair of glasses - accounts for up to 6 million blind and 100 million with significantly impaired vision. If urgent action is not taken these numbers will almost double over the next 20 years. This is unacceptable both from a humanitarian and socio-economic point of view > more

ICEE Africa runs a diversity of programs in Africa and South Africa including training courses, development of delivery models, mobile community optometrist programmes and affordable spectacle supply solutions.

In Community Outreach, ICEE has two key programmes. In South Africa we have our own “Flying Optometrist”. Currently, the public sector is unable to attract suffi cient optometrists, especially in rural areas. To address this a refractive error program was developed in conjunction with Red Cross Air Mercy Services. This involves daily outreach programs fl ying to rural areas where eye exams are conducted, spectacles dispensed and referrals for disease conditions are made. Currently, Mr Kesi Naidoo Community Optometrist (Red Cross Air Mercy Services) visits 20 clinics a month and helps, on average, 6,000 patients a year. This is part of an overall capacity building approach for the KwaZulu Natal province - as optometry posts are created and fi lled, ICEE moves out of the clinic, handing it over to the Department of Health, and establishes a new clinic in an un-served area. To date ICEE has handed over 7 clinics.

In Tanzania, our community optometrist Damas Mworia travels to remote communities in the Kilimanjaro area. ICEE Africa has paired with the Kilimanjaro Centre for Community Ophthalmology (KCCO) to provide fully integrated, “direct delivery” eye care. A complete team of nurses, ophthalmologists, the ICEE optometrist, counsellors and clinical assistants provide treatment at rural community sites that have been developed over the last three years. KCCO and ICEE are currently working together with the Tanzanian Department of Health to develop outreach programmes for their optometrists to enable them to reach under-served communities, and this programme is now being implemented in two Government Districts with plans for a third.

ICEE Africa has three major new project areas being developed: Low Vision Low Vision is a hugely neglected area of care on the African continent, and ICEE Africa is forming partnerships with Sight Savers International, CBM and Lighthouse International to deliver Low Vision training courses across the continent. It is estimated that there are over 12 million people with Low Vision in Africa.

As a fi rst step, the Vision 2020 Low Vision Working group is holding a national workshop in Durban, South Africa to train key people from around the continent on the planning and implementation of Low Vision services in their countries. ICEE is also running their fi rst Low Vision training course for South African Public Sector Optometrists early in the new year. A major barrier in the past has been the cost of devices, such as magnifi ers and telescopes, however with the development of the Low Vision resource centre in Hong Kong, these devices are now available to those in need at a fraction of the price.

National Refractive Error Programme An exciting new initiative being trialed in South Africa is the National Refractive Error Program. South Africa is in the unique position in Africa of having enough optometrists to meet the needs of the population, however 95% of the optometrists work in the private sector servicing just 15% of the population. The other 85% of the population, some 38 million people, rely on a handful of optometrists and ophthalmologists. South Africa Public sector optometry is still in its infancy and the Public Health system has many competing demands on its resources, particularly with South Africa’s Aids/HIV rate. The ultimate goal is the establishment of state run clinics with optometrists employed by the Department of Health and part of an integrated eye care team.. However in the short term, given the lack of optometrists in the public sector and the limited resources available, alternative strategies need to be explored. Recognising that there is a need for refractive services and that mobilizing the private sector can be benefi cial, ICEE developed the National Refractive Error Program which was presented to the South African National Prevention of Blindness Vision 2020 committee by Professor Kovin Naidoo. The provincial health departments present enthusiastically received this program and followup meetings have been held to map the way forward. The National Refractive Error Program utilizes the private sector in a collaborative relationship. The process is as follows: Private optometrists are recruited for the program and then provide services and spectacles (defi ned by the program) on a specifi c roster basis.

The optometrists are remunerated at a specifi c rate according to the number of patients they see. The program provides the management, monitoring and evaluation and program development expertise. The program is currently being piloted in two South African provinces - Gauteng and Kwa-Zulu Natal. African Vision Research Institute Tuesday the 19th July was an important day for blindness prevention in Africa; it saw the founding meeting and appointment of the Board of the African Vision Research Institute (AVRI) in Durban, South Africa. After being invited by the World Health Organisation to an expert technical committee meeting on Global Eye Research in Geneva, Professor Kovin Naidoo realized that public health research in blindness prevention in Africa has been limited.

Furthermore much of this research has been conducted by the developed world institutions and has not resulted in building the research capacity of African institutions and researchers. He approached other African Colleagues and raised the idea of an African Vision Research Institute (AVRI) focused on blindness prevention research and building local capacity so that local research can inform program development. The Institute for Eye Research in Australia and ICEE enthusiastically contributed support and organisational systems to enable AVRI to get a fl ying start.

The Institute will be affi liated with the University of KwaZulu-Natal (UKNZ) and with the Institute for Eye Research in Australia – both organisations having a real commitment to growing vision and eye research with UKZN keen to host AVRI. AVRI will conduct blindness prevention research to aid programmes in Africa. To date all the research institutes in Africa approached have committed to involvement as well as many optometry and ophthalmology institutions in South Africa. The institute will have a signifi cant training component for Masters and Doctoral students and will collaborate with major international universities, researchers and other institutes.