We recruit and train health workers and volunteers from the community, who provide vision screening, referral, health assessments and health education.
Across South Asia and Africa, these local eye health champions also reached nearly 800,000 people with education sessions about key health issues, like child and maternal health.
Sonam, community health worker, India
After Sonam’s mother received sight-restoring cataract surgery at one of our partner hospitals, she was inspired by the impact it had on her entire family.
“My mother’s surgery helped me experience the impact avoidable blindness can have on a family,” she says. “I was impressed by her visual outcome. I got free of my duties towards my mom and took up new responsibilities.”
In addition to now being able to work in the pasture and feed cattle, Sonam has been trained as a community health worker and joined our India project team.
Salina, community health volunteer, Kenya
For Salina, what makes her work doing door-to-door screenings rewarding is the appreciation of patients and families in her community.
“Working as a community health volunteer makes me interact with the community, who appreciate the help they get through the door-to-door screening program,” she explains.
If you ask Joana Annobil what it’s like to pursue a degree in ophthalmic nursing, her answer is simple.
“It’s a dream come true,” she smiles.
Growing up, Joana remembers her grandmother going blind but not seeking treatment because blindness was believed to be caused by spirits.
"If they knew about eye services, they wouldn't have gone blind," she says.
Now in her final year at the Ophthalmic Nursing School in Korle-Bu, Accra, Joana says she is most excited that her presence in her community will have an impact on the health and quality of life of her neighbours as well as Ghana’s health system.
“Becoming an ophthalmic nurse will help improve the state of human resources for eye health in Ghana, especially in my district of Awutu Senya, where the need for eye health services is very high,” Joana explains. “The people at the community level will have quality eye care services at their doorsteps.”
Joana says that after her schooling she will return to her district and provide eye health care in her own community.
"They are expecting much from me, because in the whole district there is no eye nurse and there is no clinic apart from Watborg Eye Services."
Her school, Ghana’s only institute of its kind, recently upgraded from providing diplomas to awarding academic degrees, thanks to Operation Eyesight in partnership with the International Agency for the Prevention of Blindness. It’s a step up for Joana and her whole community.
“This will enhance my career in the health service,” Joana adds. “I’m extremely grateful to Operation Eyesight for funding my studies.”
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It's our team's passion for working in the field and caring for patients that allowed us to impact more lives in 2021.
“I have seen people who never expected to see again, because eye care services were far out of reach, not affordable and not accessible. They waited for their death,” explains Bitul Hazarika, a paramedical ophthalmic assistant with one of our partner hospitals.
“But when we reach them…with services and care to see again, I feel satisfaction of seeing these people smiling and thanking us for the services.”
Bitul has been working in the field since 1996. In addition to working in a vision centre, over his 26 years of service he has attended more than 500 screening camps, provided prescription eyeglasses to 700+ people and referred more than 300 patients for surgery.
Today, he’s working to make his home state of Arunachal Pradesh completely free of avoidable blindness.
Samson Keitany is Head of the Eye Department at Huruma Eye Unit, our partner in Uasin Gishu County, Kenya.
“2021 was a blessed year for us. Despite the COVID-19 pandemic, our work in serving the community continued from the support we received from Operation Eyesight," Samson says.
Samson Keitany, Head of the Huruma Eye Unit in Uasin Gishu County, Kenya, says that despite the challenges that came with 2021, it's the impact that we have in the lives of patients that makes our work worthwhile.
"We started the year with school screening that saw an influx of workload at the eye unit. Our patients had their eyesight restored courtesy of consumables and spectacles we received from Operation Eyesight. When our patients are happy, we are also happy.”
Did you know trachoma is the leading cause of preventable blindness in Kenya and many parts of Africa?
This painful bacterial infection causes irreversible blindness if left untreated. Worse yet, women and children are more likely to contract this condition.
We are supporting the distribution of antibiotics in Kenya’s Narok County to treat and reduce transmission of trachoma. This is happening in partnership with the local Ministry of Health and other partners, with the goal of eliminating trachoma from the county by 2025.
Community health volunteer Peter Reyia administers antibiotics in Orbama Village, Kenya, to help eliminate blinding trachoma from the area. This work is continuing in Summer 2022 as we take one more step towards making Kenya trachoma-free.
“Narok is home to many who raise cattle, which attracts flies that spread trachoma. We are now building on the success of our work to date in the area,” explains Alice Mwangi, our Country Director for Kenya. “Treating and preventing transmission of trachoma through distribution of antibiotics is one of the most effective ways to eliminate this condition from entire regions.”
In 2021, our Kenya team distributed antibiotics to more than 460,000 people in Narok, covering nearly 90 per cent of the target population for this program. In summer 2022, we are leading another planned Mass Drug Administration (MDA) in the region.
Our trachoma elimination projects are designed to implement all four components of the World Health Organization-recommended SAFE strategy:
• Surgery to treat advanced cases of trachoma;
• Antibiotics to eliminate infection, which includes Mass Drug Administrations (MDA);
• Facial cleanliness; and
• Environmental improvement such as wells, boreholes and latrines.
Today, nine-year-old Aaliya from the village of Vallabhnagar in Rajasthan can go to school and play with her friends – but it wasn’t always this way.
Failing vision from the age of three meant the gradual loss of sight in her right eye. Aaliya’s family took her to several hospitals seeking treatment, but these efforts were in vain; Aaliya could get neither diagnosis nor treatment.
A vision technician conducts a slit lamp examination as part of an assessment of Aaliya's eyes. Her squint was diagnosed relatively late and would have led to permanent blindness if left untreated.
It wasn’t until an Operation Eyesight community health worker met the family during a door-to-door screening that Aaliya was directed to one of our local vision centres, where she was diagnosed with a squint. Also called a strabismus, this condition causes the eyes to point in different directions. If not treated early enough in life, squints can cause vision to be blurry or doubled and can impact how eyesight develops during childhood.
Aaliya was referred to our partner hospital, Alakh Nayan Mandir, for further treatment. She received prescription eyeglasses and over a number of months, received patching on alternate eyes to treat her eye condition. Doctors told her family that without proper and timely treatment, Aaliyah would have lost her vision.
"We never expected such an improvement in her vision,” says Aaliya’s father, Yusuf. “We are delighted.”
By partnering with hospitals and establishing a local presence in communities, we are strengthening India’s health system and making eye health care a standard part of primary health care. This approach allows us to bring quality eye care to patients like Aaliya, who were previously unable to access these services, as well as connect them with their local health system.
Vision centres in the community give patients local access to comprehensive vision screening, prescription eyeglasses and specialist referral if needed.
Sustainable impact
In the last six years, we have established more than 140 vision centres across India that provide eye exams, dispense prescription eyeglasses and refer patients to hospital for specialized treatment if needed. These self-funding facilities are established in accessible locations and staffed by trained eye health personnel.
Blindness and visual impairment are major public health issues in India, which is home to more than 20 per cent of those who are blind or visually impaired worldwide. The good news is 90 per cent of blindness and visual impairment is treatable or preventable.
Through the support of our donors and partners, in 2021 we referred nearly 150,000 patients for sight-saving surgery in India and provided nearly 160,000 pairs of prescription eyeglasses to patients who would not otherwise be able to afford them.
“A key part of our success is investment in infrastructure and training,” explains Troy Cunningham, our Country Director for India. “By training staff to deliver primary eye care and equipping facilities with the tools they need, we are ensuring the sustainability of our impact, long-term. We believe this approach can be replicated in states across India and are working with state governments to achieve this.
Building local expertise
We also recruit and train hundreds of female community health workers, who who provide door-to-door eye health screening in target communities. These local eye health champions identify patients requiring care or referral to hospital. They also provide health counselling and education regarding various health issues, including maternal and child health.
After receiving treatment, Aaliya received a follow-up visit from Operation Eyesight project staff.
Remaining present in the community this way allows us to deliver eye health care that is truly integrated, because it's eye care that is preventive, provides treatment and follow-up care for all eye conditions. This integrated approach to eye care allows us to focus on the individual needs of patients and families.
Delivering on the UN's mandate
By focusing on gender equality, promoting health and access to health services and bringing clean water and sanitation, we are also helping end poverty and the root causes of blindness. Together, we are helping achieve the UN Sustainable Development Goals (SDG).
The Government of India’s “Ayush Bharat” program aims to provide free access to healthcare to 500 million people nation-wide. While eye care is included in this program, many gaps still exist which prevent many Indians from accessing quality eye care.
By supporting policy development on eye health, establishing referral pathways, training staff and establishing facilities, Operation Eyesight is playing a key role in shaping India’s health system. Thanks to our partnership with state governments in Arunachal Pradesh and Madhya Pradesh, our primary eye care program is making eye care a key part of local primary health care in these regions.
“We are focused on strengthening existing health systems as well as equipping communities to look after their own eye health long-term,” explains our Global Director of International Programmes Vikas Gora.
“Eye care is primary care – thanks to our donors and partners who make our work possible, we are making this a reality in India.”
Over the course of the four-year study, the prevalence of blindness and visual impairment in the community was reduced by nearly 62 per cent.
It’s confirmation that Operation Eyesight’s focus on strengthening local health systems and empowering communities to look after their own eye health is not only effective, but also sustainable.
Vision centre staff provide comprehensive eye exams to people in the community, providing primary eye care, prescription glasses and specialist referral. Mobile devices also give vision centres the opportunity to have real time specialist consultation, if required.
“We have known for some time that the presence of vision centres in a community, supported by door-to-door outreach, has a measurable impact on health outcomes for patients and families,” explains Kashinath Bhoosnurmath, our President & CEO and co-author of the study.
“Data like this only helps us become more effective in achieving our mission of preventing blindness and restoring sight.”
The study looked at approximately 44,000 people living in an urban slum area in Pune, Maharashtra, India, who were surveyed at a four-year interval by local health workers in the community. Patients identified as having vision loss were referred to Operation Eyesight’s local vision centre partner for more comprehensive examination and treatment if necessary.
Vision centres also have referral pathways in place for patients who require referral to hospital for surgery or additional treatment.
Over the course of the four-year study, led by Community for Eye Care Foundation, Pune and our team in in India, 8,211 patients were examined at the local vision centre. During this time, the prevalence of blindness due to conditions such as cataracts decreased from 0.25 per cent to 0.1 per cent over four years, and visual impairment decreased from 0.16 per cent to 0.05 per cent.
Building a lasting presence in the community
Vision centres are permanent facilities, established in strategic locations within a project area and staffed by trained eye health personnel. In addition to linking the community with the hospital, vision centres also provide eye exams, dispense prescription eyeglasses and refer patients for specialized treatment if needed. Vision centres are critical hubs for communities that do not have access to the most basic of eye healthcare, either due to economic or geographic factors.
“By providing access to prescription eyeglasses, eye health screening and referral to hospital, the decrease in rates of visual impairment and blindness in this community can be attributed to the presence of the local vision centre,” explains Bhoosnurmath.
Operation Eyesight’s focus on involving the community at every stage of a project has ensured the sustainability of our vision centres. This includes ensuring that demand is in place for the vision centre’s services and that a flow of revenue will fund the provision of services long-term.
Operation Eyesight has established 160+ new vision centres across India. Most vision centres become self-funding within six months of operation.
Community health workers recruited from within the community are able to provide eye exams and health education connecting patients with their local vision centre or eye facility.
Recruiting eye health champions
“The key to the success of vision centres is our ability to recruit local community health workers who provide door-to-door eye health screening,” says Soumya Moosa, one of our Program Managers in India and co-author of the study.
Moosa says this type of grassroots outreach in the community is particularly beneficial to health outcomes for women.
“The study found that women continue to have a higher prevalence of blindness and are less likely to seek care in low-income communities like the one surveyed. This is why the counselling by local female health workers is so pivotal to the project’s success.”
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When 62-year-old Lucia lost her left eye and then began losing vision in her remaining eye, she lost more than just her sight; she lost her art and source of income.
She also struggled to do her daily chores at home and on the farm.
After more than a decade in near-blindness, she received sight-restoring eye surgery and eyeglasses free of charge after being referred by an Operation Eyesight Community Health Volunteer (CHV) last year, during a door-to-door survey.
In addition to reminding us of the importance of taking charge of our eye health, Lucia taught us that an awkward hard-shelled fruit could be a work of art.
“I can now decorate my gourds with beads and make clothes,” she says. “This is something I abandoned 11 years ago.”
Lucia’s village of Lamaon in Kenya’s Elgeyo Marakwet County is one of 15 villages across the county that was declared avoidable blindness-free last year, bringing us one step closer to our goal of declaring 50 villages in the county free of cases of unidentified refractive errors, cataracts and other conditions.
Lamaon village is one of 15 villages across Kenya’s Elgeyo Marakwet County to be declared free of avoidable blindness in 2021.
By empowering volunteers to screen others in their community for vision problems, we are able to identify community members with vision problems and refer them to an eye unit or partner hospital for care.
CHVs also provide health education to communities regarding primary eye care and child and maternal health.
We conducted refresher training for 10 CHVs in Kenya in 2021, out of 82 volunteers that we work with. This community-based team reached 4,477 people in their communities with health education and eye health screening last year.
“It’s our Community Health Volunteer presence in communities that ensures these communities are free of avoidable blindness not just this year but in years to come,” explains Alice Mwangi, Country Director for Kenya.
In the village of Kwanga, in southern Zambia, the rehabilitation of a borehole has meant local access to abundant, fresh water for the entire community.
For Natasha, it’s brought the ability to attend school full time. Previously, she had to walk several kilometres each day to fetch water for her family. This took so much extra time and energy that she began missing school.
Together, we rehabilitated Kwanga’s borehole in 2021. It’s one of 96 non-functioning boreholes that we have rehabilitated in the past three years, in addition to the 106 that we have drilled in the Sinazongwe district, in Zambia’s arid south.
This has helped eliminate blinding trachoma infections from the district. Locally-available water has also brought a host of benefits across communities like Natasha’s, including improved health outcomes, thriving local economies and improved opportunities for women and girls.
"Access to fresh water prevents the spread of trachoma and other infections and also brings many benefits to the local community,” explains Vikas Gora, our Global Director of International Programs.
With less time spent hauling water long distances, locally-available water gives students like Natasha (pictured here with her brother) the opportunity to attend school and thrive.
Now that the borehole in her village is functioning again, Natasha and several other girls in her class no longer have to haul water for long distances, and they are back attending school full time.
Access to clean water doesn’t just help reduce the spread of infection — it brings long-lasting and sustainable change to the entire community.
Thanks to our donors and partnerships with local Water, Sanitation and Hygiene (WASH) committees that are trained to maintain boreholes and ensure their longevity, we’re creating a ripple effect that is being felt in other communities across Zambia.
