What has underpinned the project, and in fact continues through all of our work, is a relentless determination and commitment to make sure improvements to healthcare aren’t short-lived. We have helped to set up services that are sustainable and will continue to reach the most marginalised communities and individuals well into the future.
The full project, funded by Standard Chartered and managed by the International Agency for the Prevention of Blindness, covered 22 countries, with Sightsavers working in Bangladesh, Ghana, India, Kenya, Nigeria, Pakistan, Sierra Leone, Sri Lanka, Tanzania, Uganda and Zambia.
Let me take you on a behind-the-scenes tour of Sightsavers’ work.
We’ve worked with families and whole communities to improve their knowledge of eye health and the services available to them, while fostering trust to encourage people to seek healthcare when they need it.
In Uganda, Sierra Leone and Nigeria, we used interactive radio broadcasts, phone-ins, SMS messages, discussions and jingles to make sure eye health messages reached local communities.
In Sierra Leone, our awareness campaign on the importance of vitamin A for eye health was seen by 87 per cent of families with children under five years old. In Uganda, most patients who went to health facilities for children’s eye services during the project attributed their awareness to hearing messages on local radio stations.
In Bangladesh, our strategy was a little different. We used miking, a popular local technique of sharing health messages using a microphone while walking or riding a tuk-tuk. We also visited homes, distributed leaflets, organised street plays and banners, and engaged with activist groups.
All of this activity contributed to a 20 per cent rise in the number of people living in poor urban communities attending hospitals. Interestingly, many of those who benefited from the eye health programme acted as ambassadors, encouraging their community to seek help when needed.
In Pakistan we came up with new ways to reach marginalised communities. Female health staff called ‘Lady Health Workers’ are a common part of healthcare in Pakistan, but they used to only work with mothers and their babies, particularly for rural women.
We helped to train more than 125,000 Lady Health Workers to screen people for eye problems and gave them the tools they needed for the job, so they can now refer people to be examined by a doctor.
The power of communities understanding eye health and what healthcare is available to them can’t be underestimated. In Sri Lanka we trained health workers who lacked skills in eye health and brought primary eye screenings to the doorsteps of families living in poor, urban dwellings, as well as remote rural locations.
Our success is summed up by Padma, a community worker in the Sri Lankan capital, Colombo. “Most of the community members in my area are familiar with the importance of eye care,” she says. “They don’t ignore eye health any more.”
We’ve all heard the saying: ‘It takes a village to raise a child.’ The same concept applies to making meaningful, long-lasting changes to healthcare. It takes coordinated collaboration with governments, ministries of health and education, local non-governmental organisations, large hospitals, small clinics, schools and community health workers.
By providing ongoing training for health staff in Bangladesh, more health workers are now able to perform surgical procedures such as cataract surgery, and prescribe glasses for patients who need them.
We caught up with two staff who received training more than 10 years ago to find out the impact the training has had, not just on patients, but on their own careers. Read their stories
In Sri Lanka, Seeing is Believing helped to train healthcare workers to carry out eye health work. We also trained teachers to screen children for eye problems, and enabled thousands of children to continue their education by providing spectacles and cataract operations.
When Sightsavers started working in Sri Lanka, there was no coordinated effort to provide eye health treatment. We worked with the ministry of health to embed our work into the local healthcare system so it could continue without us, and in 2016, we were confident our work in the country was finished. Read about our departure from Sri Lanka
In Uganda, our work to train health staff, as well as investing in equipment and integrating child eye health into the government’s plans, has helped to create a sustainable facility in the north of the country. This facility is now able to provide surgical services to all children referred from two main districts.
Today, children such as six-year-old Criscent, who had cataracts in both eyes, are able to have treatment to save them from going irreversibly blind.
Through all of these long-term projects, we’ve learned from our mistakes and adapted the way we work. The lessons we’ve learned in Zambia have improved how we operate. They’ve helped us to focus on the quality of how our programmes are delivered, as well as training and empowering local health teams to improve the country’s expertise and eye health services.
This will carry on well into the future: the local district teams continue to offer eye health services even though the Seeing is Believing project has come to an end. Read Postan’s story
Some individuals and communities are at more of a disadvantage than most when it comes to getting the healthcare they need, whether because of gender, ethnicity, disability, income or location.
If we’re to reach everyone, we’ve learned that health services need to target those who are often left behind. In Tanzania, Seeing is Believing trained eye health workers and social welfare officers to use and interpret data about disability, so they can identify and address how many people with disabilities are being reached.
The lessons from the project have led to a new inclusive eye health project in the country, funded by UK aid.
In the Sundarbans, an area of 102 islands in western India, more than 40 per cent of the population live below the poverty line and one in 50 people used to be blind.
To bring eye healthcare to thousands of people living in the area, we’ve overhauled eye health provision in the region, made eye health cheaper and ensured it is easier to get to, which has helped to halve the number of people in the area who are blind. More about the work in the Sundarbans
In Bangladesh, we knew health services needed to be time-efficient: many people living in informal urban settlements earn their wages daily and can’t take full days off work. Our work in the community raised awareness not only of the importance of eye health, but of the speed of testing. As a result, the number of people living in these poor settlements attending eye screenings rose four-fold.
One person who benefited from the project 11 years ago is Azimunnisa: read her story.