Overview of

Operation Eyesight and

Scope for Partnership

Dr. Santosh MosesCountry Manager - India

• We have been in existence for 52 years!• Couple of years ago we celebrated our

50th anniversary!

• We decided to go around and find out how effective we have been..

• We asked our partners: Have your eliminated avoidable blindness from your service areas?

No! Our partner hospitals deliver quality eye

care services to the poor free of cost!! Then why??

• This year we did the same

• We asked our partners: Have your eliminated avoidable blindness from your service areas?

Yes in many villages! I have been told Operation Eyesight is the only

INGO that has been able to achieve this Vision 2020 India has awarded us this year for

declaring a village blindness free on WSD So how do we do it?

Beginnings

Inspired by Dr. Ben Gullison, a Canadian doctor

Founded in 1963 by Art Jenkyns, a Calgary businessman

First program partner: Arogyavaram Eye Hospital, Andhra Pradesh

Original focus: cataract elimination in developing countries

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Who are we?

BEN GULLISON

ART JENKYNS

Who are we?

OUR VISION: For all the world to see.

OUR MISSION: To eliminate avoidable blindness.

Our work in India is centered on two key thematic areas:

Hospital Based Community Eye Health Programme

Hospital Improvement Programme

Operation Eyesight’s interventions in India

Hospital Based Community Eye Health Programme

Through this programme in service areas of partner hospitals we:

Establish Vision Centers at the community level and link them up with secondary and tertiary eye hospitals

Empower target communities to take responsibility for their eye health Deliver blindness free villages on a sustainable basis within 4 to 5 years Eliminate Vitamin A blindness among under 5 children Achieve full immunization coverage and ensure all women undergo ante-natal

care and post – natal care leading to reduced maternal and infant mortality rates

Ensure malnourished children access services available at the Anganwadi centers leading to reduced child mortality rates

Hospital Improvement Programme

Through this programme we:

Establish/ strengthen secondary eye hospitals Improve quality of eye care services:

• Build capacities of medical and non-medical staff• Introduce/ strengthen protocols and standards

Treat poor patients free of cost including surgeries:• Introduce/ strengthen cross subsidy financial management system that

ensures completely free treatment for the poor (average 52% of patients surgically treated free of cost)

Make hospitals self sustaining• Promote optical • Promote pharmaceutical shops

Reaching out to the marginalized

In 2013 we have:

Screened over 3 million for potentially blinding

conditions

Surgically treated over 120,000 (Over 50% of

them totally free) many of whom who would

have gone needlessly blind

Dispensed spectacles to over 128,000

Intervening in very remote areas

In the Aravalli Desert Hills of Rajasthan

In the riverine island of Majuli, Assam

In the tea gardens of West Bengal

In the Marathawada region of

Maharashtra

In the far North East in Meghalaya

Key achievements in the last 51 years

Developed/ supported over 100 eye hospitals across India to deliver quality eye care services

Built capacities of over 2,000 medical and para-medical staff 1st INGO to venture into urban slum eye health programmes Focused on quality over quantity and the shift to development Promoted financial sustainability through the cross subsidy model

and through establishment of optical shops and pharmacy stores Launched an innovative community eye health approach which

targets the root causes of avoidable blindness leading to promotion of sustainable blindness free villages

Developed a new model of partnerships (NFTP)

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Operation Eyesight in India

OE India Programme Partners

• 46 partners

• 60 projects

• Over 600 Women

Community Health Workers

• Covering 12.5 million people

• Screening 3 million annually

• Surgically treating over

125,000 annually

Impact of our work

Increased knowledge and positive behavioral change towards eye health in over 85% of the target population

Strong linkages between target community, vision centers and the secondary center

Integrated primary eye care services into primary health care system leading to decreased infant and maternal mortality rates

Improved quality of life – 85% of the those treated for blindness return to their livelihood activities, 90% of those treated for blindness perform their daily duties independently

Blindness free villages a reality in upto 90% of the areas where HBCEHPs are implemented

Paradigm shift: Non-financial Technical Partnerships

No more fund driven but knowledge driven• Hospital partners implement our model (HBCEHP) with

their own resources• We provide full fledged technical support – from

conceptualization to recruitment to capacity building to execution to evaluation

• We provide limited financial support to select hospitals that are remotely located for capacity building and establishment of vision centers

We are different and unique – The only INGO which is sought for its technical expertise

How does NFTP work

We have a five year strategy• Community Eye Health• Hospital Improvement

We and the partner hospital jointly agree on the objectives, outcomes and reporting requirements of a program

We do not provide financial assistance; instead, the partner invests its own resources to implement the project

How does NFTP work We provide technical support to our partners in the following

areas:• Community Eye Health and Primary Health - select geographical

areas, conduct assessment, launch and sustain Hospital Based Community Eye Health projects in the partner hospital’s service area

• Hospital Improvement - conduct quality assessment, provide clinical and related services such as infrastructural development and restructuring; developing and strengthening systems and protocols; human resource development and capacity building; and strengthening planning, review and reporting systems

• Organizational development – strengthen governance, financial and human resource management

• Programme development – strategic and operational planning, proposal development, monitoring and evaluation systems

North East India

Comprises:

• Seven sister states – Assam, Arunachal

Pradesh, Meghalaya, Manipur, Tripura,

Mizoram and Nagaland

• Sikkim

• Parts of North Bengal (Districts of Darjeeling,

Jalpaiguri and Alipurduar & Cooch Behar)

More than 2,000 km of boundary is shared

with other countries: including Nepal, China,

Bhutan, Burma and Bangladesh.

North East India – Health Profile Key Indicators National Averages Assam Arunachal Pradesh

50+ population 13% of total population 12% 0.11%

Children (< 16 years) 36% of total population 29% 38%

Poverty level(% of people living below poverty line) 23.6% of total population 36% 33%

Blindness Prevalence (<6/60) 1.1.% 3.05% 3%

CSR (Cataract Surgical Rate) 450/ lakh - -

CSC (Cataract Surgical Coverage) 70% 25% 20%

MMR 450 per 1 lakh 400 400 IMR per 1000 live births 57 66 61U5MR 74 85 87

Immunization coverage (BCG,DPT, Polio & Measles) 43.50% 31% 28%

Gr 111 Malnutrition (% of u5 weight/ age criteria) 15.80% 11.1% 11.4%

Indicators of utilization of ICDS services (% of children u5 who utilized any service)

33% 30% 15%

% of children with diarrhea who received ORS 26% 13% 13%

% of Children between 6 - 35 months who are anemic

79% 77% 77%

% of Pregnant women between 15-49 years who were anemic

58% 72% 72%

North East India – Health Profile

State Arunachal Pradesh Tamil Nadu

Eye Surgeons 0.8 per lakh population (7) 2 per lakh population (1,200)

PMOA’S 12 600

Medical Colleges 0 22

Regional Institutes of Ophthalmology 0 1

District Hospitals 10 26

NGO Eye Hospitals 1 >100

Comparison of infrastructure and human resources status

RANKING AND MAPPING OF DISTRICTS BASED ON SOCIO-ECONOMIC AND DEMOGRAPHIC INDICATORS

Fort AguadaFort Aguada

Operation Eyesight’s intervention in the NE

Started exploratory visits in 2010

Mapped regions of high need and

existing eye hospitals

1st partner in 2011

• Chandra Prabha Eye Hospital,

Jorhat

Partnered to implement a

HBCEHP in arguably the most

difficult region in the NE

Majuli Island, Assam

Home to around 150,000 people.

Populated mainly by the MISHING

tribes

Dependent mainly on agriculture

primarily cultivation of rice

Majuli is battered by floods for

atleast 3 months in a year

Health status - Majuli

Transportation to the main land is

only through a ferry twice a day

Poor access to the main land and

with very limited medical facilities

on the island have resulted in poor

health care delivery

Absolutely no eye care facilities at

all

Operation Eyesight & Chandra Prabha Eye Hospital, Jorhat

We launched a Hospital Based Community Eye Health Project (HBCEHP) in Majuli in

2011

HBCEHP Majuli – Women Community Health Workers

(WCHWs) 10 Women Community Health

Workers were recruited and trained by Operation Eyesight team for over 25 days

These WCHWs conduct door to door survey, eye and general health education events, liaise with Government Primary Health Care personnel, Organize screening programmes and ensure patients undergo treatment

HBCEHP Majuli – Door to door survey

A comprehensive door to door survey was conducted over 3 months in all houses on the island covering a population of 123,000 people

Results of the survey: 6% of the total population

identified with cataracts 6% of the population identified

with other blinding conditions 2% of the population are blind

because of preventable causes

HBCEHP, Majuli – Screening Programmes

Screening programmes are conducted by the hospital’s clinical team once a week at various parts of the village.

Persons identified by the WCHWs during the survey are motivated to attend the screening programmes

After ensuring that all patients from suffering from blinding conditions are treated, screening programmes will be phased out

HBCEHP, Majuli – Vision Centers

1 Vision Center has been established on the Island to ensure that permanent eye care facilities are available on the Island

1 more in the other end of the Island will be established by end of this year

Average opd is 15

HBCEHP, Majuli – Chandra Prabha Eye Hospital

First and final link in the project Provides surgical treatment of

the highest quality for all patients from Majuli Island free of cost

An affiliate hospital of L.V.Prasad Eye Institute

In two year since it’s launch:

• Blindness prevalence of 2.23%

• 13,090 persons screened by hospital’s medical team

• 3,400 surgeries performed

• 1,623 spectacles dispensed

• Immunization coverage increased from 43 to 54%

Scaling up

Assam

• Implementing HBCEHP in 6 Districts

• Supported establishment of 4 Vision Centers

• Partnering with SSN, Guwathi; CPEH, Jorhat and Tezpur Eye Hospital, Tezpur

• Built capacities of 12 hospital staff and 52 CHWs

Scaling up

Meghalaya

• Implementing HBCEHP in 2 Districts including an urban slum

• MEHP in Shillong City

• Partnering with Bansara Eye Center, Shillong through the Government of Meghalaya

• 42 CHWs trained

Scaling up

• Proposed to implement a District Blindness Prevention Project in Papum Pare District

• In partnership with RK Mission Hospital, Itanagar

Arunachal Pradesh

Scaling up

North Bengal

• Implementing HBCEHP in 6 Districts

• Supported establishment of 4 Vision Centers

• Partnering with SGLEH, Siliguri; TSSK, Malda and Alipurduar LEH, Alipurduar

• Built capacities of over 60 hospital staff and 32 CHWs

Key Learning

• Blindness prevalence is 1.3-1.5% in North Bengal and over 2.2% in Assam

• There are good eye hospitals to partner with in the region• Focus should be on expanding their

areas of work both vertically and horizontally

• Utilize existing resources – HR, Public Health System etc.

• Local community participation is critical• Similar results can be achieved if the

methodology/ approach is sound and all stakeholders are committed

Challenges still to be addressed

• Other areas of eye health still need support:

• Sub-specialty care

• Pediatrics

• Cornea

• Low Vision and Rehab

• Partnership with Governments and North East Council

• Partnership with NGOs and INGOs in other sectors of development

• Insurgency affected states

So what is in it for us??

We have a vested interest

• We want to have a greater presence in this region of the country

• The need is great in this region

• We can together make a difference

Our relationship with Lions

Our Lions Partners

• Greater Lions, Siliguri

• ALEH, Alipurduar

• OEU Lions, Shreeramnagar

• ULEH, Udgir

• DSKEI, Latur

• TSSK, Malda

• RRLEH, Nidadavole

I look at you as potential partners

Thank you

No region is too difficult to deliver. If there is a will there is a way

Dr. Santosh Moses

mosess@operationeyesight.com

91-8008500550

If we travel alone we can travel fasterIf we travel together we can travel further