Bring the Light

| March 24, 2011 | 0 Comments

By Yang Qiu

It is 7:00am Eastern Standard Time. I am on the plane bound for Oklahoma City, Oklahoma, yet still unsure how a trip to another state within the continent of North America can change the course of blindness prevention across the Pacific Ocean in People’s Republic of China. Twenty-four hours later, I would laugh at that moment of doubt.

The global burden of blindness has been on the rise1. Both at the international level and at the country level, much effort has been devoted to eradicate avoidable blindness. Cataract, an age-related clouding of the eye, bears the label as the major cause of avoidable blindness both in the developed and developing countries1. As Vision 2020, a global initiative supported jointly by World Health Organization (WHO) and International Agency for Blindness Prevention (IABP), sets its goal to eliminate avoidable blindness by year 20202, many countries have followed suit with respective blindness prevention programs.

Given its status as the most populous country, it is not surprising that China bears significant burden of the world’s blindness. With the country experiencing demographic transition, the segment of elderly is expected to grow. While China has had an operational blindness prevention program for over a decade, the challenge for eradicating avoidable blindness (in terms of cataract-caused blindness since cataract accounts for about 50% of blindness in China) is compounded by lack of medical resources, limited funding, and rapidly growing demand of cataract services. For China, providing cataract surgical rate of 320 per million per year3 is far from being adequate.  The mismatch between high concentration of medical resources in the urban centers and the greatest demand from the countryside, between the relatively high cost of cataract surgeries mismatched and the low income level of the population in need, and between the enormous demand and the limited number of free surgeries provided annually under the national blindness prevention program is just one of the many barriers that lead to the bottleneck in scaling up blindness prevention activities. There is an immediate need for rethinking the operations of blindness prevention in China. Simply put, the need of scaling up blindness prevention activities, especially in cataract surgeries, is urgent, the challenge of meeting the demand is dire, yet the answer to effectively eradicating avoidable blindness remains nebulous.

This is when international experiences bring the light.

Over the years, different organization models have attested the challenge of the blindness burden due to cataract. Aranvind, an ophthalmologic hospital located in India, has provided an answer to the increasingly complicated scene of blindness prevention through social entrepreneurship4. By setting up a private clinic system dedicated specifically to blindness prevention, the Aranvind model has received international praise for its effectiveness in treating the blind in India. Other models that focus on capacity building at the local level, such as education projects administered through Orbis International’s country programs, speak to the need of the continuing education of the existing ophthalmology workforce5.

At multiple levels, blindness prevention has embodied the private-public-philanthropic partnership in today’s global healthcare intervention delivery. The challenge of supplying cataract services to the most impoverished land in central China has called for innovation—the kind of innovation that comes from reconfiguring existing infrastructure and recombining existing. A private-public-philanthropic partnership may be the answer. A cross-sector collaboration, supplementing the existing framework of national blindness prevention program with social entrepreneurship in the delivery of care, may be the approach. My trip to Oklahoma City, more specifically to Dean McGee Eye Institute and University of Oklahoma’s Center for the Creation of Economic Wealth, came as the result of a decade-long endeavor of an international team of medical doctors and public health practitioners working on improving blindness prevention in China. Now with the support of a multidisciplinary team specialized social enterprise, a new vision of reshaping China’s blindness prevention program by combining existing infrastructure with entrepreneur ideas comes to light.

Between the village of the impoverished lands of Sichuan Province in central China and the glass-windowed meeting room at Dean McGee Eye Institute, between the seasoned cataract surgeons at Sichuan Provincial People’s Hospital and the multidisciplinary business planning team at University of Oklahoma, and between the classroom at Harvard School of Public Health and the operation table at West China University,  a common thread holds together the guardians of sight: delivering practical and cost-effective surgical interventions to eradicate cataract-induced blindness.

As I walk out of Oklahoma City airport, bright sunlight

bursts through the automatic glass doors.

I think I see the light coming.


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