All eyes on 20-20

The vision is crystal clear. Sri Lanka wants and hopes to eliminate avoidable blindness by 2020 and the first step in the right direction in achieving this goal has been taken by launching a five-year National Programme for Prevention and Control of Avoidable Blindness. The Programme covering the period 2007-2012 and launched by the Ministry of Healthcare and Nutrition in collaboration with the College of Ophthalmologists will see wide-ranging and innovative additions not only to the primary healthcare system but also the strengthening and expansion of eye-care facilities.

The aim of the National Programme presented at the 16th annual sessions of the College of Ophthalmologists by Health Ministry Secretary Dr. Athula Kahandaliyanage on October 26 is to reduce avoidable blindness through the development of a sustainable and equitable national programme for prevention and control of blindness as part of the national health system.

"The detailed action plan for the first year is being formulated with budgets being worked out. There will be a big meeting in the first week of December of all stakeholders to get a commitment on specifics," said Dr. Palitha Mahipala, Deputy Director-General of Public Health.

Both in the preventive and curative areas, major developments are being visualized under the three categories of human resources, infrastructure development and disease control. Extensive postgraduate training and mid-level eye-care personnel training will be provided under 'human resources' while discussions are underway with NGOs and INGOs to coordinate the efforts with regard to infrastructure development, The Sunday Times learns.

"The coordination will be through a National Secretariat for Vision 20-20 to be set up shortly to help prevent duplication and also check out the eye-care needs on a geographical and disease-based systematic manner," explained Dr. Mahipala, stressing that resource gaps could then be met efficiently.

Effective disease control will be through intervention at community level, by the integration of primary eye care into the existing and efficient primary healthcare programme. "Public health staff, like Public Health Midwives, a vital link in the health-chain, will be trained not only to educate the men, women and children in our villages on the prevention of avoidable blindness and what kind of diet could ward off non-communicable diseases which could result in eye problems but also to screen them," he said.

The public health staff at ground level could treat minor ailments and help tackle the disease burden and also promote health, The Sunday Times understands, while directing those people with slightly more serious eye ailments to the next level of smaller healthcare institutions like the central dispensaries, rural hospitals and peripheral units, which in turn could send more complicated ones to the district and tertiary hospitals and finally onto the eye centres of excellence.

Currently, the centres of excellence are the Eye Hospital in Colombo and the Eye Unit at the Kandy Hospital, said Dr. Mahipala, adding that two more in Jaffna and Galle will be set up for the convenience of the people. How did the National Programme come about?

Sri Lanka has had action plans but after the World Health Organization jointly with the International Agency for Prevention of Blindness brought in a new initiative in the form of the Vision 20-20 global programme, the country became a signatory in 2000. The programme was to eliminate avoidable blindness by 2020, says Dr. Mahipala.

To turn this vision into action, five committees, each headed by a senior eye surgeon, were set up to deal with the five eye-care problems (see box) identified as causing avoidable blindness in Sri Lanka. They submitted broad guidelines to the National Steering Committee, headed by Dr. Mahipala. Intensive consultations lasted a year.

The National Steering Committee is a broader forum, which after taking into account all concerns, reformulated the National Programme for the next five years. All these endeavours have been supported strongly by Sightsavers International, International Resources for the Improvement of Sight (IRS) and CBM.

The National Programme "has inspired our pledge for continued support to the alleviation of needless blindness in Sri Lanka and we feel honoured to be part of this moment in history", stresses Sightsavers International (UK) Regional Director for South Asia and Caribbean Region, Dr. Nazma Kabir. There is strong commitment on the part of the government and also the ophthalmologists to ensure that words become action, adds Dr. Mahipala.