Ref: Di NKRI tercatat 1.3 juta orang buta. 

http://www.asiasentinel.com/index.php?option=com_content&task=view&id=2845&Itemid=594


The Tragedy of Preventable Blindness
Written by Bobby Ramakant    

Monday, 29 November 2010 
Sanitation, funds, simple operations could save sight for millions 

According to the World Health Organization, some 314 million people are 
visually impaired worldwide, 45 million of them totally blind. The tragedy is 
that three-quarters of all blindness can be prevented or treated. 

Avoidable blindness poses an enormous challenge to the global health care 
system, particularly in low- and middle- income countries. There are 9 million 
people in Africa alone with preventable blindness, 50-75 percent due to 
cataracts and 5 percent from glaucoma, says Keerti Bhusan Pradhan, who 
represents the NGO Right to Sight, and who is to present research he did in 
Africa at the Irish Forum for Global Health biennial conference Nov. 29 and 30. 

And, while Pradhan's work has centered on Africa, his research applies equally 
to Asia. There are 4 million blind in Pakistan, 1.3 million in Indonesia. There 
are 12 million blind in India, with eye-damaging diabetes increasing in what 
health authorities call epidemic proportions. Most visually impaired people are 
older and females are more at risk at every age, in every part of the world. 
About 87 percent of the world's visually impaired live in developing countries. 

Although 50 to 75 percent of blindness is attributable to cataracts, the health 
response has been appalling. According to the WHO, cataract surgery is one of 
the most cost-effective treatments that can be offered in developing countries. 
It can allow people to increase their economic productivity by up to 1,500 
percent of the cost of the surgery during the first post-operative year.

In Pakistan, for instance, it is a simple one-hour procedure that costs about 
US$30, but that figure is well beyond what many can afford in the developing 
world. 

Besides cataract and glaucoma, other causes are age-related macular 
degeneration, corneal opacities, diabetic retinopathy, trachoma, and eye 
conditions in children including those caused by vitamin A deficiency. 
Age-related blindness is increasing throughout the world, as is blindness due 
to uncontrolled diabetes. The Netherlands-based IRC International Water and 
Sanitation Center reports that simple face washing and improved access to safe 
water and sanitation would play a major role in eliminating trachoma, which 
currently blinds more than 6 million people across the world, with 150 million 
at risk from infection. 

NGO Right To Sight is dedicated to eradicating preventable blindness through 
the use of proven techniques in cost recovery, training and surgical practice. 
One of his major landmarks is his contribution to improving eye care and 
preventing avoidable blindness in India as well as many countries in Africa.

Investing in preventing avoidable blindness is not only a public health 
imperative but also a smart investment as it saves costs for countries and 
donors, Pradhan says. According to research by Frick and Foster, the estimated 
cost of global blindness and low vision was US$42 billion in 2000. Without a 
decrease in the prevalence of blindness and low vision, it is projected that 
the total annual costs will rise to US$110 billion by 2020. However, Pradhan 
says, if avoidable blindness were eliminated, the projected cost would be 
reduced to only US$57 billion in 2020.

There are many challenges to initiatives that aim to eliminate avoidable 
blindness and two major ones are inconsistent quality of care and shortage of 
healthcare workers. One of the novel approaches Right To Sight brings in Africa 
is using private public partnership to engage the private sector in public 
health. Most of health care in sub-Saharan Africa is in the public sector and 
Pradhan envisions a growing role of the private sector in meeting public health 
needs in the region. According to a research study, US$20 billion of additional 
investment is needed for health care in private sector to improve health 
outcomes in Africa.

Pradhan believes that operational ownership of eye hospitals by the private 
sector partners is vital. Right To Sight, a nonprofit, works in partnership 
with Shalina Laboratories, a pharmaceutical company in Democratic Republic of 
Congo (DRC). Shalina plans to expand Right To Sight's private-public model of 
eye care delivery to 18 African countries with six centers planned in the Congo 
in phases.

This pilot would provide a road map for many private partnerships to have eye 
care services in Africa, leading towards the goal of eliminating avoidable 
blindness by 2020, Pradhan says.

Preventing avoidable blindness mandates a stronger response at all levels and 
from all stakeholders. The biennial conference of the Irish Forum for Global 
Health could change the game for evoking a response to eliminate avoidable 
blindness. 

Bobby Ramakant is a CNS Policy Adviser. He writes extensively on health and 
development for Citizen News Service. Email: [email protected] This e-mail 
address is being protected from spam bots, you need JavaScript enabled to view 
it , website: www.citizen-news.org)



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