The project seeks to increase awareness and provide access to screening and treatment of diabetic.
Expected impact
75 general practitioners trained
150 community nurses trained
40 medical specialists trained
30 eye health professionals trained
125,000 people reached with IEC campaign
3,000 people screened for diabetic retinopathy
375 people referred and treated for diabetic retinopathy
Results to date
The screening room and grading room have been renovated and are now operational. A fundus camera, computers and equipment have been purchased.
23 ophthalmologists, 78 general practitioners, 1 vitreo retinal surgeon, 119 internist from the endocrinology department, and 76 staff from the ophthalmology clinic, 67 diabetic eductaors and 156 health workers have been trained in diabetic retinopathy.
523,403 people have been reached through diabetes awareness activities, such as radio, newspaper and social marketing.
2,580 people have been screened for diabetic retinopathy; 549 cases were detected and 67 treated.
A KAP study for over 200 patients and 4 nurses has been conducted.
1 radio talk show has been organised and broadcast in collaboration with the Standard Chartered Bank's Seeing is Believing program.
Project details
According to estimates of the IDF Diabetes Atlas, by 2010 around 7 million people live with diabetes in Indonesia - a number which is expected to increase substantially in the next two decades. Consequently, estimates also suggest that by 2030 the number of people suffering from diabetic retinopathy in the country could be in the millions.
Diabetic retinopathy is one of the leading causes of blindness and often puts a heavy toll on the affected person's social and economic situation while also posing a heavy burden on the health care system. The Indonesian health care system is currently ill equipped to provide the necessary screening and treatment to prevent visual impairment due to diabetic retinopathy. Action is needed to improve capacity to detect and treat the condition and raise people's awareness of diabetes and its complications in order to halt the increasing prevalence of diabetes and diabetic retinopathy.
Approach
Helen Keller International is leading the implementation of the project, but other organisations will also be involved not only to ensure a successful outcome by 2012, but also to ensure longer-term sustainability of the project. Other organisations engaged in the project include the University of Indonesia, the Rumah Sakit Cipto Mangunkusumo Hospital, the Indonesian Ophthalmology Association (PERDAMI), the Indonesian Society of Endocrinology (PERKENI) and the Dartmouth-Hitchcock Medical Center.
A central part of the project is to strengthen the Indonesian health care system's capacity to detect and treat diabetic retinopathy by training health care providers, developing protocols and strategies and advocating for increased attention to the issue.
To address the general lack of awareness amongst the health care community and to improve compliance with the recommended annual eye exams for people with diabetes, 265 health care providers from the health care community including general practitioners, community nurses and medical specialists will be trained. The health care providers will be trained on the consequences of diabetes on eye health and the necessity of appropriate screening and referral. To further facilitate the referral mechanisms, a protocol for referral of diabetes patients to diabetic retinopathy screening or treatment will be developed.
The project will also train eye health professionals to provide them with hands-on skills and knowledge needed to conduct successful laser photocoagulation. A total of 30 eye health professionals will participate in a two week practical training session to enhance their skills and experience in treatment of diabetic retinopathy. The project partners will conduct advocacy work targeting professional medical associations and governmental officials regarding the potential eye health consequences of diabetes and the importance of early detection and treatment.
Additionally, the project seeks to raise awareness about diabetic retinopathy among people with diabetes. For this purpose an information and educational campaign intended to reach at least 125,000 people will be conducted. The materials produced under the campaign will include posters, fact sheets and other educational materials that will be made available to people with diabetes at the Rumah Sakit Cipto Mangunkusumo Hospital and the diabetes clinics run by PERKENI. The campaign will seek to educate and empower people with diabetes to play an active role in achieving, protecting and sustaining good eye health.
Finally, the project will also train mobile vision screening teams that will conduct diabetic retinopathy screening at PERKENI clinics. Clinics in the poorest and most underserved areas will be given the highest priority. Around 3,000 people will be screened for diabetic retinopathy. Those who are in need of treatment will be referred to the Rumah Sakit Cipto Mangunkusumo Hospital. It is anticipated that approximately 375 people will need advanced treatment.
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