Eye care at the doorsteps of rural India

Objectives

In 2007, almost 41 million people in India had diabetes. Projections from the International Diabetes Federation show that by 2025 this number will increase to almost 70 million people. Millions among them are at risk of developing diabetic retinopathy, one of the leading causes of blindness in many parts of the world and unfortunately also one of the most common complications of diabetes.

Without proper management of their condition, a lot of them may end up visually impaired or blind - a consequence that not only negatively impacts the life of the individual but also has significant implications for the community in terms of costs.

Therefore, it is vital that health care facilities are improved especially in rural and semi-rural areas and awareness about diabetes is raised to ensure proper management of diabetes to prevent complications like diabetic retinopathy, as well as create services for screening and early diagnosis of retinopathy as well as other diabetes related eye problems.

This project seeks to prevent blindness due to diabetic retinopathy through community screening and treatment.

Approach

The project will be implemented in Baghpat district in Uttar Pradesh by Jain Eye Hospital, a charity eye hospital based in New Delhi.

Three components constitute this project:
1. Strengthening the base hospital
2. Create awareness about diabetes
3. Provide screening and treatment of diabetes related eye problems

During the first three months of the project a lot of attention will be given to strengthen the hospital in New Delhi to provide services for diabetic retinopathy treatment at tertiary level. This mainly involves purchasing and installing proper equipment since the hospital already has a trained vitreo-retinal surgeon.

In the initial phase of the project time will be devoted to produce awareness materials such as leaflets, pamphlets, posters and banners in the local language on prevention and proper management of diabetes and its complications, especially retinopathy. These materials will be used in screening camps, exhibitions, fairs and diabetes day celebrations that will be organised as part of project activities. On these occasions trained volunteers and local health workers will explain to the general public about diabetes and diabetic retinopathy. In addition to the distribution of these materials, press meetings will be held and a newsletter developed.

Volunteers and health workers will receive training on diabetes and its complications, in the art of motivating people with diabetes to attend regular follow-up for prevention of blindness due to diabetic retinopathy. Besides providing information and education to people with diabetes, their families and the general population, the trained volunteers and health workers will also conduct door to door surveys to identify people who have diabetes.

To increase knowledge about diabetic retinopathy amongst doctors working in the project area training of 90 ophthalmologists and general practitioners will be organised. The training will be carried out as workshops and seminars and will focus on diagnosis and management of diabetic retinopathy and the importance of screening and regular follow-up.

In order to identify people with diabetic retinopathy 144 screening camps will be conducted screening approximately 60,000 people during the project period. These outreach camps will involve the local community, doctors and NGOs. A mobile unit with advanced facilities for screening and laser therapy will provide services at the camp sites. Those who cannot afford it will be given treatment free of charge. While pan retinal photocoagulation can be performed at the camp site, those who need focal laser photocoagulation and surgical intervention will be referred to the hospital in New Delhi for treatment. It is estimated that approximately 1,500 people will receive laser treatment and 90 will receive surgical intervention for their diabetic retinopathy during the project period.

Expected results

• 90 doctors trained
• 144 screening camps conducted
• 60,000 people screened for diabetes
• 1,500 people receiving free laser treatment
• 90 people receiving free surgical treatment