The WDF funded project "Mobile diabetic retinopathy treatment" (WDF05-110) successfully implemented in Karnataka in 2005-2008 proved that by harnessing available resources to innovative economic and care delivery models it was possible to increase compliance, patient satisfaction and the number of standardised health centres providing diabetes related eye care.However, the results from WDF05-110 showed a need for not only tertiary diabetic retinopathy care, but also strengthening general diabetes care to avoid complications and thus the need for tertiary care.Therefore, the main partner in WDF05-110, the Vittala International Institute of Ophthalmology, is trying to address these findings with this project by improving access to standardised diabetes and eye care in Karnataka.The aim of the project is to provide comprehensive diabetes and eye care in 14 districts in Karnataka.
The Vittala International Institute of Ophthalmology is a tertiary care eye hospital that works on the basis of "sustainable charity". The institute will collaborate with the Sri Keshava Trust, Prabha Eye Clinic and Research Center and Nayana Eye Care Society to ensure successful implementation of the project.The project will be implemented in 14 districts in Karnataka, namely Mysore, Chamarajnagar, Kodagu, Chikamagalur, Hassan, Shimoga, Uttar Kannada, Haveri, Koppal, Raichur, Bellary, Davangere, Chitradurga and Gadag. Together the districts have a population of approximately 18.3 million of which around 350,000 people have diabetes or are at risk of getting diabetes.The project commences with a two-day training workshop for 112 physicians to provide standardised treatment of diabetes and to detect and monitor diabetes related complications in the foot, eye, kidneys and heart. Also, 156 health care workers will be trained to provide counselling and motivation to patients as well as monitor screening visits and referrals. Moreover, 52 technicians will be trained to perform the necessary tests.In order to provide additional eye care and general diabetes care to people in the districts, two mobile vans will be utilised. One of the vans originates from the WDF05-110 project and is already equipped with the proper equipment for eye care treatment. The other van will be equipped to provide basic diabetes care and screening. Both the eye care van and the general diabetes van will visit the fixed locations at least once every six months. In addition, a central laboratory will be established to standardise all tests and offer services at subsidised prices.It is expected that at least 11,000 people at risk of diabetes will be screened and counselled on issues related to diabetes, and that 8,200 people with diabetes will receive treatment. Patients with diabetes will be encouraged to form diabetes clubs to ensure peer support and compliance with treatment.Diabetes patients who have complications will be referred for specialised treatment to the public clinic or hospital that provides the required service. In case they need surgical eye care they will be referred to the Vittala International Institute of Ophthalmology. If the patient is unable to pay the services will be provided free of charge.To enhance the awareness and knowledge about diabetes among future doctors and nurses, students at medical and nursing schools will be trained. The students will attend a number of seminars focusing on basic diabetes care, primary prevention, outpatient care, wound care, screening techniques, counselling etc. It will also be possible for the students to get practical hands-on experience with diabetes care and prevention by doing three to six months internships at a clinic or hospital. In total 1,750 medical and 1,200 nursing students will be trained.The project also has a primary prevention component which includes an intervention in 71 schools, where audio visual and interactive games and competition will be employed to emphasis the importance of healthy diet and exercise.
• 392 physicians trained • 1595 patient care workers trained • 289 technicians trained • 16,610 people living with diabetes receiving treatment• 12,310 people at risk of diabetes screened and counselled • Primary prevention activities carried out at 106 schools