According to the International Agency for the Prevention of Blindness, 75 per cent of of visual impairment is avoidable. Out of 7.3 billion people in the world, 36 million are blind, while in total 253 million people are visually impaired. And this includes people with other eye ailments. Childhood blindness is more prevalent in poorer countries of Asia and Africa. It can however be prevented with the right care.
Aeesha Malik, is a doctor working with NHS (National Health Services) UK and Global Child Eye Health Project (GCEHP). She works towards reducing cases of childhood blindness in poorer nations. “Primary eye care services for children are patchy at best and non existent throughout many low income countries,” she says.
A paediatric ophthalmic surgeon, Aeesha Malik has been working over 20 years as a doctor, trainer, researcher, advocate and in public health and policy throughout Africa, Asia and South America. She is currently working with the Tanzanian government to integrate eye care into the child health programme and train primary health care workers about early eye care. According to her, “Children under 7 years old are a particularly vulnerable group as their vision is still developing and any obstruction to vision such as cataracts or corneal scars will harm their visual development, leading to lifelong visual impairment or blindness, even if they are treated when they are older.”
She adds that to address this issue, The GCEHP looked at how to improve primary eye care services for children in low income countries. They noticed that children under 7 years old are very frequent users of primary health care services and often present, moreso than at any other time in their lives. They are seen at child health clinics for vaccinations, monitoring and any type of childhood illness. It was therefore important to include eye care into child health care services.
Aeesha in the duration of her career has come across children seeking treatment at a stage where it is late to get help or even if they do, results were found to be poor even after surgery. If treated when they are older, it could sometimes result in lifelong blindness. Aeesha says they started the project in Tanzania because, “ A local ophthalmology leader had been working with our team since 2007, having done both a pilot study and formative research on child eye health care. When we presented our local research results and our aims the ministry of health was immediately very supportive. They had considered this previously but the timing was right with the expansion of their Integrated Management of Childhood Illness (IMCI) services and training.”
The team has faced challenges in funding while trying to test their training from the ministry of health out in real life conditions, but the endeavour was a success and in May 2018 the ministry of health agreed to include our module! Since May 2018, 1,700 staff delivering IMNCI have, or are being trained in IMNCI in 6 districts in 3 regions across Tanzania. According to data by Tanzania's ministry of health, these child health workers will see on average 5,800,000 children per year, who will now benefit from prevention, and treatment of eye conditions,” Aeesha says.
Eventually, Aeesha hopes, that WHO and UNICEF will include eye care to be part of child health care in their global policy which would impact children in over 100 countries.
Aeesha NJ Malik
Consultant Ophthalmic Surgeon
International Centre of Eye Health
London School of Hygiene and Tropical Medicine