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Tuesday / May 21.
HomemifeatureEqualising Eyecare in the Villages

Equalising Eyecare in the Villages

In the course of a day, optometrist Sue Strachanwill see 14 people at her state of the art practicein Blackburn North, Victoria. In rural India, she will squeeze in 200 patients over ten hot, humid, hours in the dark room of a village school.

Despite increased wealth and technological advances in the cities, little has changed for the masses of people living in rural India.

In many remote villages, age-related cataracts develop at a much earlier age than is evidenced in developed nations like Australia. It is not uncommon to see advanced cataracts in people as young as 40. In association with cataracts, patients experience huge myopic shifts, which necessitate distribution of minus three to minus six specs as well as cataract surgery.

“Genetic and nutritional factors no doubt contribute to early onset cataracts, as well as the fact that many people spend their lives working in the fields without any UV protection,” said Ms. Strachan from Strachan Eyecare, who has travelled to India six times to deliver voluntary optometric services with the organisation Equal Health.

Despite increased wealth and technological advances in the cities, little has changed for the masses of people living in rural India.

While health specialists in India provide a high level of up to date surgery and patient care, the problem for many people with vision loss is accessing the services. Access to eye specialists is so limited that surgery is not considered until eyesight has deteriorated a lot more than we in Australia would consider acceptable. Frustratingly, even with free services available from some Indian ophthalmologists, many elderly people with mature cataracts refuse cataract surgery because they are scared to travel away from their homes to the city for treatment.

A Shock to the Senses

Ms. Strachan’s most recent trip to India took place over two weeks in February this year. She was one of 52 Australian volunteer health professionals from Equal Health. They were divided into three teams and, following a briefing meeting in Singapore, Sue’s team flew to Chennai.

With a population of over seven million, India’s fourth largest city is a shock to the senses for new arrivals. Even having been there six times, Ms. Strachan says it still takes her by surprise.

“There are people everywhere, horns honking, signs plastered on every possible space and amazing flashes of colour from the saris worn by the women. Cows wonder the streets oblivious to the chaotic traffic and the smells of litter and pollution waft through air, mixed with the aromas of curries and spices.”

The volunteers were dispatched to surrounding villages. Ms. Strachan went to Urapakkam about an hour south of Chennai on the east coast of southern India, along with ten others: an optical assistant, three doctors, one nurse, two dentists, two dental assistants, and a physiotherapist. The other two teams went to Anandaniketan, four hours north of Kolkata, and Trichy, six hours inland from Chennai.

The trip into rural India is just as eye opening as navigating the city. “Goats, pigs and dogs rummage through street litter alongside beautiful lush green rice paddies. Fish markets are sandwiched between railway lines and busy main roads, oxen draw carts, thatched-roof huts are dotted everywhere… and always, lots of people,” she said.

Ms. Strachan stayed at the base camp in Urapakkam with her team and travelled by bus to different villages each morning where they set up clinics in local schools. February’s base camp at a bible college was “relatively palatial – basic but clean: very thin mattresses on our narrow camp beds, but Western toilets and a cold water shower. The resident college chef cooked excellent food for us – amazingly varied delicious curries were produced in a kitchen that had very few of the mod cons we have in our homes.

” While some team members are able to set up their clinics in breezy outdoor spots, Ms. Strachan is

restricted to finding small dark spaces where she can conduct her eye tests. These rooms have intermittent power for fans and lighting, so they’re always hot and steamy – especially when crowded with patients and interpreters.

Not Your Typical Day

Ms. Strachan’s work in India consists of doing basic eye checks, primarily retinoscopic refractions. While she tests patients from across the population spectrum, most are in the presbyopic age bracket. “We usually see the elderly people and young mothers with children early in the day, then the field workers present later as they return home.

“The majority of outdoor workers are illiterate, but many still appreciate being able to see clearly for near activities like sorting their grains and sewing.

“We also see the teachers at the schools where we set up camp – a pair of reading glasses can often make a huge difference to them!”

The optical dispenser immediately fits those who need glasses from suitcases loaded with eyewear. These glasses are pre-made by 5,000 trained inmates in the fitting lab of a Perth prison using donated lenses and frames.

Sunglasses, or ‘cooling glasses’ as they are referred to in India, are also highly appreciated by India’s many field and construction workers as well as drivers that suffer significant pterygia. “

A big smile and wobble of the head generally indicates that the patient appreciates their clearer vision with their new glasses – this is always very rewarding, particularly with elderly aphakes who have either lost their glasses or whose old glasses are so badly scratched that they were not able to see out of them anyway… But it’s always frustrating to see so many people with badly scarred eyes or severe cataracts for whom glasses are of no help whatsoever,” commented Ms. Strachan.

Life Changing Work

Ms. Strachan plans to visit India “whenever health, home and work commitments allow”, because, she says, “the work done on each camp could be viewed as a ‘drop in the ocean’, but it can be a life changing experience for each individual provided with glasses”.

“It’s great to be able to interact and work side by side with professionals from other health disciplines, and invariably people who volunteer for this type of trip are caring people who enjoy being team players.”

“What I enjoy most is the gratifying professional ‘work’ aspects of an Equal Health India camp, but it’s always a really enjoyable personal experience – providing you enjoy hot weather, hot food and cold showers.”

As well as providing services in India, Ms. Strachan hopes to volunteer in other countries and, in particular, “would like to see ready access to glasses for all Australians, which unfortunately is still not the case in parts of outback Australia”.

Earlier this year she was appointed to the National Committee of Optometry Giving Sight, a World Health Organisation-affiliated initiative whose goal is to prevent blindness due to uncorrected refractive error. Optometry Giving Sight has a strong alliance with the International Centre for Eyecare Education (ICEE) and has provided funding for Equal Health India Camps.

“I encourage all optometrists to support Optometry Giving Sight by providing on-going financial support, either by the annual ‘Tick the Box’ campaign with OAA registration, or by donating a dollar or two for each pair of glasses sold in their practice,” said Ms. Strachan.

Rural India Needs Our Help

Paul Clarke, President of the International Opticians Association and an Optical Dispenser based in Perth, established Equal Health in 1999. We asked him about the motivation behind Equal Health.

“When I first went to India to provide spectacle aid relief, I was certainly driven by the desire to help underprivileged people. However, and truthfully, a desire to go for the excitement of visiting and living in remote rural locations, where no tourist ever gets to go, was probably stronger,” said Mr. Clarke.

“Although the excitement of travelling to rural India each year still exists, the influence responsible for the preservation and expansion of the Equal Health programme over the past fifteen years has been driven by the obvious need for help in those communities.

“Many past Equal Health team members, including me, have questioned the fairness and justification of why some people, merely by virtue of where they were born, have nothing, when we have so much.”

Equal Health relies on discontinued or unsellable frame donations from wholesalers and retailers around Australia. Although the donations have been quite generous over the years, recent donations have not been enough to maintain the program. To donate frames send them to Equal Health, 11 East Parade, East Perth 6004 or phone Vanessa: (AU S) 08 9221 4799.

For more information on Equal Health visit equalhealth.org.au.