Sri Lanka : IRIS Proposal

Having a family member who is blind invariably creates difficulties for the whole family. Blind people are unable to contribute as others do to daily life (income generation, food security, etc.) and therefore place an additional financial burden on the rest of the family.

Restoring a person's sight enables the individual to contribute once more to family life, and in very poor families can make a significant difference to the family's economic status.

An estimated 318,000 Sri Lankans are unnecessarily blind as a result of cataracts or other curable eye diseases.

Over the next 12 months, IRIS is seeking raise US$343,000 to support blindness prevention programs in Sri Lanka. By December 2006, working in partnership with the Ministry of Health, IRIS supported programs will have:

• Restored the sight of 6,000 people
  
  
• Established five functional eye clinics where ophthalmologists over the next 5 years will perform 25,000+ blindness prevention and sight restoration surgeries
  
  
• Created an eye clinic referral network by training 400 health professionals, working in catchment areas of five eye clinics, in primary eye care so they are able to recognize eye diseases and refer patients for treatment
  
  
• Provided an eye screening and surgery service to 11,000 people living in remote rural areas where there are no eye care facilities
  
  
• Established a best-practice model for providing eye care services to tea plantation workers
  
  
• Achieved priorities of Sri Lanka's National Vision 2020 Action Plan for Prevention of Blindness 2005-09 in three key areas.

Over a five-year period, IRIS initiatives will result in 30,000+ people having their sight restored and being able to fully contribute to family life.

Equipping Eye Clinics

The Ministry of Health has identified the limited number and inequitable location of existing eye
clinics, particularly in the north and east, as a major constraint to providing comprehensive
eye care coverage.
Whilst sufficient Ophthalmologists will be trained to be posted to district hospitals, these hospitals
currently have none of the basic equipment needed to perform eye surgery.

Waiting In Line for Eye Screening

In the first phase of a five year strategy aimed at creating an additional 15 fully functional eye clinics,
the MoH has asked IRIS to equip five hospitals located in the districts of Mahiyangana, Embillipitiya,
Balapitiya, Kantale and Dambulla. Each hospital requires the following ophthalmic equipment:

Once ophthalmic equipment has been provided to the five hospitals, ophthalmologists will be required
to meet A Ministry of Health target of performing between 800 - 1,000 cataract surgeries per year.

In addition to equipping new eye clinics, IRIS will also support the development of existing eye clinics,
where such intervention will lead to an increased number of blindness prevention surgeries being
performed. For example, by IRIS providing a dedicated operating theatre for eye surgeries more cases
can be undertaken by the Ophthalmologist who currently has to share and compete for operating
theatre time with other hospital departments.

Tea Plantation Workers

Eight per cent of Sri Lanka's population (1.6 million people) work in tea plantations spread throughout
the low-to-high hill areas of the country. The vast majority are Tamils, descendants of families brought
from India as cheap labour for the island's profitable tea and rubber plantations during the time of
colonial rule.

Plantation workers are amongst the poorest of the poor and are therefore unable to access or afford eye care services. IRIS has initiated an eye screening, refraction and surgery program that will benefit large numbers of plantation workers in the coming years. Working in partnership with the Health and Community Trust of Sri Lanka (HCTSL - a local NGO) and the International Centre for Eyecare Education (ICEE - Australia), IRIS is aiming to facilitate 1,500 sight restoration surgeries amongst tea plantation workers by end 2007. In addition, the vision of 20,000+ tea plantation workers will be improved through their being provided with spectacles, which IRIS has contributed to the partnership we have initiated with ICEE.

PEOPLE LIVING IN TSUNAMI-AFFECTED AREAS

Whilst populations living on the south coast remain largely unaffected by the on-going conflict
between Government and the LTTE, the situation in the north-east and east of the country is very
different. Travel, for all but essential work, is not advised to places such as Batticaloa in the
east and Trincomalee in the north-east, and this has impacted on the ability of IRIS to establish
eye care programs in these areas. However, despite the current situation, IRIS continues to stage
a twice-monthly eye screening program in Batticaloa, through the partnership established with the HCTSL.

Line Rooms

Whilst regular visits to tsunami-camps continue to be undertaken, the IRIS & HCTSL program will be expanded into other areas as and when the current state of conflict subsides. In September 2006, IRIS will equip a district hospital in Batticaloa so that surgery cases identified through the rolling program of eye screenings can be undertaken.

Primary Eye Care (PEC) Training

Sri Lanka's Vision 2020 national plan recognizes the importance of ensuring public health inspectors,
nurses, midwives and other health workers/volunteers have greater awareness and knowledge of eye
diseases and can therefore refer patients to eye clinics for treatment.

In addition to supporting the development of PEC training for health professionals, IRIS will target
Medical Officers employed on tea and rubber estates as beneficiaries of PEC training courses.
Once trained, Medical Officers will be tasked with identifying which plantation workers are in urgent
need of eye care, for whom IRIS will then organize a screening, refraction and surgery program.