January 2001

The International Centre for Eyecare Education Brien Holden, Sylvie Sulaiman and Kylie Evans Email: icee@cclru.unsw.edu.au

The VISION 2020 initiative is at heart a collaborative and cooperative programme that depends on the involvement of a number of institutions and individuals across the globe. While each of these bodies has its own mission and method of functioning, the ultimate goal in every case is the elimination of avoidable blindness. Education plays an important part in achieving that goal, and the International Centre for Eyecare Education (ICEE), with headquarters in Australia, focuses on educational initiatives to bridge the information gap in eye health care. This article provides a few glimpses of ICEE's activities. East Timor Eye Program The ICEE is part of the East Timor Eye Program (ETEP), which currently provides eye care to the population of this troubled country. In association with Dr. Nitin Verma from the Laila Foundation, the International Committee for Red Cross and Foresight Australia at the Sydney Eye Hospital, ETEP has provided ophthalmic and optometric care to almost 9000 people over two visits in year 2000. During their most recent visit the team screened 7000 patients, distributed over 5000 spectacles and performed nearly 120 surgeries.

One of the most important activities of the ETEP team is the "Teach the Screeners" training program, which instructs local East Timorese school teachers in screening children for visual defects. This helps streamline the provision of services from visiting teams, and also allows the schoolteachers to play a role in preventing blindness. Vitamin-A deficiency is one of the leading causes of preventable blindness in children in developing countries, and it is highly prevalent in East Timor due to poor diet and inadequate health services. Teachers were trained to identify Vitamin-A deficiency in its early stages and were provided with screening aids to assist with their assessment. Support for this project is provided by WHO and UNICEF, with ICEE providing the services of optometrists and spectacles for the children. A plan is now being put together by Dr. Verma and ICEE to expand this pro.gram to develop sustainable eye care in East Timor over the next 5 years. The team will be returning to East Timor in February 2001. ETEP partners are seeking financial assistance to ensure the ongoing viability of the program. Improving Rural and Remote Eye Care in Australia People in remote and indigenous Australian communities are losing their vision because of entirely preventable or treatable causes. Helping to combat this problem, the ICEE has employed two Community Optometrists in the Northern Territory and New South Wales to provide eye care to these communities. Katherine Costello is based at the Eye Clinic of the Redfern Aboriginal Medical Service. The Eye Clinic was opened in July by the State Minister for Community Services, the Hon. Faye Lo Po, with the support of Hon Dr. Michael Woo Id ridge, Federal Minister for Health and Aged Care. ICEE staff in NSW have helped establish 10 clinics at communitycontrolled Aboriginal Medical Services. Jacqueline Ramke is based in Darwin and travels on a weekly basis with a resident ophthalmologist to 31 Aboriginal communities and outstations in the area, covering around 19,000 people.

Training the trainers An important aspect of developing a self-sustaining eye-care system is providing training, not just for practitioners, but also for educators. Improving the skills of practitioners has an immediate and direct effect on the eye care they provide. Improving the knowledge, teaching skills and materials of educators, on the other hand, has an ongoing effect on all the future practitioners they teach. Increasing the numbers of educators also has a cascading effect on the number of practitioners: for instance, 100 new educators will produce 60,000 new refractionists. The ICEE is training trainers and providing educational materials, in order to develop a self-sustaining educational infrastructure for future eye care. A nine-week 'Train the Trainer' program has been initiated at University of Durban Westville in Durban, South Africa. This training involves both clinical as well as pedagogical training, encompassing teaching and communication skills. Helping people see in Tibet In a joint project of the ICEE, the Seva Foundation, USA and Seva Service Society, Canada, a Refraction Training Class was held in November 2000 for Tibetan practitioners, and an optical workshop to assemble spectacles was set up in the MenziKang Hospital in Lhasa. The spectacle workshop is the first non-profit workshop in the country managed by local Tibetans and will produce affordable spectacles to meet the needs of many Tibetans who could not otherwise afford vision correction. While establishing the workshop, it was recognised that there was a real need for human resources trained in refraction - able to provide vision screening and determine the correct spectacles needed by the patient. Fourteen practitioners, including ten ophthalmologists, two nurses and two technicians from local hospitals or health centres, underwent the three week refraction training course, which was coordinated by the Tibet Development Fund (TO F). The training course was run in the local language by Dr. Chen Hao, ICEE Coordinator in China, and three volunteer Chinese ophthalmologists. Prof. Brien Holden Chairman International Centre for Eyecare Education (ICEE) PO Box 328, Randwick Sydney, NSW 2031, Australia Tel (612) 9385 7435 Fax (612) 9385 7436