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Dear Readers,
Welcome to the sixth issue of SiteNews! We hope you have found the resources on the site to be helpful. For those of you who are first-timers this issue includes a quick overview of the new products uploaded and the feedback about the site. This section also includes an article on the World Sight Day featuring the celebrations carried out worldwide. Each issue highlights a particularly effective available product, and this issue features our Quality Cataract Series - Paramedical Contributions Module a document that provides guidance about the paramedicals role in doing cataract in the OPD, OT, ward etc. This month we feature Seva Foundation in the Collaborating Partner section.
In an eye hospital, equipments become a big investment for the organization. In The Way it Works section, we present Investment Analysis for Key Equipments - Phaco and Yag laser Tool
In addition to all our regular columns this issue provides you with an article Vision Centre and its activities that spotlight another model for delivering eye care service to the communtiy.
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Quality Cataract Series - Paramedical Contributions Module
Vol. 1 No.9 September 2004
•   Vision2020 e-resource
•   World Sight day
•   The Way it Works
•   Featured Product
•   Collaborating partner
•   Management Article

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As part of developing new products this month we have developed and uploaded the automated excel worksheet for
  1. Setting up a Paediatric Eye Care Unit
  2. Return on Investment Tool
  3. Human Resources Requirement for Paediatric Eye Care Unit
  4. Equipments list needed for the Paediatric Eye Care Unit in an Eye Hospital

Also we have got links to other websites like:
  1. Journal of Community Eye Health (http://www.jceh.co.uk/)
  2. International Centre for Eye Health (www.iceh.org.uk)
  3. Indmedica - Ophthalmology (http://www.indmedica.com/specialities.php?catid=16)
  4. VOSH International (www.vosh.org)

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World Sight Day is an annual event, held on the second Thursday of October, which focuses attention on the problem of global blindness - 'every 5 seconds one person in our world goes blind and a child goes blind every minute'. It is coordinated by VISION 2020: The Right to Sight, a joint initiative of the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB), which aims to eliminate avoidable blindness by the year 2020. World Sight Day aims to raise awareness that 80 per cent of blindness could be prevented or cured and to encourage governments, corporations and other funding sources to invest in global blindness prevention. A minimum of US$102 billion will be saved in lost productivity if VISION 2020 is successfully implemented. (Frick and Foster, American Journal of Ophthalmology135 471 2003).

Originally launched by Lions Clubs International Foundation in 1998, World Sight Day became an official 'VISION 2020: The Right to Sight' event in the year 2000. It was launched to recognize and strengthen the significance of the awareness to be created to avoid needless blindness around the world and to develop materials and create resources that could help the developing countries where the major prevalence rate exists.

This year the World Sight Day is celebrated on 14th October. Also this year is the 5th birthday of Vision 2020 - The Right to Sight.

The strategies for this WSD are:
  • Strengthening the global coalition through cooperative public relations activities as well as individual organisations awareness raising activities
  • Promoting VISION 2020 through the media to the public in donor countries in order to support fundraising
  • Promoting VISION 2020 through PR and advocacy activities to Health Ministries and professionals in countries where the need is great

You can get more information about this World Sight Day by clicking on the following URL: http://www.v2020.org/world_sight_day/index.asp

What is really needed is to conceptualize all the elements relevant to eye care delivery in a comprehensive approach. How to attain this strategy is the major question standing in front of us. Developing resources and relinquish it to the under-served communities is the only way to afford quality eye care. How to develop these resources is the question in first hand. The kind of resources developed should cover not only the clinical strategies but also the managerial practices needed to maintain the cohesiveness in the activities. Several Vision 2020 Resource centres are now developed to overcome these lack of resources and also to get attention of the community towards avoidable blindness to attain Comprehensive and Sustainable High Quality Eye Care to all people. The resources should channel the people to modulate themselves to the existing model. The existing model should depict how to get resources in first hand, what financial inputs you need to implement these strategies, how to gain those financial inputs, correct investment of those for specific purposes etc. are the works needed to keep up good results. Apart from these resources we should come up with other resources we require to fight the needless blindness. Hence we request you to provide us with materials that you find to be beneficial to encourage these kinds of programmes. We also welcome your suggestions on what kind of materials do these resource centre need to develop to achieve the goals of Vision 2020.

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Eye hospitals are heavily dependent on good equipments to aid them in their work. Not only are they heavy capital expenditure but their lifetime is also limited as technology keeps changing. For the management, the decision to purchase an equipments is dependent upon various factors, yet a proper needs assessment is rarely done on whether it is the right time for the hospital to expense in a particular equipment. The tool "Investment Analysis for Phaco and Yag Laser' will be a boon to all those particularly planning to invest in a Yag laser or a phaco machine.

The Investment Analysis Tool [IAT] is a simple and straightforward pair of financial spreadsheets that can facilitate, streamline, and perhaps even standardize the capital budgeting process.

The IAT evaluates the attractiveness of a potential investment by analyzing its associated cash flows [i.e. inflows and outflows]. A user need only enter a few key variables regarding the investment and the spreadsheet automatically analyzes its attractiveness. There is also a user manual which provides a layman a perspective on how to effectively use this tool or one has the option of the PowerPoint Broadcast to provide a tutorial for complete understanding of the tool.

How to start the search:

You can access the tool on Investment Analysis Phaco and Yag from the Resource Bank through these series of steps:
  1. Go to the homepage of the site by pasting the website address: www.v2020eresource.org
  2. Click on the Resource Bank link provided at the Menu bar of the homepage.
  3. After the Resource Bank Page has loaded, please Check mark the "Eye Hospital" box.
  4. Check mark the "Planning" box on the Management Processes section and then click Submit at the bottom.
  5. You will be taken to a page which shows you the materials listed for this selection process and please roll down the cursor to the bottom of the page where you will find the "Page numbers"
  6. Click on number "3" and you will be taken to the third page of the selection
  7. In that page you can find the "Investment Analysis for Phaco & Yag Laser" as the fifth product.
  8. You will find an "Abstract" and "Guideline" for the product and also the "See Product" link to see the full product.
  9. Also you will find the "User Manual" and "Tutorial" for the product.
  10. You can refer this product to your friend, Write a review to us and also vote the product about its usage.
Find the Product:

Have a look at the Excel Sheet by clicking here: Investment Analysis for Phaco & Yag Laser. It gives you details on the Investment Analysis for Phaco and Yag machines, the cashflow and a glossary to make things more clear. More over you can provide your comments and suggestions by clicking on the Comments & Suggestions in Worksheet 1 of the Excel document.

You can download the User Manual and also have a look at the Tutorial we have prepared for this.


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  1. This section features products which our voters have ranked highly. This month we are featuring Quality Cataract Series: Paramedical Module. Currently our site contains all the modules of the Quality Cataract Series - Introduction Module
  2. Clinical Strategies Module
  3. Architectural Design Module
  4. Paramedical Contributions Module
  5. Community Outreach Module
  6. Financial Sustainability Module
  7. Management Principles and Practices Module


Quality Cataract Series - Paramedical Contributions Module:

Abstract:
Paramedical Contributions consists of objective of the paramedical module, examples and modules, ophthalmic paramedical training, the Aravind model of paramedical staffing etc.

Guideline:
This module helps the eye care programmes/ hospitals/ practitioners in developing countries with lessons learned regarding the work of trained paramedical ophthalmic assistants and their critical contributions to high quality, large volume, and sustainable cataract surgery programmes.

Have a look at the product: Quality Cataract Series - Paramedical Contributions (provide hyperlink) This is a priced publication of Aravind. Visit our website http://www.aravind.org/publications/new/index.htm to order the product.


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Seva Foundation: We are delighted to collaborate with other resource centres and eye care websites. In this issue we wish to feature one of our collaborating partners: Seva Foundation. Seva is a US based donor-supported non-profit foundation building partnerships to respond to locally defined problems with culturally sustainable solutions throughout the world.

Aravind and Seva:
Initially, Seva assisted Aravind in establishing essential finance, community outreach, and staffing structures. Now this dynamic partnership focuses on human resources development. The Lions Aravind Institute of Community Ophthalmology engages Seva volunteers (see Volunteer) as trainers for staff from Aravind and other eye care programs throughout Asia. Seva and Aravind provide on-site training and consultation to eye hospitals that seek to provide high volume, sustainable services for their communities. Seva addresses childhood blindness and well-being by supporting the Aravind Centre for Mothers, Children, and Community Health.

Aravind and Seva realized the need for production of quality, affordable intraocular lenses and suture required for cataract surgery. Through research and development of manufacturing technologies and coordinated funding by donor organizations, Seva helped Aravind establish the AUROLAB unit, which has revolutionized eye care delivery in many developing countries by making cataract surgery supplies affordable to the poor. Also Seva has supported the development of the Quality Cataract Surgery Series with its seven modules which are one of significant resources that helps Eye Care personnel to effectively establish Cataract Services in their area. All the more Seva and their board members are strong supporters of Aravind in its various activities.

Seva and Aravind continue to expand the range of activities which provide mutual strengthening of the organizations. Hence we place our deep appreciation in strengthening the relationship.


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Vision Centre

What is a Vision Centre?
An integral part of Eye Care Service Delivery are community outreach programmes like Screening Eye Camps, School Eye Health Programme, and Village Volunteer Programme all of which provide different strategies for taking Eye Care Service to the doorstep of the community. They provide curative, preventive and rehabilitative care to the community along with IEC (information, education & communication) programmes to improve service delivery to potential patients in the community. Though Community Outreach services are considered a successful Service Delivery Model, the utilization of these services is only 7%. Also research has pointed out that people even rural communities prefer hospital services to outreach camps. The major cause for this low utilization is accessibility and lack of awareness.

As service providers look for other strategies to increase access and thereby eye care service utilization they turn to community based strategies which are broad based. Vision centre is an innovation which is being considered by different service delivery providers. Aravind is running a pilot project to start Vision Centres in the rural areas to create permanent access to the rural communities to increase the uptake of eye care services. We present below the model followed by Aravind in trying to establish the Vision Centre.

Aravind and Vision Centre:
Aravind Eye Hospital has started the Vision Centre project for the first time at Ambasamuthiram at a distance of 10 kms from Theni, a small district of about one million population situated in the South Indian state of Tamil Nadu with a main objective to extend its Eye Care Service Delivery to the rural communities at an affordable cost and create amplified access. This Centre offers primary eye care services with the help of trained ophthalmic technicians at an affordable cost. This project is supported by International Eye Foundation, USA and was started on April 14th, 2004.

Purpose:
To demonstrate the effectiveness of a community based Vision Centre Model using Information Technology to link community and the base hospital.

Project Goals:
  • To offer primary eye care services to the targeted population.
  • To create awareness and educate the community on general health and eye health promotion
  • To establish a population based eye care surveillance system
  • To increase the uptake of eye care services among the rural masses

The Vision Centre is projected to work at three basic levels.
  • Vision Centre Activities
  • Community level Activities
  • Base Hospital Activities


The centre is connected with the base hospital at Aravind Eye Hospital, Theni through internet services to enable direct patient consultation and interaction with the ophthalmologist at Theni. In order to make health related behavioural changes in the community it advocates awareness programs to promote better eye health practices. Community ownership is important to sustain the activities of the Centre and hence village volunteers are identified and trained to create a link between the community and the centre. For effectively reaching the community, concrete steps have been taken to network with Government, NGOs and other prominent leaders in the area. The overall plan is to establish one centre per 40000 to 50000 population in a district.

Manpower Requirement for the Vision Centre:
The manpower requirement for the three levels is given below.

Base Hospital level staff :
Project Manager1
AccountantPart time
Vision Centre staff:
Vision center coordinator1
Vision assistant1
Community worker1
Community levelVolunteers and Community Workers

Vision Centre Activities:
The Vision Centre activities include the following:
  1. Active Screening Services for:
    • Refractive Errors
    • Cataract
    • Squint and other external eye diseases
  2. First Aid Services include:
    • Conjunctivitis
    • Corneal Abrasion and Corneal Ulcer
    • Trauma
    • Foreign Bodies
  3. Referral Services
  4. Health Education for the people
  5. Follow up and Compliance
  6. Population based Surveillance System
  7. School Screening Programme
  8. Report generation

At the Vision Centre:
People who come to Vision Centre for examination are requested to pay Rs.10 as the fee and their name and address is registered. If the patient has refractive errors or any other complaints in the eye, their weight, height and visual acuity is tested. For patients above the age of 40, duct, intraocular pressure and blood pressure tests are also conducted.After all the tests are over, patients who have eye problems are connected to the Chief Medical Officer at Theni for consultation through internet.

The Medical Officer offers consultation and the treatment is given by the trained nurses accordingly. If the problem is severe, then the patients are referred to the Base Hospital at Theni for further treatment.



Also, the community workers train the school teachers in the villages around the Vision Centre to assess the visual acuity of the children. Those school children having problems are identified and referred to the Vision Centre nearby. Only School children who come to Vision Centres are examined there and are issued free spectacles with Government support. Other people who come to vision centre for refractive problems are issued spectacles at affordable cost.


Community level activities:
Community level activities include the following:
  • Training Programme for the volunteers to train them in eye care
  • Household survey
  • Compliance monitoring
  • General Health and Eye Care Services awareness and promotion
  • Networking with other NGO's
  • Strengthening the manpower
    1. Refreshment Training
    2. Reward given to the best performed group
    3. Getting feedback from the volunteers
  • Documentation
  • Regular contact with the Vision Centre

Base Hospital Activities:
The Base Hospital activities include the following:

  • Generating the referral list from the vision centre and the community
  • Data base on treatment offered and follow up to be made
  • Regular correspondence with vision centre
  • Reporting will be done from project office at the base hospital, Theni to Madurai

Conclusion:
The Vision Centre is an upcoming model to enlarge the reach of eye care to the rural community. This has potential to increase the access of the rural communities thereby increasing their utilization. This has been recognized among the Vision 2020 strategies but there are currently very few models of this type of service delivery available worldwide.