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Dear Readers,
Welcome to the fifth 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 website's content along with details of exciting new resources. Each issue highlights a particularly effective available product, and this issue features our "Sterilization Protocol" a document that provides guidance to how to do sterilization. . This month's featured partner is ORBIS International.
In addition to all our regular columns this issue provides you with an article "The Dawn of Eye Banking in India" that spotlight the one day workshop co-organized by ORBIS International, NPCB(National Programme for Control of Blindness) and EBAI(Eye Bank Association of India) on the strategies to strengthen eye-banking initiatives in India.
Also in the "The Way it Works" section, we have provided the detailed usage of one of the Tools (automated Excel sheets) used to calculate the Magnitude of Blindness Estimation in a given Service Area population.
Wish you a productive reading!

Happy reading!
Regards,
Vision 2020 e-resource team
The Issue Features...
Sterilization Protocol
Vol. 1 No.8 August 2004
•   Vision2020 e-resource
•   The Way it Works
•   Featured Product
•   Collaborating partner
•   Management Article
Vision 2020 E-Resource
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Vision 2020 e-resource tries to establish links with other Resource Centres and also to other Eye Care Websites. Since the SiteNews has got a very good response, this month we have got links from the Orbis International Tele-ophthalmology Network and also the Aravind Tele-ophthalmology Network. The Orbis Tele-ophthalmology page provides a good deal of material on strabismus and pediatric ophthalmology with more coming on general ophthalmology. Also we have got a link to the Vision 2020 Government Toolkit. All these materials are uploaded in the site. We have also got approval from ICEVI (International Council for Education of People with Visual Impairment) for their resources to be used as part of our site.

The Way it Works:
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Introducing Site Forum - an exciting new feature that makes it possible to ask questions or initiate an online discussion relating to eye care and virtually engage with sight workers from around the world. The Siteforum facilitates cross-learning and offers a wide platform to exchange views and allows for direct open floor questions on various topics.

With Siteforum, you can
  1. Post a question or a new topic for discussion
  2. Take part on the discussion an existing topic by replying to it

How to start the search?

Go to the homepage of the site by pasting the website address: http://www.v2020eresource.org. Click on the link Siteforum.This will lead you to the Siteforum page directly.


It also contains links to Add a new Discussion Topic and Existing Discussion topic.

If you click on the Add a new Discussion Topic,

you will be taken to a page which asks you for the new topic and you can click Submit after entering the topic in the box provided.



The homepage of the Siteforum also shows you the existing topics, in which you can choose any one, and this will take you the respective page.



The first thread message is also displayed with the name of the user and also the "Full Discussion" icon.



If you click on the "Full Discussion" icon, the following discussion page contains all the posted messages of the particular topic with the name of the user, date and time of posting, and with a "Reply" icon under each message. In this page you can reply to the original message by clicking on the "Reply" icon.

You can post your message by filling up the following form.



Also you can add a new sub topic to the existing message by clicking on the "Add a New Sub Topic" icon which is at the left corner of the Existing topic page.



We are eager to hear any feedback or suggestions about its user-friendliness. Our aim is to make this site as useful and as easy-to-use as possible for you. And with your help we can make it happen!
Featured Product
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This section features products which our voters have ranked highly. This month we are featuring one of our most popular products: the Sterilization Protocol. Currently our site contains other key protocols for Medical Records, Cataract Surgery and Community Outreach.

Sterilization Protocol:

Abstract: This protocol deals with how to sterilize the equipments and instruments to avoid infections or anyother problems during treatment with these instruments. Sterilizing the equipments and instruments is very difficult job to maintain. It involves how to sterilize the instruments during surgery, how to sharpen them etc.

Guideline: This protocol can be used as a guide to other ophthalmologists and eye hospitals to maintain the instruments and equipments in the hospital.

Please have a look at the product here: Sterilization Protocol

Featured Product
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Orbis International:

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: ORBIS International. Orbis is dedicated to the prevention of blindness ... the saving of sight ... the delivery of training ... the transfer of skills... and the creation of a world where quality eye care, education and treatment are available to every human being.

Aravind has been connected to Orbis International whether it is work through the Orbis India office or the Orbis Bangladesh or even to linking with the Orbis office in the Latin American region. Through their active supporting role in the Eye Care Capacity Building for the Sadhguru Nethra Sichikitsalaya hospital at Chithrakoot and also their partly support in the Aravind Telemedicine Network. Besides these, Orbis has also supported the Aravind - Paediatric Ophthalmology Learning and Training Centre project. As a part of this we have also established an active link to their website and we are seeking ways of strengthening the partnership.

We would like to place on record our deep appreciation of the Orbis Bangladesh team. This is what one of our colleagues had to say after his visit to Bangaldesh to specific eyey hospitals:

During the visit to Bangladesh, we received very good feedback from ORBIS office and Islamia Eye Hospital regarding the Vision 2020 E-reosurce website. At ORBIS office whenever a new tool or article appear ont eh website, it seems they discuss it among their staff and try to evaluate the applicability in their partner hospital. As each of the program officers spend 30% of their time with the partner (about a weeks stay every month) they try to discuss this with the eye hospitals. This month they want to have a discussion regarding the medical records protocol.

Mrs.Isphani (add designation) from Islamia eye hospital said that she has the habit of visiting the Vision 2020 e-resource website daily to check to see if any new items have been posted

With Warm Regards
S.Saravanan
Faculty, LAICO
Management - Article:
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The Dawn of Eye Banking in India



Author:
Sangeeta Pinto
Manager--PR & Development
ORBIS India Country Office
C-10, Gulmohar Park
New Delhi-110049
 Email: sangeeta@orbisindia.org
 Ph: 011-26960518/19
 Fax: 011-51740094
24th of July, 2004 may well be remembered as a landmark day in the history of eye banking in India. National Programme for Control of Blindness (NPCB), Eye Bank Association of India (EBAI) and ORBIS International co-organized a one-day workshop to deliberate on strategies to strengthen eye-banking initiatives in the country. The workshop boasted a rich mix of participants - NPCB, Govt. of India as well as State Joint Directors from the seven states of Gujarat, Delhi, Andhra Pradesh, Tamil Nadu, Uttar Pradesh, Maharashtra and Rajasthan, came together with Medical Directors from 12 ORBIS supported Eye Banks and representatives from EBAI and ORBIS to chalk out a workable road map for Eye Banking in India.


Dr Rachel Jose, DDGO, NPCB, in her welcome address reiterated the Governments multi-pronged strategy to encourage Eye Banking. The strategies include education, preventive measure, sustainable source of donor cornea (wherein Hospital Cornea Retrieval Program plays an important part) and community participation. She also highlighted the support being extended by the Government to Eye Banks in the form of recurring/non-recurring for operational and infrastructure costs respectively.

Dr Damodar Bachani, ADGO, NPCB, clarified that over the past year, NPCB has been the hub of much activity vis--vis Eye Banking. Proposals have been put up to increase the quantum of existing grants being made available to Eye Banks as well as for decentralization of the disbursement procedure. Targeting collection of 1,75,000 donor corneas by end of 2007, the proposed 10th five year plan calls for a network of 25 Eye Banks to which at least 2,000 Eye Donation Centers would be attached. Moreover, the Eye Donation Centers will be regulated and funded by the Eye Banks themselves. The blue-print for Eye Banking in India, he maintained would be a reality only with the non-governmental-government partnership.

Dr Brij Bhushan, DADGO, NPCB, shed light on the intricacies of THOA 94 and informed all that Eye Donation Centers need not be registered under the Act. He further apprised that several amendments to the Act have been proposed and these are: required request, presumed consent, enucleation by technicians as well as clarity in the definition of unclaimed bodies. He also informed that further to the proposed amendments, the Law Ministry had overruled the request for technicians to perform enucleation as well as removal of eyes from unclaimed bodies within 6 hours as opposed to the previous 48 hours.

With reference to awareness and publicity, Dr V. K. Tiwari, Health Education Officer, NPCB, informed that NPCB actively broadcasted spots on eye donation, jingles and documentaries in the electronic media and advertisements in the print media. Posters, pamphlets and other eye donation IEC materials are also being prepared and disseminated by the Programme.

Bringing out the need to address the focal issues of tissue quality and quantity, Ms Tanuja Joshi, President, EBAI stressed on the importance of registration, networking, availability of resources and IEC support for the eye banking movement to gain momentum.

While a lot of work has been done in Eye Banking, Dr G. V. Rao, Country Director, ORBIS presented to all the lack of reliable data on prevalence and incidence of corneal blindness as well as evaluation and monitoring templates for HCRP, public awareness campaigns, skills, manpower and resources. He called for operational and clinical research to improve quality and quantity of tissue harvested. He committed ORBIS's support to strengthening the Eye Banking initiatives in the country.

Dr G. N. Rao, Distinguished Chair for Eye Health, LVPEI, walked the participants through a road map for Eye Banking in India. He suggested that a three-tier community eye-banking pyramid was the answer to the unsatisfactory eye banking performance in the country. The top tier, he emphasized, would comprise of 5 training centers which would be responsible for tissue harvesting, processing & distribution, creating public awareness as well as training and skill up-gradation of eye banking personnel. The middle tier would comprise of a strong network of 45 Eye Banks, (organisations which would comply with all the regulations stipulated by Govt. of India/EBAI) and these would cater to a population of 20 million each. These Eye Banks would be closely linked with 2,000 Eye Donation Centers (ration of 1: 50 suggested), each of which would cater to a population ranging from 50,000 to 100,000. The cost of the entire proposed infrastructure was extrapolated to INR 26 crores, not too large a sum if the Government, private and INGO sector came together to take up this challenge. The key to the success of this road map was widespread HCRP, favorable legislations, public awareness, medical standards, accreditation and continuous training programs for the personnel involved in eye banking. The road map culminated in three action plans-immediate, intermediate and long term.

The immediate plan of 1 year, called for accreditation, establishment of medical standards and the 3-tier model for community Eye Banks by the Government, while the Eye Banks, EBAI and INGDO's concentrate on HCRP projects. Improving public awareness would be the joint responsibility the media, government, Eye Banks and EBAI while the funding should be extended by EBAI, INGDO's, Government and Eye Banks. The stipulated deadline for this plan was December 2004.

The intermediate 3-year plan called for amendments in legislations to facilitate eye banking by December 2005 and by December 2006 the Government, INGDO's and EBAI should increase training programs and networking of Eye Banks and Eye Donation Centers.

The long-term plan spanning 6 years called for EBAI, Government and Eye Banks to complete nation wide network by December 2008, all Eye Banks to comply with required standards and EBAI to assume a monitoring role of all eye bank functions. By 2006 cornea collection should be 30,000, which would gradually increase to 50,000 by 2008, 100,000 by 2012, 150,000 by 2015 and touch 200,000 by 2020.

With accreditation being highlighted again and again, Dr Usha Gopinathan of RIEB, LVPEI, shed more light on the need for accreditation, procedures and modalities. She suggested that the State and Central Government Committee, comprising of 50% representation from EBAI, be instituted for inspection, assessments and for awarding accreditation. The process would entail pre-inspection activities for evaluation of SOP's; site visits to evaluation operations of Eye Banks and post visit activities to assess and suggest corrective measures.

The participants of the workshop then broke into groups to deliberate on the issues pertaining to grants, awareness building, HCRP, legislation/registration, community eye banking and medical standards. The working groups were state specific and some of the issues they highlighted were that Government grants need to be increased in quantum and made more accessible; short term and long term awareness campaigns should be conducted utilizing print, electronic, web, interpersonal communication and curricula for students and clinical students respectively; HCRP should be encouraged in private and government hospitals; Eye Bank Technicians curriculum should be included in paramedics council; Medical standards to be made uniform and mandatory for Eye Banks and Eye Donation Centers; amendments to laws like required request and presumed consent to be actively followed upon and guidelines be devised for simplification of registration processes and interpretation of THOA 94.

The working group that comprised of the representatives from NPCB (GoI), EBAI, LVPEI, AEH and ORBIS came up with an action plan which stated that by 2007, 50 Eye Banks should be linked to a network of 2,000 Eye Donation Centers, which would include 18 news Eye Banks at the following proposed location: Chandigarh, Jaipur, Kolkata, Indore, Bhopal, Patna, Bhubaneswar/Cuttack, Lucknow, Allahabad/Varanasi, Guwahati, Raipur, Angamally/Cochin, Vishakapatnam, Pune, Nagpur, Ranchi, Surat and Udaipur. HCRP would be adopted as the main strategy to increase tissue collection. State NPCB departments would be encouraged to immediately register all Eye Banks, which would be followed by evaluations to award accreditations. Grants for Eye Donation Centers would be disbursed through the Eye Banks to which they are linked. Most importantly, a joint task force comprising of representatives from Government of India, EBAI, ORBIS, other INGO's and nominated experts would be set up to deliberate and evolve policies for accreditation, review progress of implementation, recommend for funding, develop plan of action, develop medical standards and guidelines, identify training institutes, develop training courses and training material

The workshop ended with a Dr Jose expressing her faith that together with ORBIS, EBAI and all participating organisation, the road map to model eye banking in India would well be a reality. Dr G. V. Rao and Ms Tanuja Joshi on behalf of the co-sponsors ORBIS and EBAI, respectively, seconded Dr Jose's faith in the action plan that had come through the workshop. Ms Joshi also called for a follow up meeting after a year to assess the progress on the action plan. Dr Srinivasan, formally concluded the workshop with a Vote of Thanks, expressing happiness at the emerged partnership of NPCB-EBAI and ORBIS.

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