Bangladesh
One third of the lifesavers tested needed glasses. Photo: Michael Amendolia
Well over half a million people in Bangladesh are blind from cataract, and they needn’t be. The Foundation is helping to tackle this enormous backlog by training eye health workers, strengthening screening and treatment services and supporting improvements to the public health system.
Overview
Bangladesh is one of the lowest lying countries in the world with a network of rivers that criss-cross the country and form part of a huge delta.
The delta floods regularly – 23 million people were left homeless after massive flooding in 1998 – and around one third of Bangladesh’s population of 146 million are malnourished and living below the poverty line.
Cataract accounts for up to 73.39% of blindness in Bangladesh and, because of extreme poverty and lack of awareness that cataract blindness is preventable and treatable, many people unnecessarily become and remain blind.
One big problem is that most eye care services in Bangladesh are based in major cities and more than three quarters of the country's population lives in rural areas without access to services. Other challenges include a gap in ophthalmic personnel to provide screening and treatment, a lack of appropriate equipment and minimal facilities to meet the needs of the population.
The Foundation is working with the Government of Bangladesh to support the implementation of the National Eye Care Plan to eliminate avoidable blindness in the country by the year 2020. The Foundation is also partnering with eye health NGOs to increase service delivery in eye disorders including cataract, refractive error and diabetic retinopathy.
Achievements 2011
Working together with our local partners, The Foundation:
- Performed 4,968 cataract operations and 21,310 other sight saving or improving interventions
- Trained seven ophthalmologists, three nurses and clinic support staff and 1,271 community health workers
- Held four outreach eye clinics across the country
- Screened 74,392 people
- Delivered $185,231 in medical equipment
- Extended activities into three new districts
- Conducted Rapid Assessment of Avoidable Blindness studies to determine the need for treatment in Natore, Tangail and Kushtia districts, where The Foundation will work from 2012
- Tested farmers, lifesavers, bus and truck drivers for eye disease and trauma and provided surgery, spectacles and protective goggles to reduce the risk of workplace accidents.
About the program
The Foundation’s program in Bangladesh is growing fast and we are partnering with the Government of Bangladesh and non government organisations (NGOs) in 14 districts. We are currently working in 11 districts in partnership with government owned and run district hospitals, thus supporting Bangladesh’s National Eye Care Program. We are also partnering with the NGO Islamia Eye Hospital to provide comprehensive eye care services in three other districts. A third partnership with the Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders supports the provision of equipment and training to address diabetic retinopathy in two districts.
We focus on:
- providing training for ophthalmologists, eye care nurses and other healthcare personnel
- providing equipment for outpatient clinics and operating theatres
- developing referral and supply systems at district and sub-district level to strengthen eye health services all over the districts where we work
- creating awareness of eye health and increasing screening and treatment options for people in remote communities.
With our local partners we organise Outreach Mobile Eye Clinics (OMECs), where teams from the eye units of district hospitals conduct intensive high volume cataract surgery clinics as part of the Bangladesh District Eye Care Program. The Childhood Blindness Project focuses on screening school children and providing glasses, strengthening paediatric services in hospitals and training health workers.
Diabetes is an emerging public health problem in Bangladesh and can lead to diabetic retinopathy, an eye disease which causes blindness if left untreated. Currently four million people in Bangladesh have diabetes and 25% of these have diabetic retinopathy. Through the Diabetic Retinopathy Project the Foundation contributes to reducing the risk of blindness which is caused when the eye disease is undetected and untreated. The Foundation is currently partnering with a local NGO to train ophthalmic personnel and provide equipment to address the disease.
Facts and figures
| Number of blind people | 750,000 |
| Main causes of blindness | cataract (73.39%), refractive error (8.87%), age related macular degeneration (1.86%), diabetic retinopathy (0.17%), glaucoma (0.73%), others (4.98%) |
| Number of people with cataract blindness | 650,000 people aged 30 and older blind due to cataract and an annual incidence of 130,000 cases |
| Number of cataract operations performed annually | 200,000 |
| Number of ophthalmologists | 900 |
| Reasons for low cataract surgical rates and backlog | low public awareness, lack of trained eye health personnel, lack of equipped facilities, lack of access to eye care services for people living in remote areas |
| Childhood blindness rate | approximately 40,000 children are blind (12,000 cases due to cataract) |
| Population | 150.5 million |
| Urban population | 29% |
| Life expectancy | 68.9 years |
| Infant mortality rate (per 1,000 births) | 38 |
| Children (0-5 years) underweight for age | 41% |
| Population living on $1.25 per day | 50% |
| Adult literacy rate | 56% |
| Number of doctors (per 10,000 people) | 3 |
Sources: The National Blindness and Low Vision Survey of Bangladesh, 2000 & UNDP Human Development Report 2010 & 2011, UNICEF State of the World's Children Report 2012
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