China

The People's Republic of China has a population of 1.3 billion and, with more blind people than the total population of Denmark or Ireland, accounts for approximately 17% of the world’s blind population.

Overview

China has made significant steps towards improving its population's standard of living and general health. Life expectancy has risen and infant mortality rates have dropped dramatically from 85 per 1,000 live births in 1970 to 16 in 2011.79-year-old Tu Xi Cao is looking forward to a more independent life, Gao'an County (Jiangxi Province, China).

But in such a huge country improvement varies considerably from region to region, as does access to crucial health services.

Eye care services are overwhelmingly concentrated in urban areas with around three quarters of the country’s 28,000 eye doctors working in urban hospitals, while three quarters of the blind live in rural areas.

Even where there are eye care professionals and eye units, poor patients cannot afford the high prices of surgery. A simple cataract surgery in some rural areas in China can cost patients as much as one year’s income.

The Foundation has been working with local health bureaus and hospitals in China since 1998 to develop sustainable models of affordable and high quality eye care services for the rural poor. A large part of The Foundation's work in China has been building expertise, experience and capacity among local health professionals.

Achievements: 2011

Working together with our local partners in China, The Foundation:

  • Performed 6,756 cataract operations and 51,646 other sight saving or improving interventions
  • Trained 40 surgeons, 101 nurses and clinic support staff and 1,720 community health workers
  • Upgraded 15 eye clinics
  • Expanded work into two new provinces in southwest China
  • Screened 142,681 people
  • Conducted Rapid Assessment of Avoidable Blindness studies to determine blindness levels in Sichuan Province and Inner Mongolia Autonomous Region.

About the Program

The Foundation’s focus in China is on preventing and treating cataract blindness, refractive error and childhood blindness.

Building the skills and capacity of local eye health professionals is a key focus of The Foundation's work in China. Photo: Hugh RutherfordUntil recently, we have concentrated on Jiangxi Province, historically one of the poorest areas of China with one of the highest rates of blindness in the country.

We developed a project training health professionals in modern cataract surgery at county level hospitals in Jiangxi Province and, in partnership with the Provincial Bureau of Health (PBOH), the project trained 85 doctors and support staff from 63 hospitals.

The success of The Foundation’s program in Jiangxi Province over the past 13 years has encouraged the Jiangxi Provincial Government to develop its own cataract program.

The Foundation has recently expanded its work from Jiangxi Province to four more of the poorest provinces in China – the Inner Mongolia Autonomous Region, Gansu Province, Yunnan Province, and certain ethnic minority areas of Sichuan Province.

One of these areas is Liangshan Yi Autonomous Prefecture in Sichuan Province. The Prefecture includes two ethnic minority regions that will be a focus for The Foundation in 2012.

These remote areas lack many of the eye services crucial for eliminating avoidable blindness. The region has a population of nearly 5 million, and yet there is only one hospital where modern cataract surgery is performed.

Over the three-year project period, The Foundation is committed to supporting two hospitals in Liangshan Yi Autonomous Prefecture to develop their eye care service capacities, with a focus on the key causes of avoidable blindness in the region – cataract and refractive error.

By the end of the project, The Foundation will have:

  • trained over 500 health professionals in the treatment and screening of cataracts and refractive error
  • established over 60 eye clinics
  • screened 44,000 people and an additional 50,000 children
  • supported sight restoration of 1,800 patients through cataract surgery
  • provided 3,000 people with glasses.

Facts and figures

Eye health
Number of blind people 6.6 million
Main causes of blindness cataract (47%), retina/uvea disease (13%), corneal blindness (9%), refractive error (6%) and glaucoma (6%)
Number of people visually impaired 12-14 million, mostly caused by refractive error
Number of people with cataract blindness 2.5 million backlog and an annual incidence of 1.04 million cases
Number of cataract operations per year 1. 2 million, a cataract surgical rate of approximately 900 operations per million population per year
Number of ophthalmologists 28,000
Reasons for low cataract surgical rates and backlog  cost and quality of cataract surgery, public fear and misconceptions about surgery, lack of awareness about cataract blindness, attitudes to health (particularly towards elderly people), access to services and lack of health insurance for rural populations
General health
Population 1.35 billion
Urban population 48%
Life expectancy 73.5 years
Literacy rate 94%
Infant mortality rate (per 1,000 births) 16
Children (0-5 years) underweight for age 4%
Population living on $1.25 per day 16%
Number of doctors (per 10,000 people) 14

Sources: Orbis International, National Statistical Yearbook 2006, World Health Organization, & Chinese Ophthalmology Society, Chinese Disabled Peoples Federation, second National Disabled People’s Survey (2006), UNDP Human Development Report 2010 & 2011, UNICEF State of the World's Children Report 2012, International Agency for the Prevention of Blindness (IAPB) China Secretariat.

What we can do

Help keep Fred’s dream alive.

4 out of 5 people who are blind in the developing world don't need to be. Routine treatment costing as little as $25 can restore sight and hope.