South Africa
Dr Ayodeji Adu operating at Frontier Hospital. Photo: Sandy Scheltema/The Age
The state of health in South Africa has suffered some major setbacks in recent years, particularly amongst the poor and rural population.
Overview
The Eastern Cape Province, where our program work is concentrated, is the second largest and also one of the poorest of the nine province, with low levels of education and high unemployment.
In 2008, a survey estimated that approximately 3.04% of the population in Eastern Cape Province had an avoidable form of blindness, mainly caused by cataract. The majority of these people have very limited or no access to eye care services.
One of the greatest challenges we face in the Eastern Cape Province is the tremendous shortage of trained eye care professionals at all levels of the health care system.
We have been working with our sister organisation, the Fred Hollows Foundation South Africa (FHFSA), and the Eastern Cape Provincial Department of Health and other partner organisations, to turn this situation around.
Achievements: 2010
Through the work of The Fred Hollows Foundation South Africa, we have:
- screened 23,863 people
- performed 2,491 cataract operations and 395 other sight-saving surgeries
- supported the training of 16 surgeons, 40 nurses and 98 community health workers
- supported 40 outreach visits by ophthalmologists to hospitals without resident surgeons
- assisted 10 students to enrol in a new ophthalmic nursing program, which The Foundation helped establish.
About the program
The Foundation has been working in South Africa since 1999. In 2001 The Fred Hollows Foundation South Africa (FHFSA) was established and a partnership was formed with the Eastern Cape Provincial Department of Health.
The Eastern Cape Province was chosen because of its pressing need for development assistance in the post-apartheid era. At that time the province had the worst cataract surgery rate in South Africa, a problem resulting from a lack of equipment, infrastructure and trained medical staff, and inequitable service delivery systems.
Our goal has been to improve infrastructure, training and access, and to integrate and strengthen eye care services in the public sector health system.
Since 2001, The Foundation has equipped eye units in partner hospitals – for example, we developed the Sabona Eye Care Centre at Frontier Hospital as a centre of excellence in community eye health – as well as supporting the development of a new eye care outpatients unit at St Elizabeth's Hospital, patient accommodation at Butterworth Hospital, and nurse trainee accommodation at Frontier Hospital.
We have also advocated successfully to secure the South Africa Nursing Council's approval of a curriculum for ophthalmic nursing, which will be taught in the Eastern Cape's Lilitha College of Nursing.
The Foundation supported the Rapid Assessment of Avoidable Blindness 2008 (RAAB) survey carried out in Eastern Cape Province, and the results guide the Foundation’s provincial program.
Facts and figures
| Estimated prevalence of blindness | 0.75% in 2002 (2006) |
| Main causes of blindness | cataract (50-66%), glaucoma (14%), refractive error (10%). (2005, 2006) |
| Number of people with cataract blindness) | 170,000 in South Africa (2006) and 30,000 in the Eastern Cape Province |
| Rate of cataract operations performed annually (cataract surgery rate) | 1,072 and 1,030 per million population in South Africa and Eastern Cape Province, respectively. (2009) |
| Number of ophthalmologists | 124 surgeons working in public hospitals (2007) |
| Population | 50.5 million |
| Urban population | 61.7% |
| Life expectancy | 52 years |
| Infant mortality rate (per 1,000 births) | 48 |
| Adult Literacy rate | 89% |
| Population living on $1.25 a day | 26.2% |
| Population which is undernourished | less than 5% |
| Number of doctors (per 10,000 people) | 8 |
Sources: Health Systems Trust (2009); Lecuona in Community Eye Health Journal (2007) 20(64):72; Kluever in Community Eye Health Journal (2006) 19(58):27; Sacharowitz in SAfr Optomestrist (2005) 6(4):139, UNDP Human Development Report 2010
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