Pakistan
in Pakistan, 120,000 children are blind or severely vision impaired.
Across Pakistan nearly one in ten people are visually impaired, with more than two million people blind in both eyes. The Foundation has a strong partnership with the Government of Pakistan and is working in all four provinces of the country.
Overview
In Pakistan, hundreds of people go blind every day, often from preventable causes like cataract. People in Western countries have ready access to cataract surgery, but in Pakistan most people don’t.
Most eye care services are only available in Pakistan's major cities. Around two thirds of the country’s population, and most people who are affected, live in remote areas without access to health services.
Most people are unable to travel to get help – many simply can't afford the expense. Traditional women are particularly disadvantaged as they are not expected to travel alone.
"Reaching the population of Pakistan is not easy," says Dr Gillani, The Foundation’s Country Manager. "It is also very hard to change attitudes. The Foundation has come out with a multi-pronged approach. We have trained the doctors, held eye clinics, introduced quality into the recipients and providers perspective. That has been challenging."
"I can confidently claim that The Fred Hollows Foundation has revolutionised eye care in Pakistan" – Dr Rubina Gillani, Country Manager, Pakistan
Since The Foundation started work in Pakistan in 1998, the rate of avoidable blindness is down from 1.8% of the population to 0.9%.
Our aim is to build up Pakistan’s existing health systems so that we can bring sustainable eye care services to every corner of the country.
Achievements 2011
In 2011, despite security concerns and an unstable environment, The Foundation:
- Performed 24,253 cataract operations and 18,412 other sight saving or improving interventions
- Trained four surgeons and 24 nurses and clinic support staff
- Screened 303,869 people
- Upgraded four eye units across the country, where thousands of childhood blindness and diabetic retinopathy sufferers can now get treatment
- Tested over 80,000 school children for debilitating eye conditions
- Offered the first vitro-retinal and paediatric ophthalmology fellowships at the College of Ophthalmology and Allied Vision Sciences in Lahore
- Donated 1,600 intraocular lenses for cataract surgeries on the poor in 16 remote districts
- Heavy focus on tackling widespread problem of childhood blindness (120,000 children are blind or severely visually impaired and another 180,000 have low vision) and diabetic retinopathy – through AusAID’s Pakistan-Australia Subspecialty Eye Care Project.
About the program
Since 1998 The Foundation has upgraded 50 eye units and rural health centres. We help the very poor and rural districts of Pakistan look after their own eye patients bytraining health workers, providing equipment and medical instruments and running community awareness campaigns.
The Australian Agency for International Development (AusAID) has funded The Foundation to implement the Pakistan Australia District Eye Care (PADEC) Project over two five-year periods, from 2002 to 2007 and 2007 to 2012. This funds the provision of equipment, training and systems development to district eye units.
The Australian Government is also supporting our work with the Government of Pakistan delivering a five-year project called the Pakistan-Australia Sub-specialty Eye Care (PASEC) Project, launched in 2009.
This funding means new equipment, training for ophthalmic teams in relevant sub-specialties, upgrades to infrastructure, the development of new quality control systems, as well as providing services for the prevention and control of childhood and diabetes related blindness.
The Pakistan program also involves:
- Building the capacity of Comprehensive Eye Care (CEC) Cells through training and support in each province. The CEC Cells are able to support and guide the district community eye care programs. The setting up of these CEC Cells has enabled effective monitoring of outcomes overtime by the partners themselves
- Supporting district headquarter hospitals so they can treat common eye diseases and promote awareness and confidence in district level ophthalmic services
- Support to the National Programme for Prevention of Blindness in Pakistan through complimenting its efforts. The National Programme provides the required equipment to the eye units in the districts and sub-districts across Pakistan and FHF is providing the required infrastructure and human resource development
- Training health workers (medical officers, paramedics and community health workers) in rural health centres to treat eye diseases, to educate community members about eye care and to refer the complicated eye diseases to the district eye unit
- Supporting female counsellors in remote districts to encourage female patients to seek eye care services (in Pakistan, women often won’t leave home to seek medical help for religious or cultural reasons).
Dr Rubina Gillani, Country Manager
Dr Rubina Gillani is crucial to The Foundation's program in Pakistan. Without her determination, strength, knowledge and ability to get the job done, the program’s success so far would not have been possible.
Dr Gillani is both a medical doctor and public health specialist. She has been working as The Foundation’s Country Manager, Pakistan since 1998.
"To be a Country Manager honestly means that you need to be a negotiator, you need to be a mentor, you need to be an architect, you need to be a fighter and a debater," she says.
"Our biggest challenge is to remain a development organisation which does not just provide charity. As a development organisation we must continue our work towards sustainability within communities. This takes time but…that is the only way it will work. " - Dr Gillani
Dr Gillani spends half her time in the office and the other half travelling extensively throughout Pakistan. She often has to travel up to twelve hours to get to a remote community.
Dr Gillani sees sustainability as the most important aspect of The Foundation's work in the country she loves.
Facts and figures
Eye health
| Number of blind people | over 2 million |
| Main causes of blindness | cataract (53%), corneal scarring (14%), uncorrected refractive error (12%) and glaucoma (7%) |
| Number of people with cataract blindness | over 1 million people are cataract blind, with an annual incidence of 1% (120,000 new cases) annually and an increasing backlog |
| Population affected by childhood blindness | 120,000 children who are blind or severely visually vision impaired and another 180,000 with low vision |
| Number of ophthalmologists | 1,800 (both public and private) of which more than 80% are based in urban areas (while 70% of the population live in district and rural areas) |
General health
| Population | 176.7 million |
| Life expectancy | 65.4 years |
| Infant mortality rate (per 1,000 births) | 70 |
| Population living on less than $1.25 per day | 23% |
| Children (0-5 years) underweight for age | 31% |
| Literacy rate | 55.5% |
| Urban population | 36.2% |
| Number of doctors (per 10,000 people) | 8 |
Sources: UNDP Human Development Report 2010 & 2011. UNICEF State of the World's Children Report 2012
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