Eye diseases are considered one of the major contributors to nonfatal disabling conditions in both high and low income countries. In Bangladesh, 750,000 adults and 48,000 children are blind. But with only 1,118 ophthalmologists, the country is facing daunting challenges in delivering quality eye care to its population of 160 million people. The 884,041 Forcibly Displaced Myanmar Nationals (FDMNs), called Rohingya, who have taken shelter in Bangladesh, have added to the burden.
Against such a background, international non-profit organisation Orbis International came forward to restore vision of the people in Bangladesh landing its Flying Eye Hospital (FEH) in 1985. Since 2000, the organisation has been contributing establishing long-term programmes to the development of eye care facilities, creation of manpower in the field, building of awareness about eye diseases and its prevention, their prevention and treatment, and treatment of eye diseases.
Response to FDMNs and host community
Orbis International has set up two Vision Centres in Cox’s Bazar district of southern Bangladesh, which hosts over a million FDMNs who fled from atrocities in Rakhine state of Myanmar.
At the two Vision Centres, Orbis International offers primary eye care services, which include treating conjunctivitis, allergic problems, refractive errors and foreign bodies in eye, and providing spectacles and contact lenses for correction of refractive errors. The centre sends the patients, who suffer from cataracts and require treatment at tertiary hospitals, to base hospital in Cox’s Bazar.
Balukhali Vision Centre, Camp 11, Ukhiya
The Vision Centre at the Rohingya Refugee Camp No. 11 at Balukhali is aimed at offering eye care services to the Forcibly Myanmar Displace Nationals (FDMNs).Many FDMNs living in refugee camps are suffering from eye ailments as they had almost no access to proper eye care services in their homeland. Orbis International has come up with quality eye care services for them by setting up the Vision Centre in the refugee camp area.
Sexagenarian Ziaul Haque is one of the FDMNs who availed himself of the primary eye care service at the Balukhali Vision Centre then underwent cataract surgery at Cox's Bazar Baitush Sharaf Hospital (CBBSH).
“We, the Rohingya people, didn’t have access to proper eye care in Myanmar. But here, in Cox’s Bazar, Orbis International and Baitush Sharaf Hospital have done everything necessary to give me back my eyesight,” he said.
Ayatullah, another FDMN, got back his eyesight for the services Orbis provided. Balukhali Vision Center took him to Chittagong Eye Infirmary and Training Complex, a tertiary eye hospital in the divisional city, where he underwent cataract surgery.
“Now I can see. The operation has given me a new lease of life,” Ayatullah said.
The surgery has brought back to Ayatullah the color of life that he lost with the loss of vision. According to the family, Ayatullah has begun a small trade – vending betel leaf and betel nut – from which he is earning taka 200 to 300 a day. Though the figure is not big, the money is giving extra comfort to the family.
Balukhali Vision Centre Optometrist Abdul Awal Shah said the most important service the centre offers is correcting the refractive errors of children. “If refractive errors among paediatric eye patients can be intervened at the early stage through spectacles and contact lenses, they are corrected. After the age of 10 years, it becomes very difficult to correct any refractive error,” he said.
Ukhiya Vision Centre
Ukhiya Vision Centre at the Ukhiya Upazila headquarters (pre-COVID-19 photo)
Ukhiya Vision Centre set up inside the Ukhiya Health Complex, the government-run health facility at the sub-district, is aimed at providing service for the host community. The influx of FDMNs has created huge pressure on the local community and different services meant for them as well. Health services are no exception. When the local authorities were struggling to offer services to the increasing number of people, Orbis responded to their need.
Shamsunnahar, a housewife in Jafarpallanpara village under Ukhiya sub-district of Cox’s Bazar district, is one of the beneficiaries, who were treated at Ukhiya Vision Centre and Baitush Sharaf Hospital."I couldn’t do many household chores such as needling clothes for the eye ailment. I had to encounter several other problems for that,” she told reporters in front of her small mud house.
After the operation, her vision was restored and since then she is not experiencing any problem with her eye and can see like any normal human.
Orbis does not confine its service only to providing treatment; it gives the patients all necessary medicines and spectacles free of cost. Even the organisation bears the cost of the patients’ transport from vision centres to the base hospital and vice versa.
COVID response
The coronavirus pandemic forced both the Vision Centres to cease services for a month since early March 2020 and limit them for another two months. They returned to full-fledged service after the lull but the service disruption led to huge backlog of patients requiring different eye care services.
“We resumed full-scale operation in mid-2020 and worked relentlessly to reduce the backlog,” said Md Tasnim Sadeed, Optometrist at Ukhiya Vision Centre.
The pandemic, however, changed the ways of service delivery at the centres. They are now offering services maintaining social distancing and other safety rules to prevent the spread of the deadly virus.
Balukhali Vision Centre Optometrist Abdul Awal Shah said that during the pandemic, they use all necessary safety gears when they provide services. The patients are also given protective materials and are oriented so that they themselves follow the health guidelines, particularly maintenance of social distancing while taking service at the centres. Basins have been installed and hand wash arranged for the patients to ensure that they wash their and well while entering the centres.
Teleconsultation Service at VC
Vision Centres sometimes receive patients who need consultation from expert physicians. In such cases, optometrists at the centres take tele-consultation from eye specialists stationed at the base hospital to give the patients relief from the pain of travelling to the hospital. The specialised eye doctors see and examine patients’ eyes through webcams and laptops and guide the optometrists to offer treatment and prescribe medicines for them. If the tele-consultant cannot be introduced many patients have to travel to the base hospital amid the coronavirus pandemic for consultation of specialised doctors and treatment.
Referral for Paediatric Surgery
Chittagong Eye Infirmary and Training Complex performs surgery and restores vision of children from FDMNs and host community of Cox’s Bazar (pre-COVID-19 photos).
A major portion of the patients the Vision Centres receive are children. The Vision Centres offer primary eye care service for them, but some patients require advance-level treatment, including surgery, that the centres are not equipped to give. The centres send them to the Chittagong Eye Infirmary and Training Institute (CEITC) under their arrangement and do everything for their treatment there.
Awareness Programme
Orbis International conducts campaigns in different ways to raise awareness about eye diseases, their prevention and treatment. The most important campaign tools the organisation uses are media campaign and distribution of information, education and communication materials including radio program broadcasting from Bangladesh Betar, Cox’s Bazar Center and Community Radio Naf FM 99.2, Teknaf. Orbis makes people in its working areas know the services it offers through frequent miking.
Outreach Programme
Bangladesh lacks adequate number of eye care facilities which has resulted in low coverage of eye care services. To overcome the problem, Orbis conducts regular outreach programme to bring the people at the grass roots under eye health service. Orbis, in cooperation with CBBSH, organises 30-40 eye camps every month in Cox’s Bazar, including Rohingya camps, and some parts of Chattogram under its outreach programme. A six-member medical team from base hospital conducts eye screening at the camps.
Since the beginning of its operation in Bangladesh, Orbis International has been working for improvement of infrastructure for eye care. The organisation has facilitated the development of Child Outdoor Patient Department (OPD), Inpatient Department (IPD), Operation Theatre (OT), and other services at health facilities at different parts of the country.
Bangladesh lacks behind many other countries in eye care for various reasons, including poor awareness and limited facilities. Orbis is contributing a lot to overcoming the situation.
