SEVA - Improving surgery and spectacle acceptance through community outreach in Cambodia - The International Agency for the Prevention of Blindness

Mrs. Hin Touch with her granddaughter at the eye unit after her eyesight restoration surgeries.

Reaching people who need eye care services remains a challenge around the world. Convincing these people to accept eye care services – when you do find them – proves an additional obstacle to ensuring people can see again. Seva works with partner hospitals/eye units in five provinces in Cambodia to increase access to and improve the quality of eye care services.

In partnership with Seeing is Believing, Seva addresses this challenge by conducting outreach screenings in communities with limited access to eye care as well as at schools. Seva mobilizes Community Field Workers (CFWs) to improve surgery acceptance rates in the areas where we work in Cambodia.

A community field worker takes the visual acuity of patients at an outreach screening camp.

The CFWs work with village leaders, who play a critical role in bridging the gap between the community and service facilities. Village leaders know their communities and often have the trust of community members to provide recommendations. Together with Seva’s CFWs, they conduct outreach screenings and encourage people with cataract, pterygium, and other eye diseases to visit eye care facilities for sight restoration and treatment. The partnership between village leaders and CFWs offers encouragement for people and their families who need eye care. CFWs also provide counseling for the entire community about eye care and distribute leaflets to raise awareness about these critical services.

To further build confidence in the eye care services, CFWs organize outreach screening camps in communities staffed by an ophthalmic nurse and refractionist from the eye unit. At the screening camps, patients are diagnosed and treated for minor conditions and provided with eyeglasses while surgical cases, like Mrs. Hin Touch, are referred to an eye unit.

Mrs. Hin Touch had heard that CFWs would be visiting her village to provide screenings from the village leader. On 23 October 2017, CFWs conducted a screening camp in her village, 80km from the nearest eye unit. A CFW tested her vision and immediately detected cataracts in both of her eyes. The CFW counseled her and explained that the eye unit provides eye surgery free of charge thanks to Seeing is Believing. The next day, the CFW arranged transportation for her to the eye unit. Within a few weeks, she successfully received surgery on both of her eyes and was able to see again.

Since the CFWs began conducting outreach screenings, the number of patients at the eye units have increased by 90% and the number of surgeries by 120%. In addition to the CFW outreach, Seva also collaborates with referral hospitals/eye units and the department of education, youth and sports, to conduct school screening programs. School teachers are trained on primary eye care, including how to measure the visual acuity (VA) of their students. After the teachers test their students’ VA, they refer students who have refractive errors to refractionists, who visit the schools for screening camps, while the students who have other eye problems are referred to an eye unit for further evaluation and treatment. Refractionists check all students and teachers with refractive errors and prescribe spectacles. The spectacles are made at the eye units and the refractionists bring them directly to the students and teachers when they visit the schools for screening camps. Refractionists also provide counselling to students and parents as well teachers about the importance of wearing spectacles and the role they plan to improve learning. By providing spectacles at children’s schools, Seva and SIB save families time and money so they don’t have to go to a faraway clinic.