IFGH 2012: Economically Sustainable High Quality Career Paths for African Eye Care Workers

Authors:Coleman K.

Author Affiliations:Right to Sight, Royal College of Surgeons in Ireland

Option 2– Lessons from the field; project and programme evaluations; and syntheses or analyses Presented as – Oral Poster

Issues:

Cataract surgery is both the most common and the most cost effective health intervention known, yet over 7 million Africans are blind because there is less that one eye surgeon per million population to perform this ten minute operation. Right to Sight was founded in 2006 to stimulate recruitment, training and retention of African ophthalmologists through development of sustainable quality careers, with good salaries, excellent working conditions (equipment, patient facilities), quality support staff, and research and continuous medical education opportunities, in Africa.

Description:

From 2006 to 2010 we established successful high quality, high volume, low cost, eye surgery systems in eight African countries, through capacity building, private-private public, NGO and government partnerships, and through collaboration with the Indian eye NGO, Aravind. Our capacity building has produced an extra 250,000 cataract operations and 2.5 million clinic visits in hospitals where private fees cross subsidise surgery for the poor and support surgeons’ salaries. Where possible, surgeons supervise operating non-physician clinicians, developing a new cadre and increasing cost effectiveness of cataract surgery. In 2010 we changed our focus to surgeon training, retention and research.

Lessons learned:

It is possible to provide good salaries, excellent working conditions with good support staff, high patient volumes, and continuous medical education and research opportunities in Africa, to attract, retain and develop a permanent indigenous supply of ophthalmic surgeons to eliminate needless blindness in Africa. Furthermore, it is possible to provide free surgery for the poor, cross-subsidised by fee-paying patients.

Next steps:

Right to Sight is developing rapid cataract surgery training systems (the first opened in Nairobi in 2010), research opportunities (including the African Glaucoma Initiative, vernal eye disease initiative, Squamous cell carcinoma initiative), online medical education programmes and international collaboration, in order to develop academic excellence and stimulate surgeon retention in African ophthalmology programmes.