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From The Times

March 20, 2009

Right To Sight charity steps up fight
against blindness in Africa

Simon Hampel: First person

This is a crisis moment in the fight against blindness. About ten million people in Africa are needlessly blind. Removing cataracts is a ten-minute operation, but people living in remote communities haven't got hospitals on their doorstep and often don't know that they can get their sight back.

They are generally the breadwinners in their family and if they can't work their children don't go to school. The problem stretches across the world: about 37 million people in developing countries are needlessly blind - more than the number with HIV.

Right to Sight was founded in 2006 by an Irish eye surgeon performing volunteer surgery in Africa, with the aim of helping to eliminate preventable blindness in the developing world.
In India, the first steps to deal with the problem were taken about 30 years ago. In 1976 an Indian eye care charity called Aravind started with 11 beds. Today it has 4,000 beds and runs 300,000 operations a year, 65percent of which are free.

In Africa, there are huge gaps in treatment. Malawi, for example, has only six eye surgeons. With those numbers it is difficult to achieve very much. In addition, eye clinics are not doing as many operations as they have the potential to do. If they can build up capacity, more patients can go through the hospitals with the same level of resources.

We try to increase the effectiveness of the clinics and train surgeons to do more with what they have, so that they start getting economies of scale and can recover their costs.

India has shown that there are models that work. The challenge is to translate that to Africa.
I spent three months in India seeing what Aravind was doing to create sustainable, long-term eye care. We now have project partners in the Democratic Republic of Congo, Malawi, Ethiopia,

Cameroon, Rwanda, Kenya, India and South Africa.
We charge for spectacles and medicine only for those who can afford it. Once we are doing enough operations, those patients who pay will cover those who can't. We took clinics doing a few hundred surgeries a year and are trying to get them to 5,000 a year within two years.
We are still using Indian expertise to grow. Aravind has sent Indian consultants to Africa to help on the ground and African doctors, ministers of state and tribal elders are coming back to India to see what is possible and how they can achieve it in their communities.

Our aim is to get ten projects financially sustainable by the end of 2010, with each clinic dealing with 50,000 outpatients a year and becoming a training centre for its region.

We want our partners to get to the point where, if we left, they could continue. We intend to learn from these initial projects then share that knowledge with other NGOs and governments that have a far bigger reach than we do in Africa and elsewhere.

We are not a traditional charity and will not duplicate resources. We were set up to deal with a crisis and, ideally, once we have helped scale up, we will hand over to the big NGOs and feel that we've done our job. We may disband or focus on another aspect of healthcare.

Every year new charities start up with passion and vision. The danger is that they become blinkered and go down their own path regardless of who else is doing the same thing.

Simon Hampel is the chief executive of Right to Sight




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