Vision For All - Reseberättelser

.Tanzania November 2005.

Tanzania, November 14, 2005

Dear Friends and Colleagues!

On November 4th, 2005, five members from Vision For All (VFA) (three optometrists and two assistants) flew into Dar es Salaam, were four Swedish Lions members were incorporated into the work-brigade as assistants. Our brigade was divided into two groups – one would work in the Lusanga village, Turiani and the other in Tawa, Kisaki and Duthumi, all four towns in the Morogoro District. In Turiani one Swedish optometrist and three assistants worked alongside one ophthalmologist and a general practitioner from Morogoro. All patients with eye pathologies were referred immediately to the ophthalmologist for attention. VFA hopes that this fruitful experience of working together will be repeated and expanded in the future.

In Tawa, Kisaki and Duthumi two optometrists and three assistants worked alongside a general practitioner and a nurse.
Our mission was to provide optometric services to those without economic resources to pay for an eye examination or be able to buy a pair of eyeglasses. All patients however, were asked to pay a symbolic sum of approximately $1,00 USD after the examination. Nothing should be totally free and it helped cover some of the costs for the trip. Those who had no financial means to pay for the eye exams were not denied VFA’s services.

In Turiani:

VFA worked five days in Turiani and succeeded in the following:

* 523 patients were examined, of which 179 (34.2%) were women,
344 (65.8%) men.

   * A large percent said they could read and write. How many were
      semi-illiterates is a question for future studies.
   * A high percent had wages even though they were low and only
      seasonal, temporary work.
   * Of the 571 pair of eyeglasses distributed, were 541 (94,8%) positive
      eyeglasses to correct hypermetropia and / or presbyopia.

* Only 30 (5,2%) persons needed minus eyeglasses for myopic correction.
The mayority of myopes were older people with cataract induced myopia.

* More than 50 (9,6%) of those who received eyeglasses, received either
two pair or bifocals to satisfy their needs to see at distance an near.

* Only 23 (4,4%) teenagers were examined.

* The great mayority of those examined, 461 (88.1%) were 36 years old
or older, that is to say with age related eye problems.

   * 100 eye examinations were planned for each day. In the five days the
      clinic was functioning, 523 patients were attended, that is 23 more than
      expected. We could have taken care of more patients if we had had the
      availability of more eyeglasses, particularly with powers +1,0 - +3,0.

In Tawa, Duthumi and Kisaki:

VFA worked 6 days in these 3 towns and succeeded in the following:

* 603 patients were examined, of which 168 (27.9%) were women,
435 (72.1%) men.

* Of the 626 pair of eyeglasses distributed, were 498 (79,6%) positive
eyeglasses to correct hypermetropia and / or presbyopia.

* 128 (20,4%) persons needed minus glasses for myopic correction.
The mayority of myopes, we believed, had cataract induced myopia.

* More than 59 (9,4%) of those who received eyeglasses, received
either two pair or bifocals to satisfy their needs to see at distance an near.

* Only 22 (3,6%) teenagers were examined.

* The great mayority of those examined, 530 (87,9%) were 36 years old
or older, that is to say with age related eye problems.

* 100 eye examinations were planned for each day. In the six days the
clinic was functioning, 603 patients were attended, that is 297 less than expected.

A few questions arose from this experience:

1) Is good vision a precondition for an individual to develop and
advance in society and does the access to eyeglasses make it
easier for people to fulfill their work, studies and other activities?

2) Why did we not reach a fifty-fifty ratio of men to women?

3) How can the VFA eye examination and eyeglass project
concept, which is linked to a Lions 3 year project, be improved?

4) What is Morogoro’s opinion about the work done and

about future activities?
5) What is Lion’s and VFA’s opinion about the work done

     and about future activities?
6) How can we reach future sustainability with regards to
     the eye examinations and eyeglasses?
7) Could VFA’s Screening Manual be of use in the planned screening
     of 4-500 primary schools in Morogoro and Mvomero and even in the rest
     of the country? And if so, would there be an interest in VFA collabora-
     ting with Tanzanian colleagues in training teachers to do the screening?

This final question is posed because VFA strongly believes that by screening students and young adults, much more could be accomplished and much time and money saved. If, for instance, 5000 students from primary schools in Morogoro and Mvomero where to be screened using VFA’s Screening Manual, perhaps 10% (500 students) would be suspected by the screeners of having some anomaly in their vision status. These suspected would be remitted to the visiting optometrists and ophthalmologists, upon their arrival for a thorough and comprehensive examination.

Finally VFA would like to take the liberty to criticize some aspects of the project and make some suggestions with regards question #5 to improve future VFA projects.

1. Implement the screening process as soon as possible to find those
in greatest need.

2. a) The preparation for work in Tawa and Duthumi was not good. It seems that accommodations were not arranged before hand. A lot of time was spent looking for appropriate lodging and when they were found, they were one hour distance from the place of work. Why wasn’t this organized before?
b) The group was also disappointed at not having enough patients for each day despite the fact that their arrival was known many months in advance. The optometrists did an average of 40 exams each day, half of what they were capable of doing. It is a shame that professionals that have traveled so long cannot work hard and efficiently as they had hoped to do.
Again we suggest that the dispensary personal or others (social workers etc) make a list of those in need so that the optometrists can be guaranted 75-100 patients per day. It is not enough to annonce on the radio.
c) Finally the group took initiative (after consultation with the village chairman) and fixed work in Kisaki on Sunday. That day each optometrist examined 90 patients.
d) We should not divide the group in the future as we were also forced to divide the eyeglasses and optical instruments. It would be better that everybody travel together to a town and there work during 1-2 days and then move on to another cite. As it was, one group had many eyeglasses and the other group han not enough.
e) Another reason why we are critical is that we have a responsibility towards our sponsors.

3. VFA has visited Lusanga two years in a row. Even if the need is great, plans should be made to visit other places within Morogoro.

4. Purchase 3000 pair of inexpensive eyeglasses of each power (+1,00 +1,50 +2,00 +2,50 +3,00) directly from China or India to be used in VFA projects. VFA will suppy the other Diopter powers needed.

We would like to thank Lions Clubs 101-B in Sweden, Synoptik, Hoya,
J & J, Optikerforbundet, and other organizations and individuals who have supported us throughout these years for making this trip possible. A special thanks to the Swedish peoples and Lions Clubs for the eyeglasses donated and for all those members in both VFA and Lions, who have helped in washing, adjusting and measuring the eyeglasses. For logistics help in Africa a warm thanks to our Tanzanian friends colleagues and to all the staff at the Dispensaries, our translators and assistants.

John J. Godoy
VFA, President, Optometrist