When did Orbis enter Ethiopia and why?
Orbis entered Ethiopia in 1998 because eye care was not considered a priority as part of the health system. This was partly due to the fact that there is no evidence to suggest that eye care was a problem. However, Orbis's work in the country through his Flying Eye hospital demonstrated a high prevalence of blindness in the country, and the need to open a country office was obvious for Orbis's leadership.
What did Orbis's work involve?
Since we entered Ethiopia, we have developed evidence that eye care is a major concern for public health. Between 2005 and 2006, I supported the first national study in this regard, which demonstrated that Ethiopia has the greatest global blindness burden. The results of this survey have created a lot of awareness within the eye care community and have given us the opportunity to start a humanitarian development for eye health.
At that time, Ethiopia had 65 ophthalmologists across the country. Survey results have prompted the eye care community to set up training programs in different parts of the country. Now, we have more than 148 qualified ophthalmologists and more than 100 ophthalmologists, which means that over the next three to four years there will be more than 200 ophthalmologists in the country.
How has eye care evolved in Ethiopia over the last 20 years?
Eye care in Ethiopia has changed a lot in the last 20 years.
Sub-specialty training and services were not previously discovered in the eye care system. For example, 15 years ago, if a patient developed an optic hemorrhage, the chance to receive the right treatment was zero. Therefore, the formation of existing ophthalmologists in sub-specialties such as vitreous retinal surgery, glaucoma or pediatrics has increased the quality and volume of eye care services that are available. Orbis contributed significantly to ensure that this change took place.
"Addressing major causes of blindness at primary and secondary levels has made a huge contribution to reducing avoidable blindness in the country"
We also advocated creating a hierarchical eye-care model that starts from community-based care, then moves to secondary and tertiary care; linking different stages gives people access to a referral and tracking system. We have set models that work clearly at each level and can be replicated in other areas of the country.
The three major causes of the blindness in Ethiopia are cataract, trachoma, and refractive error. 85% of these diseases are located in rural communities, while most ophthalmologists are in large cities. Therefore, creating this hierarchical model using a primary care system means that we can best deal with the needs of people's eye care.
Addressing the major causes of blindness at primary and secondary levels has made a huge contribution to reducing avoidable blindness in the country.
Are there any key achievements for charity in the country?
Optometry of training is now 100% institutionalized in the university system. When I started optometry training during 2005-2006, she was led and dependent on national governmental organizations. It is now managed entirely by universities, which has been a great success.
What is the 20-year mark in Ethiopia for charity?
It has been really thrilling to be part of the 20-year festivities, because in the last 20 years we have demonstrated that if good advocacy is put into practice, resources are localized and if there is a local and global partnership we can reduce the avoidable blindness significant. We have shown that in Ethiopia, in particular through existing human resources, investment in sub-specialist eye care services, midwifery eye training and more.
"Pre-service and sub-specialty services have not been previously discovered in the eye care system … If a patient develops an ophthalmologic haemorrhage, the chances that they will receive the correct treatment were not"
What are the plans of the charitable organization in the country over the next five years?
I think we'll eradicate the trachoma. Trachoma is the most important infectious disease and Ethiopia has the biggest burden in the world – over 46% of the global burden of trachomatis is in Ethiopia. A significant achievement in recent years has been the location of resources to eliminate the dull trach in Ethiopia, with the government committed to an annual budget to help combat this phenomenon. I think that with the current impulse we will eliminate the trachoma in the coming years.
Understanding the value of eye care is on the rise and people demand better service for eye care now. By investing in eye care, we contribute to achieving Orbis's sustainable development goals – without eyes, without vision, the vicious cycle of poverty and blindness exists.
This requires long-term investment, requires behavioral change, requires community and public awareness, and decision-makers who take responsibility. So yes, I created an impulse but it is not yet done. People grow older and life expectancy increases, so we have a greater change in eye care issues. We have a population growing in aging, and with it there is age-related macular degeneration, cataracts and glaucoma. As a result, the demographic change of eye diseases from infectious to noninfectious increases, so much remains to be done.
Image credit: Martin Kharumwa