To overcome these barriers, Robiroy put aside his medical charts and stepped into courtyards, looking to connect with people with warmth and empathy. Over cups of tea, he listened, shared stories, and spoke of restored sight as a path to dignity and independence.

Small victories soon blossomed. An elder who had received eye care could weave again. A farmer saw his fields clearly. Success stories spread across villages. Soon, Nongpoh Vision Centre saw patients surge, and 520 seniors received cataract surgeries. Families began prioritizing eye care across generations.

Currently, five of Robiroy’s 47 villages will soon be declared Avoidable Blindness-Free. He is not just restoring vision – he is sparking an eye care movement!

With files from Emmanuel Benia Tanti, Program Manager, India.

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This makes medical care difficult to access, especially for seniors like Gadami.

For six years, the grandmother lived with cataracts in both eyes. As her vision worsened, she became reliant on family members to help with even simple tasks.

“There was no doctor, no eye camp, nothing,” says our Program Manager Tapobrat Bhuyan, describing the community when he first visited it in 2021.

When community health volunteer, Dipen, met Gadami during a door-to-door screening, he referred her to a nearby eye camp. There, she was diagnosed with bilateral cataracts, and agreed to make the long journey to Jorhat, where she received sight-restoring surgery at our partner hospital, Chandraprabha Eye Hospital, free of charge.

Gadami’s granddaughter, Junu, was by her side to comfort her during the hospital stay and share in her joy when the bandages came off.

Back in Kachikata, Gadami’s world has opened up. With her independence restored, she can once again walk around the village, visit friends and fully enjoy her time with her grandchildren.

Watch a video about our work on Majuli Island!

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Priya in Nepal can’t remember when she first started having trouble seeing, but her vision kept deteriorating until one day she fell and injured herself while climbing the steep trail leading from the village to her house. Figuring that blindness was an inevitable part of old age, she stayed at home, unable to visit friends and grandchildren. Eventually she couldn’t even reach the outhouse without assistance. She felt like a burden to her family.

Mary, in Kenya, loved school from her very first day in the classroom and dreamed of becoming a teacher someday. After she turned 13, she started having trouble reading the chalk board. She had to copy notes from her friends and couldn’t do her homework in the dim light at her house. Her grades began to slip. She asked her parents to take her to an eye doctor, but money was too tight because they were saving to send her brother to college. By age 15, Mary quit school and decided to get married, her hopes of teaching now crushed.

None of these characters are real, but they represent the millions of women and girls around the world who are living with avoidable vision loss and blindness. We hear stories like these every day.

The prevalence of vision loss is higher among women and girls than it is for men and boys; 55 per cent of people experiencing vision loss are female. And while there are some biological factors at play, the reasons for these discrepancies are largely social.

Why women and girls experience more vision impairment

Women live on average longer than men, and many conditions that rob people of their sight are associated with old age. This includes cataract, presbyopia, glaucoma and age-related macular degeneration. According to estimates, two-thirds of cataract blindness globally occurs in women.

Traditional gender roles are another factor, especially in some regions.

Women and girls are two to four times more likely than men and boys to get trachoma – the leading infectious cause of blindness worldwide. Trachoma is caused by bacteria that spreads through contact on hands and clothing. Small children are especially susceptible, and in turn, they often pass it on to their caretakers. Women and girls may also get infected from household cleaning and doing laundry.

Obstacles to eye health care access

The barriers to health care for women and girls vary widely from region to region, but there are trends that we can observe across the countries where we work. These include:

• Cost and lack of financial decision-making capacity: Men often control the family finances. Women are less likely to work outside the home, meaning that the men and boys in their family who earn an income are often prioritized for spending on treatment.
• Limited healthcare infrastructure: In some regions, particularly in rural areas, inadequate healthcare infrastructure makes it difficult for women and girls to access eye care. The cost or lack of public transportation to the nearest facilities can exacerbate this problem for many women and girls, as can the social taboos and safety risks presented by travelling alone.
• Family responsibilities: Running a household and taking care of family members, duties that often fall on women, can make it challenging for women to take the time they need to get eye care.
• Lack of information: Unequal access to education for women and girls contributes to lower literacy rates and educational levels, which make it more difficult for women to learn about a specific eye condition or find out where they can get it treated.
• Cultural stigmas: Cultural norms and stigmas surrounding health issues, particularly eye health, can dissuade women from getting help. These cultural barriers may result in delayed or avoided medical attention.
• Lack of female healthcare professionals: A shortage of female healthcare professionals in the eye care sector can create discomfort for women and girls, potentially discouraging them from seeking assistance.

Addressing these diverse challenges is crucial for breaking down the barriers that prevent women and girls from accessing essential eye health care services.

Working toward gender equality

Our approach, called the “Hospital-Based Community Eye Health Program Model,” is designed to address inequalities to accessing eye health care, starting at the village level.

Most of the community health workers trained by Operation Eyesight’s partner hospitals are women, which gives them the opportunity to become trusted leaders in their communities and helps them contribute to family finances. They also bring eye health screenings to people’s doorsteps, meaning that women and girls don’t need to travel to get primary eye care and referrals.

Additionally, we work with our partner hospitals to establish vision centres closer to the communities where we work, making it easier for everyone to access diagnosis and treatment. Our partner hospitals also provide safe transportation for patients – usually by bus – to the hospital so that they can get their surgeries without worrying about how they’ll get there.

Finally, by providing surgeries, eyeglasses and other treatments free of charge – or at a highly subsidized rate – we can decrease some of the financial barriers women and girls face. We strive to provide quality eye care services to everyone – regardless of gender, age, ability to pay or other personal circumstances.

Dismantling gender-related eye health myths in the foothills of the Himalayas

In the villages of the Udhampur block in Jammu region, vision problems are often seen as a sign of bad luck. A girl wearing glasses might be told she’ll never have a good marriage, and a baby’s bad eyesight might be blamed on past life sins. A girl with a squint could be seen as a curse for the whole family.

Those are some of the beliefs a recent pilot project took aim at.

Created in partnership with NorQuest College and the Rotary Eye & ENT Hospital, the project provided services through a “Mobile Vision Centre” – a four-wheel-drive van staffed with an eye health team comprised mostly of women. The van roamed the area’s rugged roads, bringing primary eye care and education to people’s doorsteps.

More than 27,000 people received training pertaining to eye health myths during the project duration. A before-and-after survey that checked people’s attitudes and beliefs regarding eye health for girls and women showed dramatic differences after the intervention. With that success in mind, our teams are looking to implement strategies from the project throughout our programs.

Donate today to help us bring quality eye health care to more women and girls.

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The scene above was one of many such moments observed by the Operation Eyesight team during a recent community workshop in the city of Udhampur in northern India. The goal of the workshop was to get input on some new educational materials from members of the communities where they will be used.

The illustration described above is from a series of flash cards that tell the story of a mother with vision problems who doesn’t understand why her daughter has received an award at school because she can’t read the writing on the certificate. The story is meant to jumpstart conversations about why women in the region are often hesitant to seek out eye health care.

Over two days, eight community members from several villages in our project area worked with an Operation Eyesight team that included an artist, a writer, a gender equality specialist and several of our program managers.

“It’s important to note that the community was the driver for these materials,” says Dr. Troy Cunningham, our Country Director for India. “Our experts took the backseat. The images were decided by the community members, the stories were decided by them. Even before the artist and writer sat down with the community, we took them around the villages to meet people with eye problems.”

The new educational materials are just one small part of a larger eye health project we are undertaking in the region. Called “Empowering Women in Rural India by Debunking Feminine Eye Health Myths,” the project was launched in 2022 in partnership with the nearby Rotary Eye and ENT Hospital in Udhampur, and Edmonton’s NorQuest College. The project is being funded by the Inter-Council Network’s FIT program, which stands for “The Fund for Innovation and Transformation”. The program is designed to support Canadian organizations so they can test innovative solutions for advancing gender equality in the Global South, and is funded by Global Affairs Canada.  

The Udhampur Block stretches over miles of hilly Himalayan terrain in India’s Union Territory of Jammu and Kashmir. Roads connecting the region’s villages are prone to flooding and landslides. For many, it’s difficult to leave the village to seek any kind of health care, so vision problems often go ignored, especially for women and girls.

What’s more is that there are a number of gender-related eye health myths that also create barriers to seeking medical care. As a result, our team designed a custom project for the region, which includes sending a four-wheel drive mobile vision clinic staffed with an all-female healthcare team into the area. We have also trained local women as community health workers. These health workers use the new educational materials in their daily work.

Here is a snapshot of some of the new materials that our team and the community members have developed.

Jhanoo’s Cataract

Jhanoo is the oldest rhinoceros in her clan. She can’t see well because of her cataracts, but she thinks that she is too old to have them treated. The youngest member of the clan, Banoo, convinces her that she should see the local community health worker. After the visit with the health worker, Jhanoo agrees to get cataract surgery, and after the operation she enjoys a more independent lifestyle. She also gets back to a key role she plays in her community – teaching math to the local children.

This story is designed to ease fears of surgery and show the community how important eye health is to even its oldest members. It is presented to the community participants as a series of flash cards that they put in order to tell the story.

Cunningham says that, initially, his team was concerned that the community members would be offended by the artist’s use of animals to depict people, but they decided to wait and see what feedback they would receive at the workshop in Udhampur. To the team’s surprise, the community members loved the rhinos and told the artist to stick with the theme.  

Rani’s Story

Rani is an embroidery artist. She has a pair of eyeglasses, but she doesn’t wear them because her parents worry they will affect her chances of finding a good life partner. As a result, she makes a lot of errors in her work and her supervisor is unhappy with her. She speaks to a friend who convinces her to wear her glasses more often. Her work improves and she gets a promotion.

This story, shared through a poster, is aimed at getting more young women to seek treatment for vision problems and to wear their eyeglasses. It’s meant to combat the stereotypes that prevent many women from addressing their vision problems.

Next Steps

For the past few months, community health workers in the Udhampur region have been piloting these new materials as they conduct surveys and workshops throughout the project area. Along the way, the team has been continuing to tweak and update the materials to make sure they best serve the communities.

Project Manager Tapobrat Bhuyan says the materials are important tools for understanding the issues in each village.

“They can explore the main concepts and myths through the stories told in the materials,” he says. “All the materials come with a session guide, and there are some excellent questions in the guide that help them to understand the problems in the community.”

The project is just one more way we are working towards the United Nations’ Sustainable Development Goals (SDGs), particularly SDG number five, Gender Equality.

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