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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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.

The post Gender inequalities in vision loss appeared first on Operation Eyesight.

Our worldwide team of locally-recruited health workers and volunteers gives us ‘insider knowledge’ of a community’s needs and helps us deliver care that is sustainable to those who need it most.

Tapobrat Bhuyan, our Program Manager in India, says an entire community or village benefits from the presence of our health workers, because they help identify those who need eye care and encourage health-seeking behaviour through education and referral to other health resources in the area.

The position of community health worker is also a unique job opportunity, especially for women. 

Tapobrat recalls an instance where he was interviewing a prospective health worker in 2013. When prompted as to why she wanted the job, the woman began to cry. 

“She told me she was working in a small school, making little money. She could not afford her children’s education. However, her excellent writing skills earned her a spot on our team, where she remains to this day,” explains Tapobrat.

“The stipend she receives helped to pay for her children’s education, and one of her daughters is now a teacher.”

Once trained, community health workers survey their local community door to door, identifying eye health conditions and referring community members for care. They also collect comprehensive data on the prevalence of eye conditions so that progress can be tracked.  

Tapobrat has worked closely with community health workers across India. He says they play a key role in connecting communities with eye health care, through referral to locally-established vision centres, which we open in convenient locations based on the needs of the community.

“Community health workers are the key link between communities and the vision centre. Often, individuals are unaware of their treatment options, or fear that it will be unaffordable,” Tapobrat says.

“However, our network of community health workers helps to create demand for these services by raising awareness about their availability.” 

Staying locally informed 

Given their connection to their own communities, Tapobrat says, community health workers can help identify and dismantle local barriers that many face in accessing eye health services.  

“They provide not just screening, but also education sessions that aim to give community members more knowledge about eye health and other topics such as maternal and child health,” Tapobrat says. “These sessions empower community members to seek health care services when needed.”

Tapobrat says our approach has also led us to consult communities in the development of educational materials, including a recent project aimed at debunking feminine eye health myths.

Working with community members and a local illustrator and writer, he and our India team are creating educational materials that reflect the community’s collective identity and address local myths about eye health. Tapobrat notes that this was the first opportunity for community members to participate in this type of workshop, and it was met with success.  

“Rather than just focusing on disease, we are telling stories, which draws more interest and helps create deeper engagement. We are able to connect on a more personal level when people see themselves reflected in the materials they are shown,” he says.

Delivering eye care that is sustainable 
 
Door-to-door surveys are only one step in ensuring a community has access to eye care. Community health workers also follow up with those who were referred to the vision centre but have not yet gone, often counselling those who are hesitant to receive treatment.  

“We are constantly learning and growing, especially regarding the importance of language. For example, often people only know the word ‘operation’ when referring to treatments for conditions like cataracts, rather than terms like ‘surgery,’” explains Tapobrat.  

“We have learned from this and now encourage a multi-faceted explanation of treatment processes,” he adds.

While local barriers may vary across the regions we work in, the community remains at the heart of our approach.  

Across India, we are committed to addressing local needs and learning from those we work alongside.   

Learn more about our approach.  

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Targeting eye health alone isn’t enough to eliminate avoidable blindness; if other health care needs aren’t met, there will still be people suffering from vision problems or other conditions. For example, vitamin A deficiency results in preventable childhood blindness, and increases the risk of death from common childhood illnesses such as diarrhea.

With your help, we’re enabling poor communities to lead healthier and more productive lives. Not only do we educate target communities about eye health, but we also address their essential health care needs. Our trained community health workers educate communities about eye health and general health (such as the importance of vitamin A) and create awareness of the eye care services available in or around the community. They also collaborate with health care staff to deliver services such as immunizations.

We’re always proud to report the number of sight-restoring cataract surgeries performed or prescription eyeglasses dispensed, but the pinnacle of our work is the healthy communities that are empowered to lead happy and productive lives. For example, we’ve declared 1,020 villages as avoidable blindness-free. In these villages, mortality rates have dropped significantly and school enrollment rates have increased.

Thanks to YOU, entire communities have been transformed!

There are still thousands of communities that need your help! Please donate today to prevent blindness and restore sight to some of the most vulnerable people in Africa and Asia.

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