Blindness is a gender issue. Blindness discriminates. Fifty-five per cent of the world’s blind are women and girls. More than 20 million women and girls are blind, and 120 million are visually impaired. Four out of five people who are blind don’t need to be.

And this injustice is magnified in developing countries. Women face additional barriers to accessing eye care that men don’t: lack of education, limited decision-making power, restricted access to financial resources and a lower perceived priority.

One reason for the disparity is that women live longer than men, so they are more likely to develop age-related, non-communicable eye diseases such as cataract, glaucoma and macular degeneration. But despite the fact that more women than men are affected by the condition, cataract surgery rates are lower for women.

And this is only part of the picture.

Women and girls are at greater risk of contracting trachoma, an infectious eye disease that leads to irreversible blindness. Seventy per cent of those affected by blinding trachoma are women. Very young children are at risk for trachoma, and three times as many girls as boys suffer from it.

Women and girls are at increased risk for infectious eye diseases because of their traditional roles. Women and girls carry the burden of taking care of their relatives who suffer from trachoma or other eye conditions. Not only does this increase their risk of contracting trachoma themselves, but it often limits their opportunities to go to school or find employment.

Women who are blind carry the double burden of discrimination because of their disability and their gender, which can lead to social exclusion. This impacts their ability to do day-to-day activities, increases their risk of injury, and leaves them more vulnerable to violence and depression.

To achieve the United Nations’ Sustainable Development Goals (SDGs) and the World Health Organization’s VISION 2020 goals, eye care programs must eliminate all forms of inequity in access to eye care for women and girls. Eye care programs must recognize that women and girls have different needs, preferences and constraints, and women and girls should be at the centre of eye health programming.

Organizations must work with local communities to understand the barriers women face, take affirmative action in training and human resource development to ensure there are more women in the health care system, and remove the barriers to access to services. In addition, programs should integrate eye health services into maternal and reproductive health facilities to give pregnant women access to eye health screening that is not provided routinely, and provide outreach to villages where eye disease remains largely undiagnosed and untreated.

Operation Eyesight works with local hospital and government partners to provide quality eye care services to everyone – regardless of gender, age, ability to pay or other personal circumstances – while working to address the many root causes of avoidable blindness and remove barriers to health care, specifically and deliberately targeting the barriers for women and girls.

I’m especially proud of our focus on community outreach and education. We train community health workers – women who live and work in our target communities – to conduct door-to-door eye screenings and educate families about eye health and general health topics such as prenatal care, nutrition and immunization. This approach allows us to reach women and girls who might otherwise go unreached, ensuring those with eye health issues are referred to a partner hospital or vision centre for treatment.

Community health workers also refer women and their families to primary health care facilities for pre/postnatal care, vitamin A supplementation, immunizations, etc. These are just a few examples of how we’re embedding SDG 5: Gender Equality into our everyday work.

Stats on blindness and women retrieved from the International Agency for the Prevention of Blindness, Seva Canada, this article in BMJ Open Ophthalmology and this article in Ophthalmic Epidemiology.

A variation of this article was previously published on CCIC’s website for Gender Equality Week.

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One example of this is Shashi (pictured above). She lives in a small village in Delhi, India in a small semi-concrete house, which she shares with her family.

She is unmarried and lives with her mother and her two brothers. Her eldest brother is running a small clothing shop, and what he makes from his work there he puts toward supporting the family. Unfortunately, Shashi’s family still faced a great deal of financial challenges.

Shashi wanted to do something to help financially, and she heard about Operation Eyesight. When she heard that they were training Community Health Workers to go door-to-door and screen them for eye health issues, she knew right away that she wanted to be a part of it.

Shashi had a hard time finding the job. When she did, her family wasn’t immediately supportive. Many women in India are not encouraged to work, but after she was hired, her family was counselled on the importance of the work she would be doing, and the financial benefits it would bring. Finally, Shashi’s family agreed that she could do the job (SDG #5: Gender Equality).

“It’s great work. I always wanted to help people in need in my community. This was my first time working with so many people, and at first I had trouble convincing the people about the importance of their eye health, especially when it came to eye surgery. It took time, but as people were treated, I started receiving appreciation from the patients who were helped and that was a great boost to my confidence” (SDG #3: Good Health and Well-Being).

Community health work is hard and involved work. Not only do health workers perform initial screenings, they also follow up with patients. Thanks to Shashi’s dedication, the people in her community have developed awareness about the importance of eye health as well as general healthcare (SDG #4: Quality Education).

Now people happily welcome her into their homes, trusting that she can help them.

“The work is very rewarding. There was one patient I helped who had cataract in both eyes. After counselling her about cataract surgery and referring her to the partner hospital for treatment, her sight was restored (SDG #17: Partnerships for the Goals). She was so happy! Now she has become an advocate for eye health, and her quality of life has been much improved.”

While Shashi’s mother was initially hesitant to allow her to work, she is now so proud.

“My daughter is working for a noble cause and helping people by referring them to be cured from avoidable blindness! I couldn’t be happier. Thanks to Shashi, our family is financially supported, and we are respected by our community.”

Shashi has decided that once she is done working as a community health worker, she wants to study to get a degree and become a social worker, with a focus on community development.

“This job has built my image as a social worker in the community. People respect me, they consult me when they have any eye-related issues. People now call me doctor!” Shashi says smiling. “It has also helped my family financially. I’m happy I can support my family and bring us out of poverty (SDG #1: No poverty). I would like to thank everyone who has made this possible, including Operation Eyesight and the generous donors who provided me with a great opportunity to work to help my community. It’s always been my dream!” (SGD #10: Reduced Inequalities).

The best part of it all is that it’s generous people like you who make our work possible. Your support is helping thousands see hope for the future, and is giving them a chance to break the cycle of poverty and build themselves a brighter future!

There are still so many people who need our help. By donating to our Screening and Outreach programs, you can help us train more dedicated health workers like Shashi, and restore sight to those who need it most – For All The World To See!

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Together with our donors, we’re helping the world reach its goals to end poverty, promote healthy living and ensure prosperity for everyone. With your ongoing support, we’ll continue our work to eliminate avoidable blindness, contributing to a sustainable future for us all. Thank you!

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