Challenges in Ophthalmology with April Steinert

Female health care workers in Nepal on front lines of fighting corneal blindness

Marsha Link's women's advocate trip to Nepal shows the value of SightLife's blindness prevention program.

I was rambling through the woods near my home, my furry companions alongside me, of course, hoping the crisp New England fall air and the smell of freshly fallen leaves would shake something loose and provide a bit of inspiration on where to begin this month’s article. I struggled because this month’s column is not about one individual’s professional or personal struggle, but rather a global struggle that we in the eye biz should all care about: preventing corneal blindness. More succinctly, how you and I, as individuals, can put a lasting ripple in that considerable pond.

On our walk through the forest, with me deep in thought about my upcoming article, there was a bend in the trail, and as we completed the corner and were once again on a straightaway, we were greeted by a rainbow of gratitude and prayer flags, tied to clotheslines and strung from tree to tree in an elaborate labyrinth. It was unexpected and moving in a mystical way. Naturally, I felt compelled to walk through the maze and read some of the messages. They were simple, heartfelt, handwritten notes exuding love and appreciation for the things that we are all guilty of taking for granted, and to loved ones who are here and to loved ones who have passed on. The elements of life that come into sharp relief during more difficult times. Stumbling upon that scene seemed more than a coincidence because this month’s column is about charitable work done in Nepal, which was very much on my mind. Quite extraordinary really, but then again, life has always shown me small acts of grace when I have least expected them and when I have needed them most.

A day before encountering the gratitude flags, I had spoken on the phone with Marsha Link about her recent women’s advocate trip to Nepal with SightLife. I had initially been scheduled to accompany the gals on the trip, but a move across the country elbowed out any hope I had of attending, so I wanted to hear all about her experiences of the program with the expectations of attending a future trip myself. To say Marsha was gushing about the excursion would be an understatement. After hanging up the phone with Marsha, the one word that instantly leaped into my mind was “powerful.” It was clear to me that the journey had an indelible impact on her and how she will continue to move forward in this world.

The group visited the Tilganga Institute of Ophthalmology, the Nepal Eye Bank and Bharatpur Eye Hospital. Sadly, we are all aware of the disenfranchisement that women quite often face in developing worlds, but in SightLife’s prevention program, women are the stars and deeply respected within their communities. These female health care workers are on the front lines in helping turn the tide of corneal blindness through prevention. These women — referred to in Nepal as Female Community Health Volunteers (FCHVs) and in India as ASHA workers (Accredited Social Health Activists) — undergo rigorous training by SightLife. There are more than 400 local women in Nepal and India who have received training on how to identify and treat corneal abrasions before they progress to corneal ulcers, perforation and, ultimately, corneal transplantation. These prevention methods have proven to be highly effective: 46% of patients seen present with a corneal abrasion and have a 96% effective rate when treated with a topical antibiotic, while the other patients are referred to tertiary hospitals for more advance care as needed, with a 100% follow-up rate. A stunning statistic, right? And did you know that there are 12.7 million corneal blind in the world, the majority of which live in undeveloped countries, and a staggering 1.5 million are added to that number each year? With SightLife’s prevention program, it costs about US$1 per patient for treatment. Compare and contrast that with the many hundreds of U.S. dollars for corneal transplantation and the loss of wages for the patient and his/her family members, all of which were preventable.

Marsha told me many moving stories about the positive impact this program has had on local communities. There were the father and 7-year-old son whom she met and learned had walked 6 hours to reach a clinic for treatment, or the proud and emotionally invested FCHV, with little financial resources, who had used cow dung to attach the poster to her home announcing hers as one where people could seek treatment for their ocular conditions.

What lingered in my mind most after our conversation concluded was the pure joy Marsha witnessed and described to me. Also, the universality of human kindness and the resiliency of the human spirit. Material possessions did not seem as important to them as a reliable social construct, health/well-being and friendship. There was much singing, laughing, dancing and love to share, even with these new female visitors who were there to see their program in action. I ask, how could anyone not get behind such a cost-effective and worthy program? So, if you are interested in making a philanthropic investment in SightLife’s program, please contact:

Travis Thompson, Philanthropy and Partnerships Officer, 206-414-7106, email: travis.thompson@sightlife.org.

Andrea Callis, Senior Manager, Corporate and Foundation Relations, 206-414-7109, email: andrea.callis@sightlife.org.

“The only ones among you who will be really happy are those who will have sought and found how to serve.” – Albert Schweitzer

Disclosure: Steinert reports no relevant financial disclosures.

I was rambling through the woods near my home, my furry companions alongside me, of course, hoping the crisp New England fall air and the smell of freshly fallen leaves would shake something loose and provide a bit of inspiration on where to begin this month’s article. I struggled because this month’s column is not about one individual’s professional or personal struggle, but rather a global struggle that we in the eye biz should all care about: preventing corneal blindness. More succinctly, how you and I, as individuals, can put a lasting ripple in that considerable pond.

On our walk through the forest, with me deep in thought about my upcoming article, there was a bend in the trail, and as we completed the corner and were once again on a straightaway, we were greeted by a rainbow of gratitude and prayer flags, tied to clotheslines and strung from tree to tree in an elaborate labyrinth. It was unexpected and moving in a mystical way. Naturally, I felt compelled to walk through the maze and read some of the messages. They were simple, heartfelt, handwritten notes exuding love and appreciation for the things that we are all guilty of taking for granted, and to loved ones who are here and to loved ones who have passed on. The elements of life that come into sharp relief during more difficult times. Stumbling upon that scene seemed more than a coincidence because this month’s column is about charitable work done in Nepal, which was very much on my mind. Quite extraordinary really, but then again, life has always shown me small acts of grace when I have least expected them and when I have needed them most.

A day before encountering the gratitude flags, I had spoken on the phone with Marsha Link about her recent women’s advocate trip to Nepal with SightLife. I had initially been scheduled to accompany the gals on the trip, but a move across the country elbowed out any hope I had of attending, so I wanted to hear all about her experiences of the program with the expectations of attending a future trip myself. To say Marsha was gushing about the excursion would be an understatement. After hanging up the phone with Marsha, the one word that instantly leaped into my mind was “powerful.” It was clear to me that the journey had an indelible impact on her and how she will continue to move forward in this world.

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The group visited the Tilganga Institute of Ophthalmology, the Nepal Eye Bank and Bharatpur Eye Hospital. Sadly, we are all aware of the disenfranchisement that women quite often face in developing worlds, but in SightLife’s prevention program, women are the stars and deeply respected within their communities. These female health care workers are on the front lines in helping turn the tide of corneal blindness through prevention. These women — referred to in Nepal as Female Community Health Volunteers (FCHVs) and in India as ASHA workers (Accredited Social Health Activists) — undergo rigorous training by SightLife. There are more than 400 local women in Nepal and India who have received training on how to identify and treat corneal abrasions before they progress to corneal ulcers, perforation and, ultimately, corneal transplantation. These prevention methods have proven to be highly effective: 46% of patients seen present with a corneal abrasion and have a 96% effective rate when treated with a topical antibiotic, while the other patients are referred to tertiary hospitals for more advance care as needed, with a 100% follow-up rate. A stunning statistic, right? And did you know that there are 12.7 million corneal blind in the world, the majority of which live in undeveloped countries, and a staggering 1.5 million are added to that number each year? With SightLife’s prevention program, it costs about US$1 per patient for treatment. Compare and contrast that with the many hundreds of U.S. dollars for corneal transplantation and the loss of wages for the patient and his/her family members, all of which were preventable.

Marsha told me many moving stories about the positive impact this program has had on local communities. There were the father and 7-year-old son whom she met and learned had walked 6 hours to reach a clinic for treatment, or the proud and emotionally invested FCHV, with little financial resources, who had used cow dung to attach the poster to her home announcing hers as one where people could seek treatment for their ocular conditions.

What lingered in my mind most after our conversation concluded was the pure joy Marsha witnessed and described to me. Also, the universality of human kindness and the resiliency of the human spirit. Material possessions did not seem as important to them as a reliable social construct, health/well-being and friendship. There was much singing, laughing, dancing and love to share, even with these new female visitors who were there to see their program in action. I ask, how could anyone not get behind such a cost-effective and worthy program? So, if you are interested in making a philanthropic investment in SightLife’s program, please contact:

Travis Thompson, Philanthropy and Partnerships Officer, 206-414-7106, email: travis.thompson@sightlife.org.

Andrea Callis, Senior Manager, Corporate and Foundation Relations, 206-414-7109, email: andrea.callis@sightlife.org.

“The only ones among you who will be really happy are those who will have sought and found how to serve.” – Albert Schweitzer

Disclosure: Steinert reports no relevant financial disclosures.