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Village blindness control societies - a concept for implementing VISION 2020: The Right To Sight

The Global Initiative for the Elimination of Avoidable Blindness, VISION 2020: the Right to Sight, was launched in February 1999 at the global level and subsequently regions and countries followed suit. While being a signatory to this initiative is expressing solidarity with the vision and mission of prevention of blindness and visual impairment that is avoidable 2020, if the initiative needs to successful, the focus should be on implementation at the unit level or as in our case, the village level.

The author has embarked setting up what are called “Village Blindness Control Societies (VBCS)” in a rural district in the state of Andhra Pradesh in India, over the last couple of years. This article outlines the plan, model and possible structure that could further deliver decentralized eye care to those in need.

The Village Blindness Control Societies are envisaged as a platform for all blindness control activities at the village level and to address eye problems in the village. The idea is to fully utilise all the government schemes that are available at the village level through all national programmes for blindness control and involve the local population. It is planned as a 2-tier structure with the existing health human resources from the public sector supported by the local youth through volunteerism. It is presumed that by doing so a sense of societal responsibility is engendered among the future citizens of the village as well as the evolution of a more equitable social order.

The broad objectives for the VBCS are outlined as:

• To detect and eliminate avoidable blindness at individual village level.

• To identify and provide services to those with severe visual impairment and low vision in the village.

• To carry out eye care awareness programs and provide primary eye care.

Organizational Structure for a VBCS

The VBCS would have the following members and they will carry out the functions outlined below:

• The Head of the village or the “Sarpanch” as the Chairperson of the Society

• The Ophthalmic Assistant as the member secretary

• The Health Assistant or Health Supervisor as the Co-ordinator

• The Village Secretary as member

The Village Eye Health Volunteers (male and female) also as members.

Village health volunteers with respect to the eye care programme are trained in primary eye care, recording vision and maintaining records, counseling in the case of promotion of eye donation, running a community revolving fund for health collection and management as well as maintaining active and passive surveillance for eye ailments and follow up activities. The other national health programmes have also outlined activities for the volunteers to perform. These volunteers, one for every 25 households, with a good gender distribution are supported by the health funds of the local self-government and a donation-based model.

Last year, the author established VBCS in 6 blocks in his district. He was able to:

• Increase out-patient attendance at camps and fixed facilities like a primary health centre

• Contributed to about 600 cases of cataracts that were operated in the district last year

• Provided 188 free spectacles to needy students for refractive errors

• Set up a key informant system to identify children with eye ailments

• Provide eye donation education resulting in one pair of eyes being donated last year

All this was possible because of the systematic efforts of all the functionaries who worked as a cohesive team at the village level in the VBCS. Local fund raising for health activities throughout the village was more effective where such a society was established.. Community participation and intersectoral coordination has also been very successful through establishing such societies for eye care as well as other health activities.

It is such localised efforts that will help make “VISION 2020: the Right to Sight” a reality.

Personnel	Planned Responsibilities
Chairperson	Chair the monthly meetings and review the activities Facilitate organisation of monthly eye screening camps Facilitate health education and publicity activities Recruit and pay the Village Eye Health Volunteers Supervision of fund raising and disbursement Make available resources at disposal for eye care activities Arrange for consumables like spectacles for the needy Monitoring the Volunteers and other activities
Ophthalmic Assistant	National Program for Control of Blindness Implementation Updating Village Blind Registry Training of other health and volunteer functionaries Organising and conducting eye screening programmes and camps Surveillance and follow up activities Eye donation awareness and referral services
Health Assistant	Liaise with Ophthalmic Assistant for eye care activities Make health resources at disposal available Eye Health Education as main activity Volunteers training programme Co-ordinate between all eye care programme activities Attend monthly and regular meetings
Village Secretary	Assist the Village Health Volunteers in their activities Build and Co-ordinate Fund raising by Village Health Volunteers
Village Health Volunteers	Assist in implementing National health programmes Assist Ophthalmic Assistant in prevention of blindness programmes First point of contact for all ailments at the village level Responsible for 25 households in the village Assist in updating the Village Blind Registry Carry out primary eye care activities Counseli for eye donation Facilitate a revolving fund collection for health activities Assist in vital statistics collection