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Kisumu county starts community-based eye surgeries to reduce health burden

By Treezer Michelle Atieno

Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) has recorded great progress in its recently adopted response to handling cataract cases by conducting community outreaches and performing surgeries within the communities.

“This community cataract’s response was arrived at after the realization that many patients shy away from seeking treatment at the hospital due to misinformation about the cost involved. Cataract continues to be the leading cause of blindness, yet it can be prevented with early diagnosis,” says Dr. George Rae.

JOOTR, in conjunction with Achieving Integrated Eye Health in Kenya, through a three-year collaboration between Novartis and Fred Hollows Foundation, started this project. Its main objective is to reduce the prevalence of blindness caused by cataracts, glaucoma, and diabetic retinopathy in Kenya.

Globally, cataract is one of the leading causes of vision impairment. It accounts for 9.4% of vision impairments that are unaddressed.

Prof. Ojuma Stephen, head of the eye unit at Jaramogi Oginga Odinga Teaching and Referral Hospital in Kisumu, says that cataracts-which happen when the lens of the eyes, which is always clear, becomes cloudy- develop with aging or when an injury changes the tissue that makes up the eye’s lens. Proteins and fibers in the lens begin to break down, causing vision to become hazy or cloudy.

Apart from the community eye surgeries, patients referred to the hospital for further treatment are facilitated with transport. Screening using the Fundus Machine is conducted in the communities while available specialists on-site perform surgeries where needed.

“We are targeting clients already on NHIF; this will also help raise the revenue generated to the hospital, some of these people are very old, and they have challenges getting to our facility,” adds Dr. George Rae, The Chief Executive Officer of JOOTRH.

Not only is the JOOTRH Eye Unit bringing services to the communities, but those near JOOTRH are also ferried to the hospital. Two days after the surgeries are conducted, the patients are taken back to the nearest centers in the communities where they hail from.

Prof. Ojuma explains that the cataract removal surgery is uncomplicated, and takes about 1 hour. During cataract surgery, the surgeon removes the clouded lens and replaces it with an artificial lens implant that is clear and shaped to fit the patient’s eye.

Joy Ouma, the grant coordinator  for Fred Hallows Foundation, says that the project’s goals are to ensure an increase in timely diagnosis of cataracts, treatment uptake, and treatment compliance. Sensitization in the community for better outcomes is also a priority.

The project has also increased the availability of eye health supplies and commodities by implementing an enabling policy. JOOTRH has also been equipped with the Fundus Machine for on-site diagnosis.

Community Health Workers (CHW) and Community Health Assistants (CHA) are key in implementing this project. Currently, about 200 CHWs and 189 CHAs have been trained on eye health and the proper referral system, as they play an important role in referring patients covered under NHIF with cataracts to JOOTRH for surgery.

Dr. Emma Obegi, the Director of Medical Services in JOOTRH, emphasizes that eye problems lead to unproductivity. In the recent past, Kisumu has registered an increased number of people suffering from non-communicable diseases, hence the need to reduce the burden.

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