Pakistan

Across Pakistan nearly one in ten people are visually impaired, with more than two million people blind in both eyes. The Foundation has a strong partnership with the Government of Pakistan and is working in all four provinces of the country.

Overview

In Pakistan, hundreds of people go blind every day, often from preventable causes like cataract. People in Western countries have ready access to cataract surgery, but in Pakistan most people don’t.

Most eye care services are only available in Pakistan's major cities. Around two-thirds of the country’s population, and most people who are affected, live in remote areas without access to health services.

Most people are unable to travel to get help – many simply can't afford the expense. Traditional women are particularly disadvantaged as they are not expected to travel alone.

"Reaching the population of Pakistan is not easy," says Dr Gillani, The Foundation’s Country Manager. "It is also very hard to change attitudes. The Foundation has come out with a multi-pronged approach. We have trained the doctors, held eye clinics, introduced quality into the recipients and providers perspective. That has been challenging."

I can confidently claim that The Fred Hollows Foundation has revolutionised eye care in Pakistan
- Dr Rubina Gillani, Country Manager, Pakistan

Since The Foundation started work in Pakistan in 1998, the rate of blindness is down from 1.8% of the population to 0.9%.

Our aim is to build up Pakistan’s existing health systems so that we can bring sustainable eye care services to every corner of the country.

Achievements 2014 

Working together with our partners in 2014 we:
  • Examined the eyes of over 434,000 people and performed over 205,000 eye operations and treatments
  • Supported 17,576 sight restoring cataract surgeries
  • Supported 7,728 procedures to treat diabetic retinopathy
  • Distributed 4,548 pairs of glasses
  • Trained five surgeons, 27 clinic support staff and 4,429 community health workers. We also continued to support Lady Health Workers who are trained in basic health care to help housebound women and children to get to hospital
  • Supported 22 people to attend other courses
  • Upgraded nine facilities including Civil Hospital Hyderabad Sindh, which is now able to provide diabetic retinopathy screening services
  • Donated $264,521 worth of equipment
  • Launched the "Pakistan-Australian Prevention of Avoidable Blindness" (PAPAB) Project. With support from the Australian government over four years, this project aims to strengthen eye health in Pakistan, targeting emerging issues such as diabetic retinopathy, retinopathy of prematurity, and childhood blindness
  • Developed a partnership with the various provincial Departments of Education to establish new ways of screening school children for conditions such as refractive error

About the program

The Foundation has been working in Pakistan since 1998. Since then, we have worked to build local capacity through strong and wide-Mranging partnership to help the local eye health system become capable of looking after the country’s own eye care needs. We have also worked to develop and support national and provincial coordination systems for effective eye care planning and implementation.

Since 1998 The Foundation has helped develop 50 comprehensive eye units by training health workers, providing equipment/medical instruments, refurbishing hospitals, supporting systems and running community awareness campaigns.

The Australian Agency for International Development (AusAID) has been the main funder of The Foundation’s work in Pakistan.

AusAID funded The Foundation’s first national program to address cataract, “Microsurgical Training Program for Cataract’’, from 1998 to 2001 across the country. In this process, more than 120 eye units were developed for the delivery of cataract services.

From 2002 to 2013 AusAID provided two rounds of funding for “Pakistan Australia District Eye Care Project’’ (PADEC). This was to strengthen the district-based eye care systems through the provision of human resource development, equipment, systems development and advocacy campaigns.

The Australian Government is also supporting our work with the Government of Pakistan on a five-year project called the “Pakistan-Australia Sub-specialty Eye Care’’ (PASEC) Project, launched in 2009. This project has resulted in the establishment of childhood and diabetes-related blindness sub-specialty services in existing tertiary eye units at both district and provincial levels across the country, and developed referral mechanisms and community awareness to increase demand for these services. The project has supported the provision of new equipment, training for ophthalmic teams in relevant sub-specialties, infrastructure upgrades and the development of new quality control systems.

The Pakistan program also involves building the capacity of "Comprehensive Eye Care" (CEC) Cells, through training and support in each province. The CEC Cells are able to support and guide the district community eye care programs. The setting up of these CEC Cells has enabled effective planning, implementation and monitoring of outcomes over time by the partners themselves. A major role for these Cells is supporting district headquarter hospitals by treating common eye diseases and promoting awareness and confidence in district-level ophthalmic services.

Through this kind of support The Foundation has helped progress the National Programme for Prevention of Blindness in Pakistan. The National Programme provided the major pieces of equipment to eye units at the tertiary, secondary and primary level across Pakistan, while the provincial governments provide the required human resources, space and running costs, and The Foundation has been filling the gaps in infrastructure, equipment and human resource development.

In Pakistan, due to low literacy, many fears and myths surround eye health treatment. In addition to this, women often won’t leave home to seek medical help for religious or cultural reasons. To address this, The Foundation has piloted the concept of female counsellors to encourage female patients to seek eye care services for themselves and their children.

The Foundation is currently working across all four provinces in Pakistan.
 

Dr Rubina Gillani, Country Manager

Dr Rubina Gillani is crucial to The Foundation's program in Pakistan. Without her determination, strength, knowledge and ability to get the job done, the program’s success so far would not have been possible.

Dr Gillani is both a medical doctor and public health specialist. She has been working as The Foundation’s Pakistan Country Manager since 1998.
Our biggest challenge is to remain a development organisation which does not just provide charity. As a development organisation we must continue our work towards sustainability within communities. This takes time but…that is the only way it will work
- Dr Gillani
"To be a Country Manager honestly means that you need to be a negotiator, you need to be a mentor, you need to be an architect, you need to be a fighter and a debater," she says.

Dr Gillani sees sustainability as the most important aspect of The Foundation's work in the country she loves.
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