While COVID-19 is impacting everybody, everywhere, eye care is among the health interventions most significantly affected by the pandemic. Like many other “non-urgent” health services, eye health care was suspended in many countries to increase capacity to fight the pandemic.
Blind patients in remote areas face challenges accessing eye health care and those problems have been amplified during the past six months as coronavirus continues to disrupt global health services. The close contact between ophthalmologists and patients means eye checks are one of the many services which could spread the virus unless extra precautions are taken. Insufficient personal protective equipment and the redeployment of medical staff to fight COVID-19, however, has caused patients to either travel further from their community for services or simply wait longer for help if they cannot afford the transport costs.
As we seek to continue opening our doors to patients so that they can receive basic eye health care services, we find that it is of upmost importance that medical staff are working in a safe environment. In the last six months, I have identified three key ways The Fred Hollows Foundation – a global eye health development organisation – has pivoted to alleviate disruptions in the field.
1. Set funding priorities
The Fred Hollows Foundation has been working with its partner hospitals to reallocate funding from the Australian NGO Cooperation Program (ANCP) to provide PPE to hospital staff in countries including the Philippines, Cambodia, Bangladesh and Pakistan. This has not only made it safer for medical staff to carry out their work but also allowed patients to feel more reassured when visiting hospitals for check-ups.
2. Advocacy is key in helping public make informed decisions
Behaviour change is vital to prevent the spread of infectious diseases, including infectious eye diseases like trachoma. The Foundation has therefore been supporting public awareness and health messaging campaigns in different countries to support COVID-19 alleviation activities.
In Pakistan, The Foundation’s awareness campaign focuses on educating the public on personal hygiene practices, which include face-washing, and increasing their access to water and sanitation. The campaign has reached more than 400,000 people in target districts in two provinces.
3. Harness the power of technology
In Pakistan and Nepal, to help patients who are unable to leave home because of the pandemic, The Foundation has initiated tele-consultation for eye patients since mid-May. Remote consultation was provided for patients with allergic conjunctivitis, glaucoma, refractive errors, cataract and diabetic retinopathy.
Yet until a vaccine is available, issues will continue to rise as the world lives with the coronavirus. Hospitals, like those in the Philippines, has to allow limited emergency health services. Even when local health systems are finding and referring patients who urgently need cataract surgery, most ophthalmologists are hesitant and require patients to undergo COVID tests first, which is unaffordable for the poor. This causes those in need to be turned away.
The eye health sector cannot stand by and wait for the pandemic to end. We know that avoidable blindness is expected to triple by 2050 without more investment in eye health services. The 2020 pandemic disruption however, is likely to significantly worsen the backlog of people waiting for services.
As we look ahead, we urge funders who are working with national governments and other local partners to invest in improved technology, protective equipment and systems to meet the needs of a changed world. Likewise, governments and development organisations must increase their investment into global health and national health systems.
On our part, we hope to continue helping communities to respond to COVID-19 in the immediate term. At the same time, The Foundation is strengthening health systems so that pandemics like these can be better managed in the future, whilst ensuring basic eye health services can be delivered.
The article was first published at AVPN, written by Laura Lee, Chief Representative of HK and ASEAN, The Fred Hollows Foundation.