In Peru, according to the rapid assessment of avoidable blindness (RAAB), there are three principal barriers that people encounter when in need of cataract surgery: 1. Costs is a major barrier, people do not have the funds necessary to undergo surgery; 2. lack of knowledge about existing treatments and; 3. fear of the surgery.
CBM, in collaboration with seven Peruvian partners, is implementing a SIB programme in Peru, and looking at addressing some of those barriers to increase access to quality eye care services. Strategies put forward in response to these challenges have been very similar across the seven partners with slight variations due to specific contexts and geographic locations.
The clinic of one of the partner, Divino Niño Jesús (DNJ), is located in one of the poorest suburbs of South Lima. DNJ, recognizing the need to reach and to increase access for local communities, formed a team of ophthalmologists, nurses, nurse assistants, optometrists and administrators dedicated to work outside the base hospital.
To reach patients, this team has developed alliances with local community organizations such as temporary shelters, clubs for mothers, state funded senior citizen programs, municipalities, etc. Screenings are carried out three times a week and patients with acute vision below 20/100 are referred to the clinic where counselors assess whether patients qualify for free surgeries. Counselors’ role is also to address any fears, misconceptions or cultural beliefs about eye surgeries.
This new outreach strategy has helped DNJ increase the number of cataract surgeries by 60% over the last year.
Another CBM SiB partner Instituto de Prevención y Rehabilitación de la Selva (IPROS) is located in the city of Tarapoto in the Amazon region of Peru, where geographical conditions are harsh, means of communication are limited and basic services such as water and electricity are scarce. IPROS identified that one of the major problem for people accessing their services was the high costs of transportation to their base hospital. Initially, they worked in alliance with the Health Ministry to operate in their facilities, visiting each rural town with their own equipment, yet health conditions and lack of sterilized equipment prevented them from performing high quality surgeries.
To address this, with support from an innovation program, IPROS has designed and built a mobile clinic that works on solar power. This mobile clinic now enables IPROS to perform high quality surgeries. To reach more patients, IPROS works with community leaders who bring together patients who have been previously screened. When each leader can ensure that at least 10 patients will be present on a certain day, surgeries are scheduled combining visits to several towns on the same route so that post-surgical checkups can easily be conducted during follow-up visits.
This strategy has helped increase by 50% the number of patients that have had access to free surgeries who would not have been able to get to the base hospital.