In simple terms, to sustain means to maintain. Sustainability in eye care is the ability a project/hospital has to continue offering the same quality services to the same beneficiaries or even more after the support from donors have ended. Working towards sustainability is a continuous challenge.
SiB is partnering with MICEI to contribute to the reduction of poverty in the Centre region of Cameroon through support to quality cataract surgeries, refraction services, comprehensive eye outreach services to marginalized population and specific training opportunities at MICEI. To achieve this, SiB is supporting the:
- Construction of and equipping of an eye ward for patients coming from the poor and marginalized communities for cataract surgeries
- Support 4,000 surgeries on marginalized or poor patients at a subsidized or free rate through the provision of consumables
- Provide training to key MICEI staff who will be instrumental in the training of the next generation of eye care workers in the sub region
- The establishment of and comprehensive outreach team that will organize a weekly eye camp to identify cases of cataract, bring patients to the hospital for treatment and take them back to their communities.
In order to sustain these activities and be able to do more at the end of the project in 2019, MICEI has develop a cross-subsidization pricing model. This is a model where the rich patients pay premium prices so as to permit MICEI provide service to patients who cannot afford to pay or who can only pay a portion of their treatment cost. These poor patients receive the same quality of care like the premium patients, except for the fact that the premium patients are accorded a higher degree of comfort, luxury (eye wear, lodging space, etc.), and spent lesser time in the hospital. Cross-subsidization pricing model can be compared to the airline business. In a plane, we have the economic and the business classes. All passengers are been treated by the same pilot, but the degree of comfort and luxury varies. All patients are treated by the same medical staff and the same equipment but at different environment and prices. In so doing, MICEI will continue performing subsidized or free surgeries to the marginalized and poor population in the Centre region of Cameroon and beyond.
Another area to consider while aiming to sustain these activities is the HR mix and staff training. The HR mix of MICEI is 70% clinical and 30% administrative and support. The 70% clinical staff is composed of 40% trained specialist and senior level ophthalmic personnel. The remaining 60% is made of MLOPs. MICEI continuously train the MLOPs to do all the preliminary services of the clinical protocol while the very skilled staff and specialist take care of things that require greater skills. In so doing, the HR cost is less expensive than recruiting the very skilled staff to carry out a procedure that require lesser skill.
Lastly, MICEI offers two main types of surgical interventions; the Small Incision Cataract Surgery (SICS) and Phacoemulsification cataract surgery. The patients who cannot afford to pay for cataract surgeries or can pay only a portion of the treatment cost are offered the SICS and hospitalized in the subsidized patient ward constructed by SiB . The patients who can afford Phacoemulsification cataract surgery are lodged in a separate hospitalization ward more luxurious and comfortable. They pay a higher price to compensate for the comfort.
MICEI also offers treatment by laser to patients who can afford to pay. The laser treatment and Phacoemulsification cataract surgery permit us to continue subsidizing the SICS treatment for patients who are poor and unable to pay or can only pay a portion of their treatment cost
EBOT Ferdinand AYAMBA
Africa Eye Foundation Cameroon