A key barrier for women to access eye care identified through our KAP study, gender analysis and field survey, was women’s inability to travel from their homes to hospitals to receive diagnosis and treatment. Although this looks like a simple problem, there are multiple conditions which make this problem more complicated. First of all, the financial incapability of travelling long distances across rivers and hard to cross roads incurs a cost which is often deemed unaffordable by these poor and marginalized populations. Secondly, the additional cost of an accompanying person is also quite taxing and in some cases prohibitive for patients. Sometimes, they have a hard time any accompanying person to travel with. Waiting for schedules from sons and husbands, women delay their treatment for months, causing irreparable damage to their eyes. Furthermore, elderly patients can’t avail the crowded local buses and need to take auto-rickshaws known as ‘tempoo’ which are more expensive. This further increases their cost of travelling.
A simple yet smart solution of this problem has recently been pilot tested in Nacity and Rajapur upazila of Jhalokathi has shown great results. It has been identified that travelling in groups is beneficial for the eye patients in different ways. First of all, they don’t have to incur the extra cost of travelling alone. Boarding a tempo for one patient is much more expensive than sharing the tempo with 4-5 other patients. Secondly, when people from the same community travel together, they can depend on one or two common accompanying persons. This reduces the cost for per patient accompanying persons as well. With this realization, we tried to encourage patients to fix a particular day in the month and travel in a group. Through our cascade training sessions, we selected travel group leaders who would gather all the other women and travel to the district hospital on a fixed date. Later on a follow up visit we discovered that patients found it more convenient and affordable to travel in a group. After pilot testing in Nalcity and Rajapur, group travel recommendations are now being incorporated this in our communication messages and other cascade orientations.
Sakib Bin Rashid
The Fred Hollows Foundation Bangladesh