The adverse effects of impaired vision on a child’s development, including development of personality, intelligence, cognitive ability and self-reliance, are well known. Early detection of visual impairments, with provision of appropriate support, has a real impact on a child’s quality of life.
Sightsavers’ Colombo Urban Comprehensive Eye Care Project (CUCEC) project has initiated training of teachers in basic eye screening, in close coordination with the relevant authorities. By project end in June 2014, 2,000 teachers will have been trained and 625,000 children screened in Colombo and Kandy districts.
Teachers can now identify children with suspected visual impairments by noting behaviour such as holding reading material close, rubbing eyes, using fingers while reading, etc. In such cases, they screen the children to establish whether or not there is a need for more extensive examination and support; this is available at refraction camps, where large numbers of students can be examined (organised by the teachers in coordination with zonal educational authorities and Medical Officers of Health), as well as at Medical Officers of Health offices or hospital eye units.
The teachers have developed a passion for their role in eye care, with screening becoming a part of their routine work. “It is amazing to feel the satisfaction you get from this priceless service. I never knew that, being a primary teacher, I had such potential to identify children with visual impairments” says Mrs Pathiranage, who has screened more than 4,000 students in Sri Rahula College, Kandy.
Key to the success of this initiative, and to its sustainability, was the integration of teacher training into the work of Medical Officers of Health who are responsible for primary health care staff at divisional level. At the outset, the Ministry of Health trained Medical Officers of Health and Assistant Medical Officers of Health on primary eye care and the role of teachers in identifying children with visual impairments. The Medical Officers of Health worked closely with the provincial and zonal education offices and the Ministry of Health to organise training programmes for teachers.
Screening by teachers has been welcomed by education and health authorities, as it has enabled screening of more children within a short period of time and has reduced overcrowding at secondary eye units. This positive response and the enthusiasm of the teachers have spurred the Ministry of Health to replicate the initiative through its Vision 2020 national secretariat, in 21 out of 26 districts.