Human resource shortage undermine eye healthcare

By Justin Damian:
Although evidence has shown that about 80 per cent of blindness is avoidable, in Tanzania, like other developing countries, it is severely hampered by shortage of trained eye health care professionals and poor eye care infrastructure.

Eye diseases are among the top ten causes of morbidity in Tanzania. An estimated 400,000 Tanzanians are blind and an additional 800,000 people are visually impaired.

Every year, an additional 7,000 people in Tanzania go blind from preventable and treatable causes such as cataract, glaucoma, trachoma, diabetic retinopathy, ocular trauma and others.

Childhood blindness is a public health problem and a priority for National Eye Care Strategic Plan for 2013-16 and of vision 2020 initiative, both of which emphasize on the right to sight.

The Government of Tanzania joined worldwide efforts of vision 2020, a global initiative for the elimination of avoidable blindness.

Speaking during the launching of eye theatre for children in Dar es Salaam recently, the Executive Director of Muhimbili National Hospital, Dr Marina Njelekela, said the mission of VISION 2020, is to eliminate the main causes of blindness in order give all people in the world, particularly the millions needless blind, “The Right to sight”

She said, poverty and blindness tend to be intimately linked, with poverty predisposing to blindness and blindness exacerbating poverty adding that, being blind and poor has many times resulted to exclusion from basic health, education and social services and exposure to isolation, ill health and economic disadvantage.

“It has been shown that once blindness is relieved, the opportunities for work are increased and dependence on other family members reduced dramatically. This is especially true for children whose life expectancy after sight-restoring interventions is higher.

An interesting study by the London School of Hygiene, showed that the annual cost of global blindness and low vision would be $110 billion by the year 2020 with no intervention. This would be a significant loss to mankind. The story is no different in Tanzania where 45 per cent of the population are children aged 14 years and below.

As mentioned, one of the key challenges in eye care, is shortage of human resources for eye health. Like many developing nations, Tanzania is still struggling to cope up with this rising demand for eye care workforce. For example, Tanzania currently has 40 ophthalmologists for a population of nearly 45 million.

This translates to only 1 ophthalmologist per 1.2 million people against a WHO-recommended ratio of 1:250,000. Compare this to 324 ophthalmologists for 50 million people in South Africa, and 2400 eye doctors for 81million people in Egypt.

“The likelihood of adequately addressing this problem in the immediate future is bleak, unless the number of trained eye health personnel is increased through collaborative effort of the Tanzanian Government and its partners,” she said

She was happy to register the College of Ophthalmology of East, Central and Southern Africa (COESCA), saying Tanzania and its partners were committed to lead the role in tackling the shortage.

COECSA, Sightsavers and other eye care partiners are working closely with the Government to address the shortage of eye health workforce and to improve access to eye care services for all.

The Eye Department at Muhimbili University of Health and Allied Sciences (MUHAS) and Muhimbili Natinal Hospital (MNH), are some of the founder members of COECSA.

“Infrastructure is no doubt one of the key inputs needed to improve our services in health. Today we are here to witness the opening of this facility. The hospital provided the space which was renovated using funds donated to MUHAS by the Prevention of Blindness Union (PBU) and Middle East Council of Ophthalmology (MEACO).

The funds were channeled to MUHAS through COECSA and Sightsavers. We now have a good facility that is equipped with the essential equipment. The renovation will not only improve the quality of children health care and survival, it will also enable the hospital to increase number of surgeries, hence reduce blindness and also provide the MUHAS trainees with increased opportunities for hands-on experience. Special thanks to Sightservers- Tanzania country office for overseeing the renovation and handing over process,” she added

She commended MEACO for the generous donation to the eye department which has made the renovation possible. I congratulate MEACO and COESCA for coming together as a medical professional group to work and strive to improve the quality of training and increase the number of eye care health workers in the region.

“You are not only raising the profile of your society, certainly you are attracting students from the region to choose ophthalmology as a carrier. I know that ophthalmology has not been a popular specialty in the medical field as compared to others. COECSA is actually providing regional leadership, a sense of unity, shared purpose, and setting standards for eye care.

I as a director of the hospital and my counterpart, the Vice Chancellor of MUHAS (prof Kaaya) will play our part in supporting the department. The Hospital will continue provide conducive environment and space for MUHAS to provide standard training expected for the university and we look forward continued symbiotic partnership with the University.

MUHAS and MNH hope that the partnership will continue and that sightsarvers, COESCA, MEACO, St Thomas and other partners will continue to support the department in acquiring more equipment to deal with the rising demand of eye care in Tanzania,” she said.

Oh his part, Dr Emeritus Chibuga, who is COECSA Treasurer, said COECSA is one of the largest Ophthalmic professional bodies in Sub-Saharan Africa, It was formed as a merger between Ophthalmological Society of Eastern Africa (OSEA) and Eastern Africa College of Ophthalmologists (EACO) adding that, currently COECSA has 8 member countries (Tanzania, Kenya, Uganda, Burundi, Rwanda, Ethiopia, Malawi and Zambia).

He said COECSA has many activities, all focusing at increasing an improved and affordable eye care service in the region.

“COECSA facilitate restructuring of ophthalmic training processes not only in clinical but also in administration, advocacy and policy making, moreover is engaging in providing equipment and learning facilities as well as infrastructure development in affiliated institutions. In addition, COECSA facilitate provision of scholarships for ophthalmology training at different levels,” he said

Dr Chibuga noted that COECSA has a long working relationship with MUHAS. This event of opening the theatre could have not been possible, if the relationship would have been poor. “We understand MUHAS was faced with various challenges on the course of restructuring its infrastructure but we are proud to see one of the outcomes of the work we did together with MUHAS has been greatly achieved.

“We as COECSA, are not working alone, we recognize enormous contribution from various partners, to name a few are Sightsavers International and MEACO. Their contributions have played a larger role towards what we are about to witness today at the opening of this theatre,” he added

He further noted that, COECSA is committed to continue working with MUHAS at provision of various levels of eye care services. All partners are invited to join hands with us to make eye care services of Muhimbili Hospital reach the highest standard and yet affordable to everybody.