India

Lead Agency
Sight Savers International

Name of Project
Muzaffarpur CEC Project

Name of Partner/ Implementing Organisation
Muzaffarpur Eye Hospital (MEH)

Location
Muzaffarpur District, Bihar

Annual Report
View 2004 Annual Report

BRIEF DESCRIPTION

The project aims to reduce the incidence of avoidable blindness through the promotion of better eye health, prevention and treatment of eye conditions and the provision of eye care services to a total district population of 3.5 million.

MEH is the major eye care service provider in the project area, and a long-standing SSI partner. It has a 100 bed eye hospital in Muzaffarpur city with four full-time and two part-time ophthalmologists and twelve paramedics. The majority of the population of the project area live below the poverty line and MEH provides free or subsidized treatment to around 70 percent of all patients accessing services. MEH has the potential to develop as a tertiary eye care centre - there currently being no provision in the project area.

Over the course of the programme, MEH will continue to build the clinical and management capacity of the eye hospital as well as carry out screening camps to refer patients from the community. Other planned activities include:

· The development of specialised eye services such as diabetic retinopathy, paediatric
surgery, glaucoma and low vision.

· The development of ancillary services including an optical fitting and grinding unit,laboratory and dispensary.

· The development of MEH as a primary level eye care training institute, including the development of linkages to the government medical college and district health authorities with the aim of providing training to medical students, government doctors and health workers.

· The construction of residential accommodation for doctors and paramedics - such provision is crucial if MEH is to be successful in recruiting and retaining clinical staff.

· The construction of a hostel and classrooms for trainees.

BACKGROUND

Muzaffarpur Eye Hospital (MEH) is a long standing partner of SSI which has developed from a surgical camp into a full eye care project. In 2003, SSI support to MEH was extended to include Comprehensive Eye Services (CES). As such, medical eye care activities, Community Based Rehabilitation (CBR) and Integrated Education (IE) strategies were jointly planned by SSI and MEH. The project area for the medical services covers the entire Muzaffarpur district of Bihar, and the area for the Community Based Rehabilitation (CBR) covers the Motipur block of Muzaffarpur district.

Muzaffarpur district is located at the northern side of Bihar, a significantly poor Indian State. The entire area is prone to frequent floods as it is in close proximity to four rivers. Seasonal agriculture is the main source of livelihood but it is not able to provide sufficient crops throughout the year because of poor irrigation and flood management. To maximise the chance of survival, the rural population migrates to urban areas. Child employment is quite common which has lead to a poor literacy rate.

The rural population is quite unaware about health care in general and does not prioritise eye care. Government health facilities do not adequately meet needs, because there are fewer health care institutions and low placement rates of trained personnel. The District Blindness Control Society (DBCS) is conducting 2500- 3000 cataract surgeries every year giving an estimated Cataract Surgical Rate (CSR) of 950. In Indian terms this is very low, as some States are 5-6 times higher. Lack of proper infrastructure and an absence of advanced treatment facilities compels patients to seek treatment across the border in Nepal. Those who cannot afford to go sometimes seek help from local alternative unqualified sources.

With this in mind, MEH was set up. It is a well equipped 100 bed eye hospital with six ophthalmologists, 12 paramedical staff and 30 other support staff members. As the district is well connected by road and rail, accessibility to quality eye care services has increased. MEH has also started rehabilitation services to provide assistance for those who are irreversibly blind. A situation analysis was carried out which helped SSI and MEH to frame the strategies for the current project period (2003-2005). These are:

• To build clinical and management capacity of the eye hospital.
• Conduct outreach screening camps to refer patients from the community.
• Cross subsidise free/subsidised treatment for poor, from paying patients.
• Develop specialised eye care services.
• Develop comprehensive CBR services.
• Develop optical fitting & grinding unit, pharmacy and pathology lab.
• Develop MEH as a primary level eye care training institute.

PROGRESS

• The optical fitting and grinding training was completed in March 04 and then in April the optical shop was established.
• Free cataract surgery rates are already higher than expected.
• Construction of the residential facility for doctors and paramedics is nearly complete, with a proposal to construct a third floor in the doctor’s quarters, due to the dramatic increase in staff.
• Screening for diabetic retinopathy has started in the base hospital, with a treatment unit now established.
• Glaucoma services have been initiated, with a glaucoma treatment unit established in September 2004.
• CBR started in February 2004 after successful completion of the CBR first training module.

HIGHLIGHTS

A slit lamp, synaptophore, double frequency Yag laser, non contact tonometer, OT table, auto keratometer and field analyser have been made available to MEH in 2004.

TIMESCALE

2004 - 2006

APPROXIMATE COST (Year 1, 2, 3 & Total)*

US$ 390,000 (see table below for breakdown)

ESTIMATED NUMBER OF TOTAL BENEFICIARIES

Number of beneficiaries receiving sight-restoring procedures: 12,825
Number of beneficiaries receiving other eye care services: 220,000

Information compiled on 20/6/05 by Peter Renew and Katy Dore at SSI, for publication on Fundraising Online.

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