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Pakistan
Lead Agency
Sight Savers International
Name of Project
Layton Rahmatulla Benevolent Trust:
A selection of work from the following hospitals
· Korangi Base Eye Hospital
· Lahore Eye & Cancer Base Hospital
Name of Partner/ Implementing Organisation
Layton Rahmatulla Benevolent Trust (LRBT)
Location
· Karachi, Sindh Province (Korangi Base Eye Hospital)
· Lahore, Punjab Province (Eye & Cancer Base Hospital)
Annual Report
View 2004 Annual Report
BRIEF DESCRIPTION
The World Health Organisation (WHO) considers Pakistan as a priority country for blindness prevention and treatment. It is estimated that blindness is prevalent in approximately 1 % of a population of over 142 million. This means that there are nearly one and a half million people in Pakistan who are blind.
The principal causes are:
- Cataract - 66%
- Corneal opacity - 12%
- Refractive error - 11%
- Glaucoma - 3%
- Other - 8%
One of SSI’s partners in Pakistan is the Layton Rahmatulla Benevolent Trust (LRBT), a non-government organisation that runs a network of nine eye hospitals throughout Pakistan.
LRBT was founded in 1984 by two retired businessmen, Graham Layton (British) and Zaka Rahmatulla (Pakistani). Their shared vision was to develop an organisation dedicated to providing a network of quality eye care services in poor and previously underserved communities in Pakistan. Although both founders have passed away, they left behind a solid management structure that has enabled the Trust to maintain, and indeed increase, its eye care services.
LRBT’s network of hospitals have been opened one by one throughout Pakistan since 1985, and they make a significant contribution to the delivery of eye care services throughout the country. The Trust now has seven Field Hospitals and two tertiary-level eye hospitals in the cities of Karachi and Lahore. A tenth hospital will open in 2004.
- The tertiary eye hospitals provide primary, secondary and tertiary level eye care services. They are also the centre for complex cases referred to them from the field hospitals.
- The field hospitals provide primary and secondary eye care services (including cataract surgery) and refer more complex cases to hospitals with tertiary facilities.
BACKGROUND
The Layton Rahmatulla Benevolent Trust (LRBT) has been one of the key partners of SSI for two decades. It has been the largest service provider of eye care in Pakistan through its network of ten field hospitals (the latest, at Shahpur Saddar, opening in Nov 2004) and two base hospitals in Karachi and Lahore. Standard Chartered Bank funding is committed for the two base hospitals which offer a full range of tertiary level services.
All hospitals are well equipped with appropriate diagnostic and surgical instruments. The LRBT network now has a total staff of 520 which includes 100 doctors, 194 paramedical and 226 support staff. Karachi and Lahore also have part time consultants who provide professional expertise and further training for the other doctors.
Total patient visits to all out patient departments (OPDs) in the LRBT network since inception has been 9.1million and 966,000 major & minor surgeries have been performed. LRBT services are free; although, until March 2004 most patients were required to purchase their Intra Ocular Lens (IOLs). Since April 2004 thanks to funding from the Graham Layton Trust UK, non-foldable rigid IOLs (as used in non-phaco SICS and ECCE surgery) are now free.
LRBT and SSI enjoy a very mature partnership which is based on core funding being supplied to LRBT for general application to their programmes. Though SSI maintains a keen interest in the affairs of this organisation, and is in regular contact, the scope of the work is under the daily management of LRBT without individual details of support being agreed item by item. Thus the nature of SCB funding also follows a similar pattern. Though the SCB funding is nominally earmarked to the Karachi (Korangi) and Lahore base hospitals, it benefits the entire organisation and its work in Pakistan.
PROGRESS
In 2004, more than 97% of the cataract surgeries were with IOLs. In total, 15 outreach clinics are supported through Korangi & Lahore. These help to increase the referrals for surgeries and treatments through community primary eye care centres in each area. These primary eye centres, located in slums and poor areas, screen the patients and refer the cases to hospital for treatment and surgery when required.
Regarding preventive eye care; audio-visual lectures to all patients attending the hospital are delivered at Korangi hospital. Personal consultation and verbal lectures for Primary Eye Care and hygiene were delivered in field hospitals too, thus further enhancing community support.
A new Management Information Systems software package has been installed at Korangi and is now up and running. It will soon be implemented at Lahore too and, in future years, a modified version at LRBT’s field hospitals.
Regular internal reviews of clinical and surgical practice are carried out at the tertiary level hospitals of Korangi and Lahore. There are periodic reviews of practices at secondary hospitals by Consultant Ophthalmologists who visit regularly from Korangi.
SITUATION
Economic activity in Pakistan is picking up gradually. The government announced low inflation in 2004, whereas in reality, the consumer price index has grown significantly this year.
Mr. Shaukat Aziz, a financial expert by profession and previously finance minister, became the Prime Minister of Pakistan during August 2004 through a smooth transition within the ruling party.
All non profit organisations in Pakistan now have to be certified by an Independent Certification Agency to become eligible for tax benefits and we are pleased to report that the Pakistan Centre for Philanthropy evaluated LRBT, giving them 84.3% against a minimum requirement of 60% for eligibility of tax benefits.
HIGHLIGHTS
On World Sight Day 2004, the Standard Chartered Bank (SCB)office in Karachi organised a press briefing for local electronic media to announce its formal launching of the Seeing is Believing (SiB) programme in collaboration with SSI. The Programme Officer from the SSI Country Office attended and the Managing Trustee of LRBT was also present to give a briefing about LRBT’s work.
As a component of the SCB surgical training scholarship, LRBT is going to start a manual small incision cataract surgery (MSICS) training programme for its own surgeons, and also surgeons from other NGOs from January 2005. LRBT has a plan to provide this training to accomplished ophthalmologists having a minimum output of 500-700 cataract surgeries per year. Two ophthalmologists, one in Lahore and one in Korangi, will be trained each month. This is a very important contribution to the overall efforts of the SiB programme as MSICS is seen as being of major importance in the development of sustainable surgical services throughout South Asia. Three senior doctors from LRBT have now received MSICS training at Lahan in Nepal and will be the Master Trainers for the LRBT training in MSICS.
Across the entire LRBT network there has been a 33% increase in outpatient department visits and a 37% increase in surgeries, in comparison to targets. Likewise there has been an 18% increase against 2003 output.
TIMESCALE
2004 - 2006APPROXIMATE COST (Year 1, 2, 3 & Total)*
US$400,000 over the three years
Due to the nature of our partnership with LRBT, our support for 2004 totals US$331,040. The protocol for support for 2005-6 is currently being finalised, but is forecast to be approximately US$300,000 per year. Standard Chartered’s support is for the implementation of programmes at two LRBT hospitals: Korangi and the Eye and Cancer Hospital in Lahore.
* Note all stated costs are provisional figures
ESTIMATED NUMBER OF TOTAL BENEFICIARIES
54,000 people will receive sight-restoring operations and another 325,000 people will receive medical treatment and / or other types of surgical treatment, through LRBT.
Information compiled on 20/6/05 by Peter Renew and Katy Dore at SSI, for publication on FundraiseOnline.
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