Vietnam

Vietnam The Bring Back Vision project aims to restore sight to those who are blind and bring blindness prevention firmly into the priorities of local health authorities.

Lead Agency
The Fred Hollows Foundation (FHF)

Name of Project
Bring Back Vision - Capacity Building for Eye Care in Quang Nam Province

Name of Partner/Implementing Organisation
Quang Nam Department of Health

Location
Quang Nam province in Central Vietnam

BRIEF DESCRIPTION

There are currently more than 100,000 sight-restoring cataract operations being performed in Vietnam annually. The vast increase in numbers of operations over the last few years is an indication of the success of comprehensive blindness prevention initiatives such as this. Unfortunately, many disadvantaged provinces, like Quang Nam, have not reaped the benefits of this progress. Quang Nam is a very poor province in coastal, central Vietnam, with the population of 1,500,000 people. It has sixteen districts, including eight mountainous districts where people of ethnic minorities live. 90 percent of the population are farmers, and annual per capita income is estimated at US$250. The prevalence of blindness is about 1.2 percent of the population, i.e. about 17,500 blind people. The number of people with blindness due to cataract is about 8,000. The capacity to manage blindness prevention is very weak - for example, there is not even an operational Eye Station in the province.

About 500 cataract operations are performed per year at the Eye Department of the Provincial General Hospital, leaving the people in the mountainous areas with no accessible service. There are about five eye surgeons, but they lack essential surgical equipment. While there is a willingness to improve the situation, there is a lack of infrastructure to address other eye problems such as refractive error in schoolchildren, trachoma and general lack of awareness of eye care in the community.

Vietnam Map

BACKGROUND

Eye care in Vietnam runs on a two-tier system, partly through the Ministry of Health and its network of Provincial and District hospitals, many of which will have an eye department. These departments are dependent on walk-in patients. The second system consists of eye stations which promote community ophthalmology under the directive of the Vietnam National Institute of Ophthalmology. This system delivers community level services and actively promotes eye health and the identification of patients needing treatment.

The objectives of the Fred Hollow Foundation (FHF) project in Quang Nam are:

1. To develop the primary eye care system from province level to communities through training and providing necessary medical equipment.
2. To increase awareness and knowledge of primary eye care among local people, leading to blindness prevention practices.
3. To offer eye treatment and cataract surgery for poor people, and to examine and supply glasses for school pupils.
4. To build the capacity of the key eye authority to manage primary eye care programs, and to sustain and develop eye care activities.

PROGRESS

During the preparation period of the project the following activities were accomplished.
As 2004 is the first year of the project, needs assessment and project design have been key areas of work. Since June, FHF staff have visited Quang Nam to meet with the Provincial Department of Health, the Provincial General Hospital, Eye Department, and the District Health Centre for needs assessment, project design and budget discussions. Documentation was sent to Sight Savers International (SSI) in July and once approved the first activities were launched.

In October, FHF programme staff met with the Chief Executive of Standard Chartered Bank (SCB) in Viet Nam - Mr. William A. Gemmel. The meeting resulted in Mr Gemmel agreeing to support the project. Also, Mr. Vo Trong Ky the Executive Director of SCB in Vietnam, who attended the World Sight Day celebrations in Nui Thanh, had discussions with Quang Nam health leaders, and confirmed SCB support for the project. FHF Vietnam opened a project account for the SCB program at SCB Hanoi to receive funds.

A project planning workshop was held in Quang Nam in October, attended by representatives from the health and education sectors of the province's 16 districts. This stakeholders’ workshop discussed how support and co-operation would assist the project in achieving its objectives.

The agreement between FHF Vietnam and the Quang Nam Department of Health was signed on the 27th October. Programme activities began after this date.
The FHF team made regular visits to the provinces for technical support and checks. The project received strong support from local government leaders. A Project Management Board has been set up and the Director of Provincial Department of Health is the Board chairman. In December, the International Programs Managers for FHF together with FHF Vietnam team traveled to Quang Nam to meet the partners, review the work and assess needs.

In December, FHF organised a workshop in Danang city for its provincial partners. The workshop covered project management, including planning and implementation, as well as capacity building for project partners. A computer was provided to the Project Management Board for reporting work and email communication. Two training courses on Primary Eye Care and cataract patient screening were provided to 100 community and village health workers in Thang Binh district and Tam Ky town, as a step towards establishing local eye care systems, advising people on eye care, and screening patients in mobile surgery campaigns. All the above will contribute to the effective running of the project.

The following implementation activities were subsequently accomplished:

In October 2004, the World Sight Day Celebration was held in Nui Thanh district of Quang Nam. The celebration contributed to raising awareness of community eye health. The message was that cataract blindness is treatable and vision can be restored with simple cataract surgery.

The December project management workshop was attended by FHF project staff and key project members from Quang Nam project management board, and was an opportunity for all to learn from experience and good models of blindness prevention activity.
A surgical bio-microscope was provided to the Eye Department of Quang Nam Provincial General Hospital to support their surgery capacity.

SITUATION

This is the first blindness prevention project in the province. As mentioned above, the project received strong support from the provincial government and other local sectors. The leaders of the Quang Nam Department of Health are delighted to be involved, as compared to other areas in the country, Quang Nam's eye care system is weak with no eye centre or hospital in a province with a population of nearly 1.5 million.
After receiving surgery, patients have returned to live with their families, but are now living more independently. Communities now "believe" in eye surgery that can restore sight to the blind, which will play an important role in mobilising patients for surgery.

The project plan is to:

(1) Strengthen the capacity of the provincial Department of Health to manage blindness
prevention;
(2) Establish an operational Eye Station in the province;
(3) Increase the cataract surgical rate through enhancing surgeon’s skills and providing
essential surgical equipment;
(4) Facilitate access to eye care services for poor people through enhancing the network of community health workers, fostering eye care education activities and enabling mobile
teams to reach remote communities.

TIMESCALE

October 2004 - June 2005
· Establish Eye Station and train eye surgeons
· Provision of equipment
· Mobile teams set up

June 2005 - September 2007
· Cataract surgery
· Trachoma control
· Refractory disorder reduction in schools
· Community eye care awareness raising and education