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Poverty, Cost-Effectiveness and Eye Care

Blog submitted by Barbara A. DeBuono, MD, MPH

Barbara A. DeBuono, MD, MPH is President and CEO of ORBIS

Cost-effective analysis is a measure that is discussed frequently in the context of healthcare in the United States. This process compares the costs and the benefits of a healthcare-related intervention. In the field of eye care it is clear that the benefits outweigh the cost.

On World Sight Day, I had the opportunity to attend a VISION 2020 congressional briefing in Washington DC with other eye care partners and government officials. The theme of the event was Cost Effectiveness of Blindness Prevention Activities. The event featured a presentation by Dr. Kevin Frick, professor at John Hopkins University Bloomberg School of Public Health and an expert in calculating cost-effectiveness of health care.

We all know that the cost of blindness and visual impairment in the United States is enormous. According to Dr. Frick, in the United States a blind individual aged 40 or older spends an extra $2587 on medical care every year. In 2008, the estimated United States societal medical cost of all blind individuals was $2.7 billion.¹ Imagine what this would look like on a global scale.

When we apply these factors to the developing world, this cost goes beyond an economic and financial burden. Yet, we do not have strong data and research to support this assumption. What we do know is that blindness and visual impairment impact quality of life. In these communities, these conditions can hinder an individual’s ability to gain an education, gain employment and contribute to family financial stability. Ultimately, this can trap a family in a cycle of poverty. Studies have shown for example that individuals with cataract are more likely to be poor than those with normal vision.²

There has been little research to examine the correlation between blindness and poverty. ORBIS and partners in South Africa are currently working to help fill this gap. Using results of a household survey conducted by the South African War on Poverty Initiative, ORBIS and partners collected data regarding eye care in poor South African households. This will be followed by an analysis of the relationship between factors such as disability, access to healthcare and blindness. The results will be shared with the South African government for planning and advocacy purposes.  Examining blindness in the context of poverty can serve as a powerful advocacy tool for increased budget and attention to eye care services.

This is the data and information we need to put eye health on the global agenda. At ORBIS we hope to continue to work with global partners and use such data to advocate for increased eye care services and blindness prevention globally.

Children perform at the opening celebration for the ORBIS supported Pediatric Eye Care Center in Durban, South Africa in partnership with the KwaZulu Natal (KZN) Department of Health.

1. Frick, K. “Cost-Effectiveness of Blindness Prevention” Vision 2020 World Sight Day 2012 Congressional Briefing. Washington DC

2. International Center for Eye Health. (2009). Cataract Impact Study: Summary report. Retrieved from https://www.iceh.org.uk/display/WEB/Cataract+impact+study#

The Great Ethiopian Run: I’m elated, and terrified.

Blog submitted by Charlotte Coleman-Smith

Charlotte Coleman-Smith is one  of the over 30,000 people who will take to the streets of Addis Ababa to participate in Africa’s biggest road race – a challenging 10km at 10,000 feet above sea level.  She is part of the ORBIS Ireland team taking on this massive challenge at the end of November 2011. Charlotte shares with us her preparations, fears and excitement in anticipation of the race.

After two years of procrastination, I've finally made the decision to join the ORBIS Ireland team on the Great Ethiopian Run. I'm elated, and terrified.
 
Elated - because it's the trip of a lifetime, a huge personal challenge for me, and a chance to prove that I am more than just a Mum, and all-round domestic goddess. I get to go to a fascinating country - one that's been on my list for many years and I can't wait.
 
More importantly, by supporting ORBIS, I'm turning my mind towards people who are so much less fortunate than myself. The pictures I've seen of little boys suffering from trachoma in quiet agony, red-eyed and despairing, contrast so starkly with my three strapping, healthy, happy sons. Their situation throws so many things in perspective. And because the aim of ORBIS in Ethiopia is so simple - to restore sight - it makes my goal crystal clear. This helps hugely with motivation when I am dying of boredom on my fourth lap of the local sports field.
 
I'm terrified, though, because I'm no athlete, and 10k is twice as far as I'm used to. In 2010 I was in hospital more times than I care to remember, having been diagnosed with breast cancer in 2009. I'm certainly fit to go now, but I'm keeping my expectations low - I'd like simply to finish the course. 
 
As I write, late at night, I’m basking in the scent of newly baked brownies and fresh flowers. Every chair we own stands to attention against any available wallspace, in anticipation of a crowd of mums (and possibly one dad) I’ve invited over tomorrow morning. The dishwasher is labouring over its load of sticky spoons and cake beaters.

The time has nearly come for my fundraising coffee morning.

‘Nice life you have’, shrugged my husband earlier as he eyed the cakes and scones. ‘Coffee mornings, trips to Ethiopia ...’ I remind him that after I’d cooked and cleared up the family meal, I did 5k on the treadmill in the gym, returned to the kitchen and incorporated my own body weight in sugar and dark chocolate into 46 brownies. It’s not easy being an elite athlete.

I’m new to the area, so I’m not sure how it will all go. I’m hoping that the mix of caffeine and chocolate will entice my new friends to be generous to the cause. Who knows, I might well recruit some victims for next year’s run.

In just one week we’ll be on the plane to Addis. What a thought. If I go to the gym every day, I wonder if that’s long enough to work off a plate of brownies?

Charlotte Coleman-Smith