VISION 2020 is an umbrella project encompassing five individual health links aimed at strengthening eye care training in Eastern Africa – currently Kenya, Uganda and Tanzania – through visit exchanges.

The links involve the following hospital trusts:

Eastern Africa Teaching Hospitals:
1. Muhimbili University of Health and Allied Sciences – Tanzania
2. Kilimanjaro Christian Medical Centre – Tanzania
3. Mbarara University of Science and Technology – Uganda
4. Makerere University Hospital – Uganda

Partners from the North:
1. Guys and St Thomas Foundation Trust, London
2. University Hospital Birmingham NHS Foundation Trust
3. United Bristol Healthcare Trust
4. Royal Free Hospital, London

Harsh realities of East African limited sight sufferers

In the three countries involved within the link, there is an estimated 1,010,000 blind people, 3,030,000 with uncorrected refractive error and a further 4,170,000 who suffer from low vision. The number of blind people is expected to rise to 2 million by 2020 unless effective interventions are put in place. Eye care in Eastern Africa is characterised by inadequate personnel and facilities; poor state funding, with preventable and treatable conditions being the leading causes of blindness; and lack of educational and training opportunities.  In Eastern Africa, approximately 140 ophthalmologists are expected to treat a population of 140 million people – an estimated ratio of one ophthalmologist per one million. 60% of these are based in the capital cities of Kampala, Dar es Salaam and Nairobi. With WHO recommending 1 ophthalmologist for every 250,000 persons, there is a desperate need for Human Resource Development (HRD) in Eastern Africa.

The umbrella of improvements

The target of VISION 2020 has been the people of Eastern Africa who suffer from blinding eye diseases, with consequent personal suffering and economic deprivation that affects their families and communities. To reach this goal, the links have aimed to develop a cohort of well trained and accredited ophthalmologists that are able to provide better quality care for their patients and to train future ophthalmologists for Eastern Africa. The improved training and range of activities of eye care workers (including eye nurses, OCOs, optometrists, orthoptists and refractionists) in the four training institutions in Uganda and Tanzania have increased their skills, job satisfaction and morale. An institutionalised collaborative framework has been developed that enables the institutions to expand learning opportunities in areas of mutual interest. Through this programme, the network between East Africa College of Ophthalmologists (EACO) and the five teaching hospitals from the region has been strengthened. EACO has received requests from the DRC to support the local universities in developing an ophthalmology training curriculum as well as from the Aravind University, India to support subspecialty training and exchange visits.

Making a difference

“As a result of my three months’ experience I have improved my ability to serve my patients and to teach both residents and undergraduates better. I improved in my ability to assess patients with orbital and oculoplastic conditions and improved my surgical skills in those areas to a modest extent” - Amos Twinamasiko, an Associate Professor in the Department of Ophthalmology of Mbarara University Faculty of Medicine

“I had an opportunity to learn about other courses that are offered at the facility including MSc in Community Eye Health which seeks to enhance skills, knowledge and attitudes of eye health workers, mostly clinicians, whose training is biased towards clinical medicine but who are involved in community eye health programmes.  This is important information to be able to provide information to those ophthalmologists aspiring to acquire new knowledge, skills and attitudes in community eye health” – Danny Irungu, Programme Manager, EACO on his five-day visit to the International Centre for Eye Health (ICEH) at the London School of Hygiene and Tropical Medicine (LSHTM) and the Royal College of Ophthalmologists (RCOphth).

IHLFS Team, British Council Kenya