Elimination of mass blindness: Is it a basic human right?

Elimination of mass blindness: Is it a basic human right?

By Rita A. Widiadana

SINGAPORE (JP): Arthur Lim Siew Ming is the clinical professor
and head of the department of Ophthalmology at the National
University of Singapore and the head of the Singapore National
Eye Center.

At 65, the inventor of Lim's lens, an artificial lens implant
used in thousands of cataract operations to restore normal
vision, has been restoring the eyesight of more than one million
people blinded by cataracts in Southeast Asia, China, India and
Bangladesh.

As president and founder of the World Cataracts Surgeon
Society, he has long been an outspoken critic of international
organizations which have failed to effectively manage and treat
mass cataract blindness in Asia, where an estimated 20 million
people suffer from the disease.

Calling the elimination of eye diseases a human right, he has
criticized these organizations for "discriminating against" the
third world by continuing to use outdated methods.

In his fight against blindness, Lim has helped raise millions
of dollars and trained eye doctors in the region. "When I was
young, I was taught to give 10 percent of my pocket money to
charity," said the professor, the son of a wealthy lawyer and
politician.

Tan-Hoong Chu Eng, the general manager of corporate marketing
and physician relations at Parkway Group Healthcare, warned that
the professor often appeared a quiet and sometimes reticent
person unless he was in a good mood. His tight schedules have
often prevented him from meeting with the media.

An interview with the man long recognized as one of the
world's leading ophthalmologists, however, turned out to move
easily along with him sharing his thoughts from eye diseases,
cataract blindness and health care in Asia, to his hobbies and
his great passion to arts and literature.

A friend of President Abdurrahman Wahid, Lim said he used to
talk with him about eye problems, health, social issues to pop,
jazz, classic music, arts, culture and new books.

"Certainly not politics. He is a broad-minded and multifaceted
man," Lim said as he showed several photographs in which he posed
with the President, Malaysian Prime Minister Mahatir Mohammad and
Chinese leader Li Peng, all of whom are his close pals.

Lim acknowledged that he had direct access to Abdurrahman as
he had his private telephone numbers. "He said he would not be
able to read my letters or my faxes so he gave me his personal
numbers," Lim smiled.

He has numerous Indonesian friends from all walks of life,
including eye surgeons and business tycoons such as the Riadi
family of Lippo Group and art connoisseur Sutedja Neka.

Lim is an avid art collector (listed by Art International
magazine as one of the 200 great art collectors in the world) an
aspiring painter and sculptor. He has written medical text books,
short stories, novels and poems.

Entering his spacious office and eye clinic at Gleneagles
Hospital was a journey into the art world. The professor was
proud of his collections of paintings by Affandi, Srihadi, Jeihan
and many others. His Chinese paintings by Chen Wen Hsis were
scattered everywhere on the office's walls.

While painting his self-portrait, the professor talked about
eye problems in Indonesia and other Asian countries. The
following is an excerpt from the interview.

Question: How do you view eye problems in Indonesia and other
Asian countries?

Answer: Similar to other Asian countries, eye problems in
Indonesia are very serious, especially when the economic crisis
hit the country.

Many children are malnourished and older people suffering from
cataracts and other eye diseases find it difficult to get proper
eye care because of escalating medical costs.

I have frequently visited Jakarta and places outside Java.
The situation between a capital city and remote islands is of
such contrast. I am so concerned over the health condition,
including eye problems, of children and adults in remote places
because they have no access to quality health care.

In Asia, eye problems and mass blindness are mostly caused by
malnutrition and infection. These kinds of eye diseases are
actually preventable and curable but little effort is made to
eliminate them.

Do you mean that people and governments in Asia have done
nothing to solve the problem?

Why have we failed to prevent blindness from trachoma when we
have known the cure for decades? Why do a quarter million
children become blind from vitamin A deficiency each year when we
know it takes just an annual nine cents per child to prevent
this? Why are there millions who become blind from cataracts when
the condition can be simply cured by removing the opaque lens?

The reasons for the failure of Asia's eye care delivery system
are complex. They are dependent on the political, socioeconomic
and cultural factors.

The majority of Asian countries are developing nations. Their
governments have been working hard to improve basic needs like
housing, education and other primary needs. Eye disease is not
the only problem.

It requires a strong political will to change this frame of
mind. Vision is important in the lives of people. When thousands
or millions of people are blind or visually impaired, a country
will suffer from major social and economic losses.

Mass blindness is a manifestation of poor organization and
poverty and will double by the year 2000. The main reason is the
failure to mobilize knowledge and technology into effective
action.

Is there any quick solution to such problems?

There are a lot of things people and governments can do to
help reduce eye problems. People should be encouraged to take
care of their eyes. In the past, the World Health Organization
(WHO) delivered vitamin A tablets to cure vitamin A deficiency
among children, especially in third world countries like
Indonesia. It was so impractical. Mothers can cook their children
a large variety of cheap green vegetables in their daily meals.

Mobilization of medical people, eye surgeons, the government
and the community is important. I believe Indonesia and other
Asian countries have capable eye doctors and surgeons but they
are concentrated in urban areas.

It is urgent to persuade them to go out to rural and remote
villages. Prevention of blindness has for decades been the role
of nutritionists and public health workers combined with lay
volunteers.

Your ideas sound excellent. Do you think it feasible for the
Indonesian government to adopt it?

For me, this is the best time for Indonesia to move on. Your
President is suffering from eye problems so he will really
understand and feel the urgency of having quality eye care
centers and other health facilities.

But it will require quite a lot of funding which Indonesia is
now lacking. Do you see any possible resources or help?

It is the job of the United Nations, rich countries and
international organizations like Lions International, the Rotary
Club, Helen Keller Institutes and other agencies to help nations
in need.

Two years ago, a number of international eye surgeons,
including myself, established the World Cataract Surgeon Society.
It works to mobilize eye surgeons to utilize their skills to the
benefit of less fortunate people. It is not just an international
and professional organization, it is about humanity -- the
willingness to help the needy. It is a challenge the eye surgeons
of the world should accept.

How does society work to carry out its mission?

The number of eye doctors and surgeons in Asia is still
limited compared to the rocketing number of patients. We would
like to train and share experiences with our colleagues in Asia
and around the world on the latest technology for curing eye
problems. I would be very much willing to train Indonesian
doctors. In the past, many doctors from developed countries came
to poor countries and performed several eye operations, and that
was all they could do.

We prefer a different approach. If you give a man a fish, you
feed him for one day. If you teach him how to fish, he can feed
himself for a lifetime. If you operate on one man, you restore
vision to one man, but if you train your colleagues on how to
perform low-cost quality cataract surgery, they will help save
the world.