Self-funding surgery system on the way to help blind

Fitri Wulandari, The Jakarta Post, Jakarta

Cataract, which has affected millions of mostly impoverished Indonesians, has become a national headache, but help may be on the way soon.

The Indonesian Association of Ophthalmologists (Perdami) released a report that shows that three million people throughout Indonesia (1.47 percent) suffer blindness and 1.5 million of those are victims of cataract. Each year, 210,000 people lose their sight due to cataract-related problems.

The World Health Organization (WHO) has ranked Indonesia first with the highest number of blindness cases among Southeast Asian countries.

With only 700 ophthalmologists throughput the sprawling archipelago of over 17,000 islands, Perdami estimates only 80,000 people can be operated on each year.

Surgery costs around Rp 500,000, which is far too expensive for the majority of people with cataract because around 80 percent of those with cataract are poor people.

Perdami chairman Istiantoro proposed a self-funding operation system because the government just does not have the money to shoulder the surgery costs, purchase facilities or train ophthalmologists.

In this scheme, a medical school or a public health care center, with the help of an international non-governmental organization (NGO), sets up and manages its own eye surgery room.

"It is impossible to wait for the government's assistance. It is better for the community to take the initiative," Istiantoro told The Jakarta Post.

He cited an example of a self-funding eye operating room or OK Mata Swadana, run by the medical school of the University of Indonesia. It was set up two years ago with the help of Christoffel Blinden Mission, a German based non-governmental organization.

OK Swadana has two operating rooms with international standards. One is for the well-to-do patients and the other is for poor patients.

This model allows a "cross-subsidy" system. The wealthy patient has to pay for the service but the poor do not.

In addition, the NGO-operated eye centers can serve as a training ground for ophthalmologist candidates to upgrade their skills, Istiantoro said.

Cataract is a cloudiness in the eye lens which causes gradual loss of sight. It mostly happens to people after the age of 50. In a few cases it is caused by trauma such as overexposure to ultraviolet light, an accident or an injury.

It can only be treated with surgery to remove the clouded lens and replace it with an implant lens.

"The NGO model has many benefits. We can help more poor people, improve ophthalmologist skills and money comes (from foreigners) to manage the facility. Hospitals will also benefit because there will be less poor people who come asking for free cataract surgery," Istiantoro said.