Treatment of cataracts still poor, ophthalmologist says

Yuli Tri Suwarni, The Jakarta Post, Bandung

An ophthalmologist from the Bandung-based Pajajaran University has expressed concern over the poor treatment of cataracts, which cause half of all blindness cases in Indonesia.

Gantira Natadisastra, a lecturer at the university, said he feared the poor treatment was set to continue, leading to an increase in the incidence of blindness in the country.

He said that existing ophthalmologists were able to conduct cataract operations on 50,000 patients in the country per annum, far below the number required to keep pace with the growth rate of new cataract patients.

According to data from the World Health Organization (WHO), the number of blind people in Indonesia reached over 2.9 million in 1997, with an average increase of 250 people per one million every year.

"If the number of those suffering from cataracts is increasing by 210,000 annually, about 160,000 of those affected by the disease are unable to get proper medical treatment, and are believed to suffer total blindness, every year," Gantira explained.

The WHO says that over 1.5 million people in Indonesia are currently affected by cataracts, putting Indonesia in second place behind India in terms of the number of sufferers in Asia.

Of the 50,000 cataract patients operated on every year, about 10,000 are treated in hospitals and the other 40,000 under a cataract safari program launched in various areas throughout the country, Gantira said.

Gantira, who was installed as professor of ophthalmology at the Pajajaran University's Medical School in Bandung on Sept. 29, 2001, said that, based on a survey of eye and ear diseases conducted by the Health Ministry between 1993 and 1996, the implementation of various public health programs in the provinces had been left far behind by the growth in the incidence of blindness.

He said that the survey, which was conducted in West Java, Central Java, East Java, South Sulawesi, North Sulawesi, West Sumatra, South Sumatra and West Nusa Tenggara, demonstrated that the programs had not managed to curb the growth of blindness.

Instead of falling, the number of blind people actually rose from 1.2 percent to 1.47 percent of the Indonesian population in the 1993-1996 period.

Gantira explained that the prevalence of blindness had caused Indonesia to suffer total losses of approximately US$1 billion in productivity, in addition to the costs of special education and rehabilitation for the blind.

He also explained that the implementation of the WHO program -- Vision 2020: The right to sight -- launched in February 2000 to fight against blindness, had not run as well as expected.

"The poor implementation of the program is caused mainly by the limited availability of resources," said the eye specialist.

He further disclosed that the number of ophthalmologists in Indonesia reached 700 in 2000, serving the country's population of 210 million.

However, most of the ophthalmologists prefer to work in hospitals in capitals of provinces or regencies and municipalities, and only a handful of them are prepared to work in public health centers (Puspkesmas) in subdistricts.

For example, only two of the 92 ophthalmologists available in West Java work in Puspkesmas at present.