Wed, 23 Feb 2000

Vision 2020 campaign fights for people's right to sight

JAKARTA (JP): People's ignorance about eye care, poor nutrition and the inadequate number of ophthalmologists combine to keep the incidence of preventable blindness high in Indonesia.

The World Health Organization (WHO) says an estimated three million of Indonesia's 206 million people are blind. And even worse, this number increases by 600 every day.

To reverse this trend, WHO and the Global Task Force, which includes several non-governmental organizations, launched last week a national drive called Vision 2020, to help eliminate preventable blindness in Indonesia. The time frame to achieve this goal is 20 years, or in the year 2020.

The campaign was launched by Vice President Megawati Soekarnoputri on Feb. 15, the day after the Intercountry Consultation on the Development of Regional Strategy for Vision 2020 opened. The meeting ended on Feb. 17.

WHO Southeast Asia regional director Uton Muchtar Rafei said that in this day and age, with major advances in medical technology, "it is unacceptable that we have not been able to better control preventable blindness. It is unacceptable that even today, millions who could be saved go blind".

There are 45 million blind people in the world today and there are three times as many people with impaired vision. Of this number, 15 million, or nearly one-third of the world's total number of blind people, live in Southeast Asia.

According to WHO, most cases of blindness can be prevented or cured. These include blindness caused by cataracts and Vitamin A deficiency, and childhood blindness. Trachoma and glaucoma also account for a number of cases of blindness in the country.

"Unfortunately, many are severely disabled visually from easily correctable or preventable causes. Some cannot see merely because they do not have a pair of glasses to correct the refractive error," Uton said in a speech at the launch of the Vision 2020 campaign.

Ninety percent of the cases of blindness in the region are preventable or curable at very modest costs, according to Uton.

He said those suffering blindness from cataracts could easily be cured through a simple surgery. A quick operation can be performed to remove the cataract and insert a lens for as little as US$15.

"Yet it is hard to believe that we have close to 10 million people in our region who have gone blind due to cataracts," Uton said.

In Indonesia -- the country with the third highest incidence of blindness in the world -- there are at least 1.5 million cataract cases.

"There is a need to increase the number of people who can be trained to perform this simple operation. Without an increase in the number of service providers, thousands will remain permanently blind," Uton said.

Indonesia's some 500 ophthalmologists perform around 40,000 cataract operations per year -- lower than in Bangladesh and Thailand, where 60,000 cataract operations are performed each year.

Around 630,000 cataract operations per year need to be performed to cure the 1.5 million Indonesians suffering from cataracts.

"At the present rate of 40,000 cataract operations per year, it will take 25 to 30 years to clear the backlog of 1.5 million cataract cases," Uton warned.

But people suffering from cataract can breathe a sigh of relief. According to the Ministry of Health's director general of community health, Azrul Azwar, the Indonesian Ophthalmologists Association has agreed to train general practitioners at community health centers to give them the skill to perform cataract operations.

"In the first phase, the ophthalmologists will train the general practitioners practicing in areas which have a high incidence of cataract cases," he said.


According to WHO, the global cost of blindness is around US$25 billion in lost productivity. If the costs of educating and rehabilitating the blind were included, the price would be twice as high. In fact, the worldwide cost would rise to over $75 billion annually if the expense of caregivers was also taken into account.

"In a country like Indonesia, the cost of blindness is estimated to be $1 billion annually in lost productivity and in special education and rehabilitation for the blind," Uton said.

He said programs for the prevention and control of blindness were among the most cost-effective public health interventions.

"Blindness aggravates poverty, therefore preventing and relieving blindness are effective measure of alleviating poverty." (ste)