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Blindness in Pakistan - a growing problem.

Blindness in Pakistan - a growing problem

The very root of this programme towards Prevention of Blindness and tackling the curable population, can only be achieved, if there is political commitment to it by the Governments, irrespective of their party affiliations, to get the programme included into a National Five Year Plan

There are two types of blind in any given society; only the numbervaries. One, those who cannot see due to some defect in their eyes and the others who refuse to see despite perfectly normal eye sight - refusing to recognise the obvious -"the seeing blind" or the ostriches, as they are generally known. There is no dearth of either category amongst us! But being an Ophthalmologist, concerned with the eyes medically, I would better stay put with the subject of blindness in its physical aspects, only hoping that those who refuse to see the problem of real blindness may at least have a good look at it. In any scientific study, statistical data as accurate as one can get, should be the basis for a start. According to the Blindness Data Bank of the World Health Organization, the statistics for blindness in Pakistan are as follows:

The data above may be supplemented by recent information from a study conducted by Professor Saleh Memon in the rural areas of Sindh and Balochistan which reveals that out of 19,448 eyes examined, 2.45% had vision lower than 3/60 and 4.3% had vision of 6/18 to 6/60. The major causes of these low and poor vision were cataract in 73.60% errors of refraction in 6.90%, corneal causes were 11.60%, glaucoma 2.50% and others 5.30%.

If we convert these standards to the national scale which would be a fair assumption, we would arrive at a grim figure of 2.5 million blind people to which part of 4.6 million are almost ready to join unless something is done in an organized manner to check the onslaught of blindness in Pakistan.

And the scenario though grim by itself is only the tip of iceberg, for it has been pointed out by almost all the speakers including the representatives of the International Agency for the Prevention of Blindness as well as the regional representatives of the W.H.O. in Asia at a recently concluded session on Prevention of Blindness at the XIIth Congress of Asia-Pacific Academy of Ophthalmology in Seoul, South Korea, that if the problem of prevention of blindness is neglected or postponed, by the Year 2030, i.e. 40 years from now, it would be multiplied four times due to: a) aging population producing more

patients b) genetically transmitted diseases c) rise in diabetic blindness and d) the failure of medical and paramedical

facilities to keep pace with the growth

in population both by birth rate and the

better life expectancy.

When the above mentioned observations are applied to Pakistan, with the stipulations of increase in the population at a very modest rate of 2.5% per annum, further increases through better life expectancy, improved living conditions and reduction in infant mortality etc., we would end up, even by most conservative estimates, at a figure of about 10 to 12 million prospective blind people who will need attention to stop them from going permanently blind. Are we even thinking about it, leave alone planning for it on a national scale?

It appears that only the N.G.Os (Non-government Organizations) are presently active in the field of preventing curable blindness and had it not been for their efforts and enthusiasms, Pakistan would have been in a terrible situation, not that we are in any comfortable position even now. But the N.G.Os cannot be expected to tackle such a problem of national magnitude without the involvement and active participation of Government, both at the Federal and the Provincial levels.

The very root of this programme towards Prevention of Blindness and tackling the curable population, can only be achieved, if there is political commitment to it by the Governments, irrespective of their party affiliations, to get the programme included into a National Five Year Plan and committing adequate financial provisions in if for: a) Allocations for Preventable Eye

Diseases b) Curative programmes like eye

hospitals and eye centres all over the

country-the existing facilities are

enough. c) Manpower development of training

eye specialists by establishing one

national and four provincial institutes

of ophthalmology which should be

manned by full time teachers and

students who should be well prepared

forresearch in prevention and cure of

blindness. Para medicals should be

trained side by side because without

this pillar of support, no plan can be

implemented and is bound to stumble

and stop. d) Science of Ophthalmology has

advanced to its present state due to its

equipment, precision is required when

dealing with micro-needles and micro-instruments,

not only the skill

counts, but the skill can only be

practised with required instruments.

Operating Microscopes, Lasers, Ultrasound

etc., are some of the most required

accessories to good results. In the

same context, if we should invest in

these expensive machines, we need

to have adequately trained

technicians and electrical electronic

engineers for its upkeep and maintenance.

These are no ordinary problems and each will need integrated attention andapproach by those responsible to execute the national mandate. The best service that any political party and Government could give to the Blind people of Pakistan is to create a high powered autonomous body of respected individuals interested in promoting the cause of prevention of blindness from all sectors of life, like businessmen, bankers, lawyers, chartered accountants, newspapers owners, editors and journalists, advertising agency, social service organisations like the Lions and Rotarians, Professional Managers (M.B.As), N.G.Os, involved in the work. This Committee should be nonpolitical and service oriented which should form the board of trustees.

At the second tier, there should be planners who should put up a National Plan drawn up by them in consultation amongst themselves. These should consist of Ophthalmologists and N.G.Os at each provincial level; and ex-officio one expert from Planning Division and Ministry of Health to guide the Ophthalmologists. The plan and budget so prepared be presented to the Board of Trustees by the Ophthalmologists and N.G.Os on behalf of the planners to convince them of the feasibility.

The Board of Trustees will be responsible for: a) All the finances given for the purpose

in the National/Provincial Budget on

five years basis. b) Will be free to raise its own finances

from the private and public charities, c) From Overseas charities and

individuals. d) Will present an annual report to the

Nation on its efforts and results for

the year. e) Will be free to cooperate with any

other national or private organisation

formed to prevent and fight blindness

in achieving the goal. Each of the

national and provincial institutes will be

fully autonomous and will co-operate

with each other and government grants

will be given for their administrative

and other costs, but the committees

so running the institute will be entitled

to raise their own finances through

donations etc. Each institute will

publish their annual reports and financial

audited statements for public

scrutiny, through the National Board of


In return for the autonomous status granted without political interference, financial discipline and sound administrative and professional practices will be the corner stone of tier.

If the above suggestions could be implemented to start with: a) Small select study group with a

targeted date be formed who will be the

future Board of Trustees and

responsible for drawing up a "National Trust

for the Prevention and Cure of

Blindness". b) If agreeable the National Prevention of

Blindness Programme of

neigbourhing countries with almost similar

problems be acquired and studied. c) Provision for a corpus be made in the

next budgets of federal and provincial

governments in accordance with the

population based data 100 million rupees

at the rate of Re.1/-per head of

population would bemodest but fair basis

to start with. This could be

supplemented from Zakat Foundation and

Foreign Aid being given for social

services in the ruralarea.

The Programme is multifaceted: i) To prevent blindness so that the

socio-economic pressures on the

families affected is reduced. ii)To rehabilitate who are blind by way

of education of blind children and

youngsters, job opportunities after

adequate training of the adults,

succour to those who cannot be fitted

into the system, white cane projects,

talking books, braille Presses. The

idea if persuaded, in right spirit, and

to its logical goals could benefit

hundreds of thousands and make them

self respecting, self reliant Pakistanis.

All this can be done, if we have the `political will' to do it. It is a challenge worth its weight in gold. [Tabular data Omitted]
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Title Annotation:Pakistan
Author:Wania, Jamshed H.
Publication:Economic Review
Date:Aug 1, 1990
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