Curing blindness in the third world

Dr James Muecke is an Adelaide-based ophthalmologist who co-founded the Sight For All Foundation. After I interviewed him for medicSA magazine about his work preventing blindness and how the Foundation came to be, it reminded me of something the Rev Tim Costello had said to me when I interviewed him, about how in a world where 40,000 kids die each day from preventable diseases, “surely political and spiritual imagination might have a go at that problem, and say why don’t we really solve this? There’s wonderful challenges out there to have a go at.” Dr Muecke is taking on such a challenge whole-heartedly.

Back in 1989 James Muecke worked as a volunteer at a small hospital in the mountains in Kenya. “One of the reasons I enjoyed that so much was that people actually got better. I’d come from my internship at the RAH where there was so much chronic disease, and patients just seemed to be on a downward course… so actually helping people get getter was a very special feeling.”

At the same time James was exploring ophthalmology as a career.  “My interest then turned towards blindness prevention. And with about 45 million people around the world who are blind, and 160+ million who are visually impaired, there’s a lot of work that is needed in this area.”

After he finished his eye training, James worked in Jerusalem in the refugee camps and villages in the Palestinian occupied territories.

“That continued to build my interest… and when I finally came back here to settle down and work – about 13 years ago – I wanted to continue doing that work, and I got involved with Henry Newland doing blindness prevention work in Burma, and together we built up a program there.”

Over the last few years, this work has expanded into a number of countries, so it made sense to the pair to create a Foundation to raise awareness and fundraise for the work they were doing.

“There’s three parts to what we are doing,” explains James. “Overseas development in Asia, because a major part of the world’s blind population is there; a smaller program in the Aboriginal communities of South Australia; and a general community awareness program called the My Eye Health Program.”

The Sight for All Foundation now has projects in a number of countries. In Burma, it runs a million dollar AusAID-funded national prevention program; and something similar in Laos. In both countries, the major issue is cataract blindness.

The Foundation equips new eye centres as well as upgrading facilities at existing eye centres. Then it organises health promotion amongst the health care workers in the region to get the word out to the village level, raising awareness.

“The other major thing is educating our colleagues,” says James. “We bring eye surgeons from partner countries to South Australia to train in a certain area of eye surgery.”

The Foundation has trained over 20 doctors in the past decade or so in some speciality areas of eye surgery. It trained Burma’s first children’s eye specialist and set him up in a new clinic.

“Now he can see hundreds of children every week; he can train his own colleagues. That’s the level of sustainable impact you can have by offering training fellowships at that level. “

“We’ve got a fellow coming from Bhutan this year, who is training to be the first glaucoma specialist in her country. We’ve also got a fellow coming out from Nepal, who will be going back to the major teaching centre there – what we call an ocular plastic surgeon…”

The other area the Foundation is involved in is research; in 2007 it completing the world’s largest blindness survey in Burma, which has the highest level of blindness in the world. A team was sent to Burma to take part in the survey by going to the schools for the blind, of which there are seven.  They found that the major cause of blindness in the schools was measles.

“Measles combined with malnutrition and particularly vitamin A deficiency becomes a potentially blinding – and deadly – disease. It was so disturbing to do this survey and see these kids who were quite horribly disfigured, when it was preventable. It’s really hard to take when you have young kids of your own…

“After the survey was completed, I met with the UNICEF medical officer in Burma, and it brought about the upscale of the measles vaccination program there.”

Another outcome was that the Burmese Ministry of Health began to open new eye centres and a facility in the capital city to train eye surgeons.

The Foundation has also done a number of surveys around Asia into child blindness.

“Half of the blindness that we find is preventable or treatable. So research is very important in terms of identifying the problems, but then also tackling the problems and attracting donors.”