Blindsided by virus, eye doctors saved by gifts

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Australian ambassador to Cambodia Pablo Kang (centre, jacket) oversaw the donation of sanitation supplies to Cambodia’s eye health sector. Photo supplied

When Thol lost her eyesight, her husband abandoned her. She spent her days being guided around by her small children while her oldest son fished for food to keep the family alive.

With the assistance of the Fred Hollows Foundation, Thol was lucky enough to receive a surgery which had the potential to restore her eyesight. When the bandages were finally removed from her eyes, she smiled and pointed to her children one-by-one, according to a video produced by the foundation in 2016.

In the video, Thol says of her youngest son: “He’s fat! I’m so happy with my successful surgery . . . this New Year, I am dancing!”

Able to see again, she was able to get back to selling vegetables and provide for her family.

Cataracts have been identified as the leading cause of avoidable blindness in Cambodia and cataract cases have been increasing over the past 10 years.

“Of all causes of blindness in Cambodia, 92.2 per cent are avoidable, 80.9 per cent are treatable, 5.9 per cent are preventable with primary health care and/or primary eye care and 5.4 per cent are preventable through more advanced ophthalmic services,” said Aildrene Israel S Tan, the global communications coordinator at the foundation.

Tan cited a 2019 report by Cambodia’s National Rapid Assessment on Avoidable Blindness (RAAB), saying that if cataract surgical services keep expanding at their current rate, the number of cataract patients would double or triple between 2019 and 2030.

He said blindness can be prevented by receiving regular eye checks and having surgery in the case of cataracts.

Australian ophthalmologist Fred Hollows founded his eponymous foundation in 1992 to ensure his contributions in the eye health sector would continue into the future.

Today the foundation works in more than 25 countries including Cambodia and has restored sight to over two and a half million people worldwide.

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X-rays were used in place of proper prevention equipment. Meas Kim San

“Starting in Cambodia in 1998, the foundation was created to assist government partners to establish the Cambodian Ophthalmological Society, conduct Cambodia’s National Rapid Assessment of Avoidable Blindness (RAAB) survey in 2007 and 2019 and establish an ophthalmology residency training programme,” said Tan.

They established a national refraction training programme and an ophthalmic nurse training programme, developed the National Strategic Plan on Blindness Prevention and Control, included eye health in the national minimum package of primary health activities and supported the establishment of numerous eye units in provincial referral hospitals.

When Covid-19 emerged, it damaged the health sector and minimised people’s access to many health services, including eye care.

As eye care services were considered essential, they weren’t fully closed during the pandemic.

To pursue the important sight-saving work, the foundation provided technical support to hospitals and eye units in Cambodia.

However, Tan says, service providers and hospitals faced challenges in preventing Covid-19 cross-contamination. They needed more protective equipment to adapt to the “new normal”, following recommendations from the Ministry of Health.

Amid the crisis, the Australian government donated protective equipment including surgical masks, alcohol sanitiser, eye shields for slit lamps, face shields, safety glasses and N95 masks.

Australian ambassador to Cambodia Pablo Kang said: “I am so glad about the emergency donations to support eye services during Covid-19. With the Fred Hollows Foundation and Sight For All, we gifted 25,000 surgical masks and almost 1,000 litres of alcohol sanitiser.

“It’s another example of how Australian aid is adapting in these uncertain times.”

The donations also allowed the foundation to conduct risk assessments in eye health clinical settings, train eye health professionals and distribute information to the public.

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Face shields were an urgent need for eye health doctors. Meas Kim San

Professor Ngy Meng, director of the National Programme for Eye Health (NPEH), said: “Your support contributes greatly in our progress to make sure eye health personnel and their work environments are safe.”

The foundation has worked with NPEH to adapt and provide eye services throughout the four stages of the country’s Covid-19 response – prevention, detection, containment and treatment.

Four of five of the blind worldwide could recover their eyesight with adequate treatment, according to a report of the World Health Organisation.

However, people suffering from eye conditions are at risk of going blind if they don’t get treated immediately.

Dr You Piseth, an NPEH Ophthalmology representative, said: “The donations come at the right time so that health staff can go forward and continue their practice. Having protective equipment and supplies will protect health staff and patients from the risk of getting the virus.”

The donations will provide benefit to about 250 eye health personnel in national and provincial referral hospitals. With all safety measures in place, 6,120 patients are expected to receive eye health services as Cambodia enters the new normal, according to a report by the foundation.

The foundation’s Cambodia country manager Tokyo Bak said: “We would like to express our sincere thanks to all our donors who have shown great flexibility, and allowed us to pivot and allocate budget to support the fight against Covid-19.

“Your donation is greatly appreciated. It has given us the ability to respond to Covid-19 in countries like Cambodia, where the need is greater, and resources are fewer.”

Before receiving protective equipment, some health staff invented unusual solutions to lessen the risk of transmitting Covid-19. They used X-ray films as a protective shield for slit lamps and many patients were not comfortable looking at their doctor through an X-ray of someone’s ribs.

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This ophthalmic nurse used a donated protective shield for this slit lamp instead of x-ray film. Meas Kim San

Dr Sea Mean Viseth, a Kandal Eye Unit ophthalmologist in Kandal province, said: “The donation is timely, and it enables us to continue our work at this stage. We are committed to providing eye services and we will do so in a safe and disease-free manner.”

Dr Kak Seiha, head of the Battambang Provincial Referral Hospital, said: “The protective equipment will help us fulfil our responsibility as doctors and nurses, and build our image of providing safe and healthy services to the people.”

The foundation works with the health ministry, NPEH and provincial health departments to improve eye health services in the Kingdom.

“Cambodian people can access eye care services in public health facilities including their respective provincial eye units,” said Tan.

According to the foundation’s 2019 report, 45,352 Cambodian people were screened and 6,465 eye operations and treatments were performed including 4,268 cataract operations.

For those who would like to send their donations, they could access the Fred Hollows Foundation’s website: https://www.hollows.org/us/donate.