UNLOCKING POSSIBILITIES DURING COVID LOCKDOWN

COVID-19 pandemic has affected millions of people worldwide, infecting more than 1.8 million people and pushing over half the population globally to face certain level of lockdown, driving them in confinements of the new normal.

The lockdown has changed the way eye care fraternity in the country operates. The Government of India has urged hospitals, which are not catering to the COVID relief and response to temporarily suspend their OPDs and routine check-ups, with only emergency services made available to patients.

Adhering to the guidelines, all Orbis partner hospitals are considering emergency cases only for treatment. All outreach activities are on hold and community engagement has been suspended for many of our partner hospitals across the country.

While COVID-19 might have changed the way we work, it cannot keep Orbis from its efforts to work towards its mission of transforming lives through prevention and treatment of avoidable blindness.

Our action in India has been two-fold. We are continuously engaging with our partner hospitals, connecting with them through Cybersight, working with them to identify training requirements, arming them with the knowledge and tools to prepare them for a brighter future. We are also reaching out to the key opinion ophthalmic leaders in the country to spread the message on eye health in these challenging times.

While connect with our partner base is one of the focus areas of Orbis, we are also keen on finding ways to reach out to the community at large. Orbis India team has been exploring innovative ways to connect with the marginalized communities and ensure that the eyecare support reaches the last mile. While it is somewhat challenging to reach out to the masses at these times, we believe that all efforts leading to the smallest change possible, might mean the world for the ones in need.

Susrut Eye Foundation & Research Centre, an Orbis partner, has initiated ‘Reach Out Program for Eye Emergency’ in Kolkata, West Bengal. Since 2014, Susrut, with support of Orbis India has been reaching out to the underserved community. The lockdown and suspension of public transport implies not only that eye health services are inaccessible for the community but also that they cannot reach the people who need it most.

To address the challenge, Susrut collaborated with local Police Commissionerate (Bidhannagar Police) to identify the patients who need emergency services. Seeking support of Police volunteers, working in the local area, Susrut identifies and reaches out to patients, first through a phone call to understand the urgency of eye care services required. Vision Vans, supported by Orbis, are then bring used to deliver eyecare services at the doorstep of the ones in need.

Susrut and the Police Commissionerate are maintaining WHO protocol on safety, including social distancing, sanitizing and use of PPE to conduct the Reach Out Program.

The layout of the Program is as follows:

• The Team comprises of a doctor, an optometrist/VT and two medical assistants. The support team comprises of a driver, Reach Out Program Incharge and Police Volunteer at the spot. All team members are being provided PPE and sanitizers and are asked to maintain social distancing.

Some of the members of Vision Van team and many other ophthalmologists, optometrists and nurses at Susrut have been trained by Orbis over the last few years. The trainings involved leadership trainings, outreach community & project management trainings, quality audit and, clinical & non-clinical Hospital based trainings on pediatric ophthalmology.

• At the pre-decided venue, the waiting area is demarcated and is kept closer to the washroom so that patients can wash hands, maintain social distancing and wait for registration.

• Patients are encouraged to wear masks and in case anyone is not carrying the mask, we are providing the same keeping in mind the safety.

• Registration on ICOM is being done one by one maintaining social distancing. Patients are encouraged to use alcohol-based hand sanitizers.

• Patients are then guided inside the Vision Van one by one where an optometrist does the initial screening and then the doctor sees the patient (all maintaining hygiene and social distancing). Patients are being given manual prescription and discharged immediately. Those requiring dilatation, are being made to wait in a separate area. Dilated examination is also being performed, maintaining social distancing and discharged immediately after prescription is being issued. A copy of the prescription remains with the hospital.

The Reach Out Program, initiated on April 12, catered to 77 patients on day one. 47 were provided with clinical intervention and further referred to hospital, 6 patients were given near vision glasses, and the rest were prescribed medication. Out of 47 patients, 13 patients were identified with cataract.

Orbis has been long associated with Susrut. In 2005, Orbis partnered with Susrut to host Flying Eye Hospital (FEH) Program in Delhi & Kolkata, and again in 2013 when FEH came to Kolkata. Orbis recently collaborated with Susrut as part of Comprehensive Childhood Blindness Initiative, implemented from April 2014 – March 2020, with an aim to reduce avoidable blindness and visual impairment among children in West Bengal. Implemented in 2 phases, Orbis helped Susrut in improving quality management systems and developed its capacity to deliver high-quality eye care services, during the first phase. The second phase focused on delivering paediatric eye care services, with 5,02,736 screenings, 57,502 medical/ optical treatment, 3,641 spectacle delivery and 1,421 surgeries during the project period.

As the fight against pandemic seems long, yet positive, we are on the lookout of such innovative approaches with our partners. We see collaboration as one of the imperative steps to enable transformation in these challenging times. Collaboration to facilitate outreach campaigns, collaborations to learn & share, and finally, collaboration to replicate & scale-up.

We foresee possibilities in the Susrut model (and many such unexplored models) to deliver eye care in current times. Replication and scale-up of the model in Kolkata, and other regions in India seems urgent. This work though can only be strengthened and continued with generous support and funding from our donors.