Reimagining Orbis Programs

The coronavirus is not only a health crisis of immense proportion—it’s also an imminent restructuring of the global economic order on how businesses, civil society and hospitals work. The shift is evident in operations, financials and the future plans, with consideration of the next normal.

Orbis India has been taking extensive measures to reimagine its programs on ground, connect with its partner hospitals and continue its mission of making eye care accessible and preventing avoidable blindness.

One of the focus areas of Orbis is providing training support to medical and paramedical eye care teams at its partner hospitals, globally and in India. As pandemic affected the in-person training, we leveraged our existing telemedicine platform, Cybersight and swiftly moved to virtual modes of training. Cybersight also became the platform to deliberate on the impact of COVID-19 on eye care ecosystem and how eye hospitals and professionals can cope with the new normal. We engaged Eye care leaders to decode the epidemiology of COVID, what new normal looks like for hospitals, systems management post COVID-19 and more. Later, a webinar was also organized on the pressing need of managing mucormycosis, role of eye health providers and the imperativeness of cross-collaboration required to effectively manage the disease.

While the webinars at Cybersight reached out to thousands of eye care professionals from over 40 countries, we wanted to offer more customized and need based trainings, especially for the extensive network of partner hospitals in India. The in-person Hospital Based Training on Patient Counselling was shifted to virtual mode, reaching out to more number of counsellors than we would have in the physical set-up. A series of seven Patient Communication webinars were organized with the participation of 28 partner hospitals and over 150 patient counsellors.

The webinar series was followed by more in-depth and hands-on training on counselling, again in the virtual set-up.

2020 was a special year for Orbis in India, with completion of 20 years of its presence in the country. As the year rolled out with unforeseeable events, we made conscious efforts to re-strategize our initiative to achieve what was planned earlier. Before the COVID-19 pandemic emerged, the Flying Eye Hospital was due to land in Delhi in 2020, for its 19th visit to India since 1988. The flight though didn’t get to India in its usual avatar, rather made a virtual landing! The first virtual Flying Eye Hospital Program in India trained 160 eye care professionals from 10 states in the following areas- medical retina procedures related to diabetic eye disease, cataract surgery, ophthalmic nursing and biomedical engineering.

Orbis is supporting HV Desai Eye Hospital and Dr. Shroff’s Charity Eye Hospital to strengthen infrastructure of state of art wet labs, capable of delivering high quality simulation and distance education. The wet labs at the partner hospitals are being upgraded to Digital Training Hubs (DTH) to offer enhanced ophthalmic education for ophthalmologists, ophthalmologists-in-training, ophthalmic nurses, and counselors. The training hubs will combine simulation, digitization, tele-mentorship, telemedicine, and tele-education.

With local/ nationwide lockdowns in 2020, followed by restrictions in public gathering and schools’ shutdown, the delivery of eye care services had to undergo changes.

Orbis worked with its partner hospitals in India and Nepal to continue eye screening through door-to-door visits and vision vans. Orbis REACH project, which is based on school screenings to identify and correct refractive error among school going children was substantially affected due to closure of schools. In Nepal, we worked with our partner, Nepal Netra Jyoti Sangh and its network hospitals Sagarmatha Chaudhury Eye Hospital, RM Kedia Eye Hospital, Mechi Eye Hospital and Biratnagar Eye Hospital to undertake door-to-door screening of school aged children in Sunsari, Jhapa, Siraha and Parsa Districts.

Orbis also extended its approach of door-to-door screening in its projects in West Bengal and Madhya Pradesh. With the support of USAID, Orbis partnered with Susrut Eye Foundation and Research Center to establish five Green Vision Centers (GVCs) and conduct screening of children in Mushirabad District, West Bengal. The team ventured into door to door screening approach, due to closure of schools. Children identified with eye conditions in the primary screening are being referred to GVCs for secondary screening and the secondary hospital at Mushirabad for surgical intervention. Recently, Sadhguru Netra Chikitsalaya in Chitrakoot also initiated doing door to door screening around the catchment area of seven vision centers in Satna and Rewa districts.

While adopting the door-to-door screenings was largely successful, it came with its own set of challenges, including seeking permission from government officials to engage female community health volunteers (FCHVs), conduct their trainings and handling the logistics of visiting every household, amidst the pandemic. Each screening team rigorously follows COVID safety protocols while screening children at the doorstep, with verbal consent from the parents. The household visits also gave us a unique opportunity to interact with parents and create one-on-one awareness on eye health, which was otherwise not possible in school screenings. Post screening, parents/guardians of those children identified with an eye condition are counselled further and supported in seeking referral services or wearing spectacles if prescribed.

The model of door-to-door screenings was later piloted in select wards of Narayanpur village of Garkha block, Saran District, Bihar. Orbis, in partnership with Akhand Jyoti Eye Hospital, organized screening activities at the doorstep, leveraging the vision van. While children with surgical eye condition are being referred to the base hospital, those with refractive error are called for secondary examination in the vision van.

Data plays a crucial role in effective and efficient execution of development programs, help analyze the impact of an initiative and improve accountability. Orbis has been leveraging REACHSoft and Integrated Community Outreach Module (ICOM) to plan, implement and manage data of its eye health programs.

ICOM, which consolidates data during community outreach activities, helped us transform data management with improved referral management, better time and resource management and stronger monitoring mechanism. All of this, while unravelling the continuity of care between outreach services or vision center and the base hospital. While ICOM was more focused on outreach activities, REACHSoft was designed to manage data at every step of Orbis REACH programs, including developing the school database, collecting school-wise student database, scheduling planning and service delivery activities, collecting data at the individual student level during service as well as monitoring progress and generating reports.

With COVID-19 pandemic, as we shifted our program approach to door-to-door visits, we felt that there is a need for an app that can help the Project teams at partner hospitals with easy and improved data capturing and management. The recently developed Orbis Door-to-Door Screening module, which is an extension of ICOM and REACHSoft will now be used by Orbis partners to capture outreach data. The mobile app has been developed to help outreach teams capture individual data of door-to-door visits, without the need of internet. So, the teams can capture data offline, and sync it later when they have access to internet. The app is currently being used by select partner hospitals in India and Nepal, with scope of widening its usage and increasing the user base in near future.