A. Introduction The matrix of the community in North East India is unique. It is diverse in culture, beliefs and social systems. Its unique geographical isolation, poor connectivity, scanty eye care services and uneven distribution together creates a rather harsh picture. However, it is a vibrant landscape enriched with cultural and natural resources and has great potential for the development of Human Resources.
Sri Sankaradeva Nethralaya Institute of Community Ophthalmology (SSDNICO) adopts a rather unique approach in its projects relating to the service to the Community. The ‘Structured Community Service’ was inaugurated by the then Honorable Governor of Assam, Late Lokanath Misra, back in 26th of March 1996.
i. Community Needs Assessment SSDNICO conducts community needs assessment on a regular basis in collaboration with NGOs, community groups and grassroots level workers. This activity is done to determine short and long term priority eye care needs. In order to better understand the community needs, given our committed responsibility to the society, we have developed free programs for the economically underprivileged sections of the society in need of treatment.
ii. Free Service Facility at Sri Sankaradeva Nethralaya Main Patients who fall below the poverty line can report to the reception for free treatment and surgery of the eye ailment. At the time of reporting, the patients are required to comply with certain procedures like submission of Identity Proof and Income Proof. Patients are then registered and systematically examined and necessary treatment, including surgery, are provided free of cost.
iii. Reaching the Unreached, Last Man Connectivity Program This program consists of comprehensive screening in different rural and remote villages. The patients requiring surgery are transported to SSDN’s main hospital for surgery and on successful completion of surgery, the patients are dropped back to their doorsteps. Two-way transportation, accommodation, food & medicine during pre and post operative period and surgery are provided totally free of cost to the poor and underprivileged patients.
iv. Hospital Based Community Eye Health Program (HBCEHP) The Hospital Based Community Eye Health Program is a community eye health program that was directly executed and implemented by our Institution; and the first such program was taken up at Dimoria Development Block of Kamrup Metropolitan district of Assam in the year 2014. The mission and vision of this program was to eliminate avoidable blindness in the service area of the hospital by 2018 by integrating Primary Eye Care with Primary Health Care Services. Community Health Workers of SSDN, Government ASHA/ICDS/ANM Workers, Social Workers, Local NGOs, Local Clubs and the Community as a whole, were included in the project. The total number of villages of HBCEHP in the service area of Sonapur project was 140, which were declared free from Avoidable Blindness by the end of this program by His Excellency, the Governor of Assam, Prof. Jagdish Mukhi on 27th December, 2017. the rest of the 38 villages were declared free from Avoidable Blindness on 11th October, 2018, jointly by the Officials from Operation Eyesight Universal and SSDN. The total number of Avoidable Blindness Free Villages declared under this project, thus, was 178. Further on, 25 more villages were declared as being free of Avoidable Blindness by October, 2019. Of these villages, 15 were from the areas of Hajo and Sualkuchi; and 10 were from the Bijoynagar area by the State Program Officer, NPVB & VI, Govt. Of India. All in all, a total of 203 adopted villages have been declared to be free from Avoidable Blindness by Sri Sankaradeva Nethralaya by 2020. Work is in progress to declare more adopted villages as Avoidable Blindness Free.
The project started with the recruitment of Project Coordinator and Community Health Workers; and the training of the Health Workers in a systematic manner. A Vision Center was established in a well communicated and accessible area in the cluster of villages; and a survey area mapping was done. Total population covered was 139680; number of villages covered was 178; total households visited were 29840 and total number of Gaon Panchayats covered was 12. This process was strictly evaluated and scrutinized by our technical partner Operation Eyesight Universal, Canada. A total number of 4000 patients were cured from Cataract Blindness and all of them rejoined their original jobs. Moreover, many women joined the self-help group as well, thus improving their quality of life, as they regained their dignity, allowing them to socialize freely.
Post – surgical follow-up and operating procedures are done as per standard protocol during the 1st post-op day and at one week and one month intervals following the surgery.
Declaration Ceremony of Avoidable-Blindness-Free Village
Upper Tepesia, one of the Declared Blindness-free Karbi Tribal Village
Story of Mr. Uken Rahang: (Male, 60 years, village - Diksak, Police Station Khetri, Kamrup Metro, Assam) Uken Rahang was blinded due to total Cataract and was unable to move independently. Living with his sister on a hillside, he used to be an excellent artisan, earning his livelihood by making and selling different bamboo and cane products, until Cataract blinded him. Blindness cost him his business and he was forced into a life of misery and dependency. It was then, that our community workers identified him during their door to door survey and screening. With some counseling, he agreed for surgery. He was then escorted to the SSDN Main Hospital in Guwahati, where his cataracts were surgically removed, thus, allowing him to regain his vision completely. A month following the surgery, he went back to his business and his economic status improved. The surgery came as a blessing for him when he needed it the most, though he wasn’t in a position to afford it.
After the successful completion of HBCEHP at Sonapur, SSDN implemented another six Vision Center Based Community Eye Health Programs at Bijoynagar, Hajo, Sualkuchi, Morigaon, Mangaldoi, Bongaigaon and Nagaon. The Sonapur Vision Center was also integrated into the program after the successful completion of the HBCEHP project in the year 2018.
This Vision Center is a primary eye care center in the project area, where patients are screened and referred to the base hospital for Cataract surgery and other surgeries. The Community Health Workers have been further empowered by a ‘Structured Curriculum’ through which, teaching sessions were conducted for them by Ophthalmologists, ICDS/CDPO, ASHA, Gynecologist/ANM, General Physician and Local NGO personnel.
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