Pakistan Institute of Community Ophthalmology

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Comprehensive Eye Care (CEC) Cell

Comprehensive Eye Care Cell (CEC- Cell) is a significant part of PICO. The cell envisions bringing improvement and promotion in eye health care system by upgrading and strengthening Ophthalmology departments of the tertiary hospital and secondary level health care system. In addition, CEC-Cell also undertakes community outreach programs with partner across the province with the objective to promote preventive cure for avoidable blindness. For this purpose the CEC-Cell plan, design, implement and evaluate different program and conduct operational research to suggest solutions to emerging needs and answer unexplained questions relevant to eye health care. The Cell works under the overall supervision and guidance of the Director-PICO and its other members consist of consultant Community Ophthalmology, Program Officer, Sociologist and office Assistant.

Key achievement of CEC-Cell for year 2017

1.    Improving service delivery structure and up-gradation of district eye departments:

Under the umbralla of national program for prevention and co  ntrol of blindness (NPPCB), the CEC-Cell of PICO is manadated to upgrade and renovate eye departments in the province. Under this project CEC-Cell upgraded and renovated 06 teaching hospitals, 24 District Headquarter (DHQs) hospitals and 06 Tehisl headquarter (THQ) hospitals. This year eye department of tehisl headqaurter hospital in Puran district Shangla was upgradated with a cost of 03 million rupees.

2.     Community awareness raising and advocacy Program:

Alongside with improving curative care, preventive care is equally important to reduce blindness prevalence ratio among the general public. Raising awareness among communities to reduce risk of blindness and vision impairment is a main goal of the CEC-Cell. For this purpose PICO CEC-Cell organized several events including celebration of World Sight Day, World Glaucoma Week etc.

a.    World Glaucoma Week Celebration:
World Glaucoma Week (WGK) is celebrated every year in March for elimination of glaucoma blindness. This year CEC-Cell of PICO celebrated glaucoma week from 12th to 18th March 2017. Theme set for this year was "BIG" (BEAT INVISIBLE GLAUCOMA). Key publicity seeking activities are listed below:

i.    Development, printing and dissemination of awareness raising materials:
Under this activity Panaflex banners and paper brochures were development and distributed among 24 districts of Khyber Pakhtunkhwa. The district eye specialists displayed the banner on main entrance of the hospital and the brochures were distributed among the general people.

ii.    Group Discussion with Glaucoma Patients:
A group discussion was arranged with glaucoma patient on 11th March, 2017. The event was recorded and broadcast on a local TV Channel (Mashriq TV) program "Da Pekhawar Ghag". Besides group discussion, few interviews were also recorded with Director, Consultant Community Ophthalmologist and Program Officer in which PICO role in prevention and control of blindness and vision impairment were discussed in length. It can be accessed at https://www.youtube.com/watch?v=wjBEg436R30
 
iii.    Free Eye Screening Camp at Hayat Abad Medical Complex (HMC)
Free eye screening activity was organized on the occasion of WGW celebrations. One camp was organized in Hayatabad Medical complex and second camp in Madrassa Junaidya Peshawar. During these camp more than 1000 patients were examined for eye related diseases and were provided with medical aid and medicines. The event was participated by Dr. Shahzad Akbar (Medical Director at Hayatabad Medical Complex Peshawar) and Director PICO. They appreciated the efforts and commitment of the team.

iv.    Speech Competition on Glaucoma at HMC auditorium
Another important event was the Speech Competition Seminar. It was participated by a large number of students from Khyber Medical College for boys, Khyber Girls Medical College, Rehman Medical College and Pakistan International Medical College and Pakistan Institute of Community Ophthalmology, Peshawar. The students who won the positions were given prizes by chief guest (Dr, Mohammad Daud).

v.    District initiatives for celebration of World Glaucoma Week
District Mansehra
-    Awareness raising week
-    Free eye screening camp  for 435 patients
-    Distribution of awareness raising material at 190 medical stores

DISTRICT SWABI
-    Display of awareness raising materials
-    298 patients were examined for glaucoma disease
-    Distribution of awareness materials
-    Awareness raising sessions with staff nurses and patients

District  HARIPUR
-    Awareness raising walk
-    Distribution of brochures in 161 medical stores
-    Screening of 422 patients
-    Distribution of 161
-    Broadcast of awareness messages on FM radio

b.    World Sight Day (WSD) Celebration 2017
World Sight Day shortly WSD is the most important advocacy and communication event celebrated to focus global attention on blindness and vision impairment. WSD is celebrated on second Thursday of October every year. This year WSD is celebrated on 12 October 2017 with "Make Vision Count" a theme for this year call to action.
Pakistan institute of community ophthalmology is an important member of International Agency for the Prevention of Blindness (IAPB) and always actively participate the agency activities to prevent avoidable blindness and vision impairment. Likewise, its previous efforts, this year too, Pakistan institute of community ophthalmology organized different events and activities to celebrate world sight day with its partners with the purpose to enhance mass awareness on eye health care and on vision impairment. Gulbahar Lion clubs Peshawar and Khyber Pakhtunkhwa special education department put their efforts altogether with PICO for ensuring wider impact of the event.

Highlights of key awareness raising activities
i.    Free Eye screening camps:
PICO organized free eye screening camps at two locations, one for community members in Nasirpur Peshawar and second for media persons in Peshawar press club. In both camps, nearly 1000 people were screened among which 350 were women. In the result of these camps, 55 patients have been referred to eye surgeries and 400 were provided eye glasses whereas all diagnosed patients were given free of cost medicines.

ii.    Awareness raising Walk:
On October10, an awareness raising walk was organized to mark world sight day and to draw attention of general masses towards WSD and eye health care on main Khyber road in the city of Peshawar. Participants of the walk were local members of lion clubs, children suffering from blindness of special education department, media persons, PICO students and faculty members, local commuters etc. At the end point of the procession, Director PICO talked to the media by explaining the purpose of the walk and highlighting the importance of WSD for preventing blindness

iii.    Awareness rising seminar:
An awareness raising seminar was held on Thursday 12th October to observe World Sight Day. The event was participated by a large number of students, medical professional, media and prominent figures to show their commitment to improve eye health care and to prevent avoidable blindness. Chief Guest (Mr. Shahram Khan Tarakai (Senior Minister for health Khyber Pakhtunkhwa) and other prominent medical processionals addressed the participants on the occasion.

iv.    Display and dissemination of printed materials:
In order to promote mass awareness bilingual printed materials e.g. Banners and posters were developed and distributed among tertiary hospitals primary and second health care units and degree awarding institution publicity purpose. These materials have key messages like increase intake of vitamin A, recommending regular and periodical examination of eyes etc.

v.    Media Coverage:
Printed and electronic media were engaged for wider publicity and coverage. WSD activities were properly reported on daily newspaper and on TV channels

vi.    World Sight Day activities at district level:
Besides, District Peshawar WSD activities have also been implemented in 04 SIB (seeing is blessing) districts of Khyber Pakhtunkhwa namely District Mansehra, Swat, Swabi and Haripur. The district teams organized free screening camps at different location in which total 1,387 have been examined for eye related problems.

3.    Community outreach programs:

Another contributing area of CEC-Cell is to implement community outreach programs in the province. These programs are designed with the objective to improve eye health care through improved service delivery and preventive care. These initiatives include donor funded projects, free eye screening camps, conducting field survey and operational researches.

i.    Seeing in believing (SIB) Project:

Yielding results to its objectives, CEC-Cell has designed several projects in past and currently implementing a project titling "A new vision for eye health in Pakistan's Khyber Pakhtunkhwa province". This project envisages contributing to sustainable provision and increasing demand for eye care service in the target districts and it was launched in 2016 with partnership of Sightsavers International and Fred Hollows Foundation and generous funding is provided by Standard chartered Bank. This four years project is now entering in its third year of implementation after two years of successfully execution. The project focuses four districts of Khyber Pakhtunkhwa namely Haripur, Manshera, Swabi and Swat.

Key achievements of the project for year 2017 are:

-    Till date 66,383 patients have been screened for eye related disease
-    34,429 refractions have been done
-    28,286 individual were prescribed for using of spectacles
-    818 major surgeries have been done
-    685 minor surgeries done
-    69 awareness raising sessions were conducted
-    198 health professionals were provided training on primary eye-health care
-    Under this project a District coordination committee was formed in each district which will ensure smooth implementation of the project in its respective district. In this matter first meeting of  the committee was held and few implementation issues were resolved. To ensure sustainability of the project in longer run the committee recommended schedule of new expenditures (SNE) for new post to the government of Khyber Pakhtunkwa.
-    Trained project staff on report writing and case study development

ii.    Free Eye Screening Camps:-
Providing easy accessible convenient and affordable health services, CEC-Cell regularly organizing Free eye screening camps across the province. In these camps, individual are screened for eye related diseases and medicine and spectacles were prescribed for free and where applicable patients are also referred for surgeries. Following are the details of free eye screening camps conducted in the year 2017:-

4.    Trachoma Mass Drug Administration (MDA)

Trachoma Mass Drug Administration project is one of its kind started in August this year. Trachoma prevalence survey was conducted in 39 districts across the country. In this population based survey two districts of Chitral and Qambar Shahdad kot were declared with significant prevalent of active trachoma. To cure trachoma disease a Mass Drug Administration (MDA) program was designed in these two districts for which medicine were donated by International Trachoma Initiative (ITI). Pakistan institute of community ophthalmology is leading the implementation of this program through the active support of district health office of Chitral.  For effective drug administration program lady health supervisors (LHA) and lady health workers (LHWs) were given training. During first phase campaign a total 400,000 individual received Zithromax drug to cure trachoma.
 
5.    CEC-Cell monitoring and evaluation role for National Program for Prevention and Control of Blindness (NPPCB)

To ensure high standards in eye health care CEC-Cell regularly monitors eye health facilities in the province and evaluate their services in term of efficiency and efficacy. For this purpose CEC-Cell has conducted quarter based monitoring of all SIB (seeing is believing) project districts. In addition, the eye departments of two far flung districts D.I. Khan and Tank were also visited in March, 2017 with a view to assess the latest progress and problems/issues in smooth working. It was noticed that the eye department of DHQ Hospital Tank is still deprived of the services of an eye specialist which in turn is affecting the poor community of the district and surrounding areas. In the result of these monitoring visits issues identified were reported and communicated to relevant department and corrective measures were suggested.

6.    Capacity Building program:

Availability of skilled Human resource is prerequisite for every successful activity. Considering the importance of the skilled and qualified human resources, CEC-Cell is providing leadership to growing field of eye-health care in the province. For this purpose a capacity building workshop was organized for Trainees associated with medical professions in field of ophthalmology Vision 2020, team building and management skills and government working procedures related to budgeting, planning, procurement and communication.