Context
Afghanistan has been devastated by decades of occupation and civil war. Extreme poverty is the daily reality of the majority of the population. Persons with disabilities are among the most vulnerable in Afghan society. Partner organisations know the local context, speak the language and are in a good position to improve the lives of persons with visual or other disabilities.
Programmes
SERVE intensified cooperation with the Ministry of Health, International Assistance Mission (IAM) and Comprehensive Health & Education Forum (CHEF). Around 900 people received eye surgery by or through SERVE’s intermediation, including 107 children with complicated eye problems. Over 25,000 people received treatment for eye diseases. More than 57,000 people received information on hygiene and how to prevent eye problems. SERVE prescribed nearly 5,800 reading glasses and 1,800 other spectacles. 403 employees of hospitals and clinics were trained to recognize and to refer eye problems or to administer simple treatment. 153 teachers were trained to do basic eye tests in children. 1,730 children were referred for eye treatment or glasses.
The SERVE-programme for rehabilitation and inclusive education achieved his objectives. 427 pupils with various impairments entered inclusive education or preparation training. 164 students with visual impairments received training in Braille, Orientation & Mobility and daily living skills. 28 volunteers were trained to rehabilitate children and adults with disabilities. 419 persons with disabilities were rehabilitated, 56 people got a work experience place or started a business. SERVE played an important role in getting legislation adopted by Parliament in favour of persons with disabilities.
The eye care programme from CHEF started much slower than planned. Finally, in August 2010, the first patients were operated. The run-up was arduous, but ultimately worthwhile. The project has become fully part of the public hospital in Fayzabad and is now under government responsibility as well as the board of the hospital. This means that, after the end of the project, staff and activities will be financed by the operator and the government. CHEF has already acquired a place in the National Commission that is developing an eye care policy. In 2011, targets were surpassed: 332 cataract operations and 6,200 eye treatments were done. One ophthalmic nurse was trained.
IAM started its ophthalmic training centre later than planned, due to bureaucratic obstacles.
Learning
Eye care organisations shared experiences with small payments by patients for the delivered care. That's not obvious in Afghanistan, because the government wants to offer health care services for free. Exceptions are only possible after long negotiations. On the other hand, these experiments are important because the population expects free health care, while funding is needed to make these services sustainable.
The future
In the coming years, SERVE will focus even more on training existing health care workers and less on the provision of eye care. When this transition is successful, a major step will have been taken towards further preservation of eye care in the countryside. After the duration of the project in Fayzabad, eye care services in the hospital will be taken over by existing partners, resulting in a successful model for eye care in district hospitals and local hospitals in Afghanistan.