As part of its ongoing mission to build sustainable eye care in developing countries around the world, the John A. Moran Eye Center’s Global Outreach Division conducted its fourth major mission to Tanzania in February 2019.
The team of volunteer physicians and technicians traveled to the capital city of Dodoma and the northern city of Mwanza, the country’s most populated region, and performed 1,420 eye exams and 590 surgeries, and distributed over 800 pairs of readers and 150 pairs of prescription eyeglasses. They also provided training for six local physicians and eight local nurses.
Training and Partnerships Making a Difference
In a country with one ophthalmologist for every 1.6 million people and high rates of cataracts and other blinding conditions, the challenge is ongoing. But strategic partnerships with a common goal of creating sustainable systems for high-volume, low-cost eye care are making a difference.
Since 2014, the division has partnered with the Benjamin Mkapa Hospital at the University of Dodoma and the Tanzanian Ministry of Health to train ophthalmologists.
Frank Sandi, MD, is the only ophthalmologist teaching at the University of Dodoma and is now opening a surgical center thanks to training by Moran physicians. Sandi visited Moran as an observer and continues to improve his surgical skills and output.
In Dodoma, Moran physicians have been working with Evarista Mgaya, MD, and Christopher Mwanansao, MD, through training exchanges and hands-on surgical teaching. Mgaya and Mwanansao are moving toward establishing their own residency program to increase the number of ophthalmologists who can provide care to the 5 million people in the region.
First Aravind Assessment
In 2017, Moran became a North American Academic partner of India–based Aravind Eye Care System, the acknowledged innovator in low-cost high-volume surgery around the world. In addition to training Moran’s international physicians in India, Aravind doctors are augmenting Moran’s in-country training.
An Aravind administrative team joined Moran on its February mission to assess operations and protocol in both locations. The team made several recommendations to improve overall efficiencies for the staff so they can treat more people in less time. In some cases, patients have to travel great distances to the clinics, accompanied by a family member who has had to leave school or work. If the clinics are backed up, these patients often have to forego treatment because their caretaker cannot afford to wait.
On-the-ground research to assess needs
In conjunction with February’s outreach mission, Moran resident Bradley Jacobsen, MD, and a team of ophthalmic specialists conducted a study on the prevalence of retinal diseases and associated risk factors in Mwanza.
Funded by his Achievement Rewards for College Scientists (ARCS) Foundation Scholarship, Jacobsen set out to asses eye health needs in rural areas where it is difficult to know what eye diseases to address, how to support eye care specialists in these areas, and how to help improve infrastructure.
“There are so many rural areas of developing nations where no one has assessed the range of eye health needs,” said Jacobsen. “We have to create a roadmap before we can begin to address the critical issues.”
In Mwanza, the team gathered demographic and basic clinical data and tested visual acuity and intraocular pressure as well as gathering retinal images for 1,073 people. The results showed vitreoretinal disorders, including macular lesions, age-related macular degeneration (AMD), and retinal vein occlusions, in 22.8% of the participants. They also correlated risk factors associated with vitreoretinal disease with factors such as lack of education and income.