Introduction
PEC is a proud partner in a unique project called Nayana
Along with VIIO, Sri Keshava Trust, and funded by the World Diabetes Foundation this project is bringing about a quiet revolution in specialty eye care
This project aims at creating a locally available, viable and sustainable Diabetic Retinopathy treatment programme.
The project will be executed by Vittala International Institute of Ophthalmology a Super specialty medical center with a dedicated Retinal clinic, Sri Keshava Trust a Vision health centered NGO and Prabha Eye Clinic and Research Center, one of the country's oldest ophthalmic hospitals.
This project is targeted at two discrete groups. One consisting of local Ophthalmologists in 8 districts of Karnataka who are currently not delivering Diabetic Retinopathy treatment due to paucity of equipment and training. This project will aim to provide training and equipment to diagnose and treat patients locally. The second group will be local health care providers( GP's ) in the target districts for early detection, education & referrals to group one for further management.
We will be partnering with the National Association of the Blind Karnataka for community outreach, members of the Karnataka Ophthalmic Society for forming local treatment clusters. GP education and general diabetic care will be achieved in association with Cauvery Diabetic Foundation a diabetes centered NGO.
Keeping in mind the cost and logistical hurdles of duplicating the sets of equipment required in many remote locations, the project aims to achieve this goal by creating a mobile van with diagnostic and therapeutic equipment to act as a mobile hospital. Tertiary referrals in the beginning will be achieved via satellite/video conferencing with our base hospital staffed by in-house vitreo retinal consultants. We expect such consultations to gradually decrease over the duration of the project . The project will aim to cover 70 ophthalmologists and a target population of 280,000 diabetics . The mobile hospital/s will cover 70 stations every month by the end of the project
Main Goals of the Project
1. Provide World Class Diabetic Retinopathy Treatment locally, aim to minimize treatment related travel to less than 50 KM for patients against the current average travel of over 200 KMs. In the target districts of our project there are only 3 centers providing DR treatment covering a population of 14.4 million The mobile unit will have 30 regular halts serviced twice every month during the first year ,50 in the second year and 70 in the third year reaching a potential diabetic population of 280,000.
2. Reduce the overall cost of treatment by taking diagnosis and treatment to within a 50 KM radius of the patient's residence.
3. Prevent avoidable blindness
4. Make the treatment plans sustainable by implementing our economic grading criteria to better target free treatment and to charge patients woo can afford to pay. All patients with a monthly family income of less than USD 30 will be treated free of charge.
5. Empower local Ophthalmologists through Diabetes Care training, specialty equipment and expert handholding by video conferencing/satellite hook up to the base hospital.
6. Increase health care community workers awareness and ability to detect diabetes and refer patients for management and treatment to the nearest center.
Diabetes and the Indian Context
Diabetes is considered on of the main health concern for India. Most diabetic related complications require long term and sustained care, especially in case of ophthalmic care. The Vision 2020 program recognizes Diabetic Retinopathy as one of the major causes of preventable blindness.
Geographical spread, expensive treatment and urban rural gaps in health care compound problems for most of India. Most of healthcare in India is subsidized and top down with little or no local ownership and plans of long-term sustainability.
The current project aims to act as a role model for community based alternative models for delivering super specialty eye care in the context of Diabetic Retinopathy. We hope that the general awareness and infrastructure created through this program will reach beyond ophthalmic care and cover general diabetic healthcare. There is also a need for accurate data on prevalence and diet-based variations in diabetes for better targeting of resources. A successful implementation of this project will open up avenues for further non-traditional medical interventions
Methods and Plans
We have made an intensive study of existing Ophthalmic care centers, both mobile and static along with our experience of rendering rural specialty services and conducting Diabetic Retinopathy screening camps
The project will be under taken primarily by The Sri Keshava Trust a public charitable trust engaged in vision care , Vittala International Institute of Ophthalmology a 4 Million USD super specialty Ophthalmic Institute and Prabha Eye Clinic one of Karnataka's oldest eye clinics founded in 1941. National Association of the Blind will assist us in patient education, screening and follow up and has been involved in community based vision care and rehabilitation for over 30 years.
Cauvery Diabetic Foundation a diabetes centered NGO will assist in conducting Diabetic Screening camps, education of GPs and health care workers.
A dedicated Mobile van with digital slit lamps, visual fields, tonometers, frequency doubled lasers, fundus imaging cameras, basic clinical lab and communication equipment is being built.
It is our belief that we should augment existing services and not replace them wherever available. In this regard we plan to create a route calendar with fixed stops for the mobile clinic where local ophthalmologists and specialists can use the advanced digital equipment for first level diagnosis locally and use the therapeutic equipment to treat them. This will ensure that more and more people will receive quality eye care that has been denied to them due the prohibitive cost of equipment and non availability of facilities and trained manpower
The treatment role will be filled in by our traveling ophthalmologist in the initial stages.
The clinic will also allow consultations with specialists at the Vittala International Institute of Ophthalmology as a secondary referral via video conferencing, satellite or store and forward methods
We will use the case studies and databases as a learning mechanism
The local care provider can recommend locally untreatable cases for follow up and requisite surgical/non surgical treatment to Vittala International Institute of Ophthalmology
The Clinic will also augment existing Diabetic and Eye health screening camps
and conduct Epidemiological studies for Diabetes
Continuing Medical Education
Local ophthalmologists and technicians will be trained in diabetes related complications and care.
Training for Health care workers and local motivation workers and other NGOs
Research Studies
Epidemiological and incidence studies will be carried out along with institutes and research organizations.
A monitoring and co ordination committee drawn from the staff of VIIO and participating Ophthalmologists will over see the program implementation. All cases will be digitally documented and followed up using software developed in-house.
Project Coverage
Notes:
- Coorg is also known as Kodagu
- Chamarajanagar is also known as Chamaraja
Chamarajanagar District is not a part of the project (See Project Impact section for details)
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