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
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
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
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: