August 2017

As we commemorate women’s month, the nation asks itself: how do we see the women of our country? But what we should be asking ourselves is, how do the women of our country see?

By Helen White

The fact is, many of them don’t – and not because they were born blind. In many cases, the visual impairment and blindness that women in the region suffer from, is entirely preventable or treatable. Now, a new study has uncovered some of the reasons why so many women in the region are unable to access the eye care they need – especially cataract surgery which can restore sight. The study was conducted in Zambia, but according to Lene Øverland, CEO of Orbis Africa, “These findings are crucial because they shed light on circumstances that are replicated over and over again in different countries in the region – and South Africa is no exception.”

The study was conducted because of a worrying asymmetry that is evident along gender lines: Approximately two thirds (of the estimated 39-million blind people worldwide) are women and 87% live in developing countries. Over half of all blindness is due to cataracts, and women are 10-15% more likely to have cataracts than men in developing countries. In Africa, women account for between 53% and 72% of all people living with cataracts – which means they should appear more frequently on the cataract surgery lists.

But, the reality is, they don’t.

The cataract surgical coverage rate for men in developing countries is up to 1.7 times higher for men than women. So, what are the barriers that stop women from receiving the help they need? This is what the study sought to find out. Two main issues came up: Firstly, women face major delays in even getting the advice they need about going for surgery. And secondly, even when they have received a referral for surgery, cultural and socioeconomic barriers prevent them from getting it.

The delays – which are generally between 9 months all the way up to 14 years – had may different causes. Many patients were losing time trying home remedies and traditional medicine, or hoping that their religious beliefs would bring on a cure. Also, many were waiting for a specialist to visit their area, and some were even advised to wait for the cataracts to mature before seeking professional help. Some received poor counselling at diagnosis, and others simply felt fearful of surgery. “This was made worse by the general limited education levels of the women,” says Øverland. These problems are compounded by socioeconomic and cultural barriers at play. Many women have limited decision-making rights in their communities and also, even if they decided to seek help, the “costs associated with travel to suitable facilities was a problem”.

Where to from here? According to Øverland, “It is important to bring families into counselling sessions (or where counselling is unavailable, information sessions) when women are referred for surgery to discuss the potential benefits of sight-restoring surgery.” Also, she said, misconceptions needed to be addressed and “general awareness on the benefits of sight-restoring surgery should be raised within communities.”

According to Unathi Matwasa of the Institute for Race Relations, “While progress can be seen, there is a need for a further upturn in the socio-economic status of women in South Africa. Accordingly, policy focus should be aimed at a more inclusive economy, including the safety and security of women.” Says Øverland, “Policy should also focus on the link between healthcare and the other forces at play in the lives of women in our region. Poverty and lack of access are, unfortunately, often hand in hand.”