March 2018

There are more than 400,000 blind children in Africa; this represents one in every five blind children in the world.

Knowing that 50% of the cases are treatable or preventable, makes one question whether the commitment to realise children’s right to sight, as enshrined in international human rights conventions, is being met. It is fitting that as South Africans celebrate Human Rights Day on 21 March, Lene Øverland, Orbis International Africa Regional Director, contemplates this disconnect.

Vision develops through life

Vision, as with any other developmental domain, develops across the lifecycle of the child. This means that the provision of age-appropriate services at different ages is key to optimal health and the prevention of blindness.

Vision plays many roles in life. At birth, vision allows the infant to connect with its caregivers, whereas at age 5 it enables play and social interaction and at the age of 15 it gives access to education and lifelong opportunities.

With 80% of learning taking place through vision it is not difficult to draw the conclusion that child blindness has significant implications on a nation’s ability to prosper.

Early Childhood Development

The South African Department of Health is responsible for the provision of health services to support the development of all children in the country. The government can only fulfill their duty if adequate platforms are in place and there is clarity and agreement on the continuum of services needed across the lifecycle of a child.

The Road to Health Booklet

One exceptional initiative that has been developed in South Africa, under the leadership of the National Department of Health, is the Under Five Campaign. Amongst its initiatives is the revision of the Road to Health Booklet (RtHB) with the view to ensure that it provides a platform for delivery of early childhood development services through public health facilities and through community healthcare workers.

Orbis International Africa, an international NGO that is dedicated to saving sight in Africa with a primary focus on children, is invested in this work as we engage with key stakeholders to fight blindness together. As an active member of the South African Civil Society Coalition for Women’s, Adolescents’ and Children’s Health (SACSoWACH) Early Development initiative, Orbis works hand in hand with the South African National Department of Health to ensure full implementation of expanded health and development services through the primary health care system. It is through this collaboration that Orbis is supporting children’s right to sight as well as children’s right to health on a broader level.

The role of the community in delivering health services

In 2013 Orbis conducted research to identify barriers to early presentation of eye problems. Research indicated that most patients seeking treatment first consulted Traditional Healers before visiting a healthcare clinic.

Based on the findings, it was determined that nurses and traditional healers would benefit from collaboration in identifying, referring and treating as early as possible. In the spirit of collaboration, before launching the pilot programme in KwaZulu-Natal, Orbis consulted a group of traditional healers in the development of an eye health training manual and engaged with community stakeholders and clinic committees.

Following the training, the traditional healers started to refer children to the clinics where they were welcomed by the primary care nurse. This referral was endorsed by the Provincial Department of Health and overall served as an indication of the acknowledgment of the importance of civil society and government collaboration in meeting children’s right to health.

Health system strengthening

As an organisation Orbis spends most of its resources on medical and clinical interventions with the view to support the strengthening of health systems. Orbis also invests in policy development and systems implementation with government. Neither of the approaches can succeed without the other.

The right person at the right place with the right skills

Achieving our goal of providing quality, age-appropriate eye-health services to all children in need is only possible when we see the right person, whether a traditional healer or an ophthalmologist, with the right skills in the right place.

Essentially, stronger public health systems will secure children’s access to quality eye health care services which ultimately will realise their human right to sight.