The ability to visualize things around us is a vital aspect that influences the quality of life that one can enjoy. On a day to day basis, people make important decisions based on what they see with their eyes.

Doctors, nurses, business executives, pilots and other professionals look at objects, data and information and process it to make life impacting decisions. Access to quality eye care services is however out of reach for many especially in the rural areas because of prohibitive charges related to treatment. Since 2012, Vision For A Nation Foundation (VFAN) has been promoting access to quality eye care services to through out the country.

In partnership with the Ministry of Health, VFAN supports all 502 Health Centres in the country to provide quality eye care services through training. Currently half of all nurses in Health Centres are trained to offer eye care services. While VFAN initially focused on building the capacity of nurses to offer eye care services, few people visited the Health Centres either for check ups or seeking treatment. Many people were not aware of the available services. In addition to using the media to communicate about the services, VFAN embarked on a new village outreach program in 2015 that has now seen over 800,000 people benefit from quality eye care services.

The village outreach program which began in Rutsiro District before being extended to other Districts, has brought eye care services closer to the population. Under the village outreach program, each Health Centre is allocated 30 villages whereby it conducts four visits per village and cover 2 villages on a monthly basis and screens up to 200 people per month. Speaking about the village outreach program, Abdallah Uwihoreye, the Country Director of Vision For a Nation Foundation said that the village outreach program was an important initiative because it was observed that majority of the population were not aware that they had eye problems and therefore did not visit Health Centres to specifically screen for eye problems. "Many people are living with different eye problems because they are not aware of available services that could help solve the problem. Statistically we know that there are many people with eye problems but the number of people visiting the centres seeking for treatment was very low. On the other hand, there are others who have eye problems but are not aware of them. This is why this program is vital. By going to the villages, we create awareness about available services for people who are aware of their eye problems but do not know where to go for treatment and through screening we are able to identify people with eye problems and offer them the appropriate treatment” he said. To date, 5,000 villages have been reached. "Through the village visits, we have found that some people have eye problems which can be solved by eye drops, others have refractive error problems which is easily be corrected by spectacles. Those with complicated cases are referred to hospitals for specialized treatment. Those that are found to have no problems are educated on how to care for their eyes to avoid future problems.” Uwihoreye added.

Beneficiaries Speak

Eus Mugemana 63, a resident of Mugera cell, Gatsibo sector of Gatsibo district started suffering from eye problems when he was forty. Although the got some medication that enabled him to manage the pain, his problem was not treated. "Lately my eyes have been hurting but I have not managed to go see a doctor. I am fortunate because they (VFAN) has brought us nurses to our village to treat us for free” he said.

"This is a good opportunity for our community to benefit from eye care services. There are a number of villagers here who suffer from eye problems but do not seek treatment until the situation is worse. This visit ensures that no one is left behind to suffer from eye problems.” Mugemana added.

Uwamahoro Nyiragafureba is a Congolese refugee living in Nyabiheke Camp in Gatsibo District. When she heard about the free eye treatment taking place in her village, she immediately rushed her eight year old boy there; abandoning her market activities for the day. Her son had been suffering on both eyes for the past three years but she did not have money to take him to the hospital for treatment.

"As you can see my son’s eyes have turned red in colour. This is my first time to take him for a medical check-up because of the financial problems am facing. I am consumed by daily activities of ensuring that the family has food on the table and because of this I had not managed to take him to see a doctor. I am happy that today he has been screened and referred to the hospital for specialized treatment” she said.

Esther Uwizeyimana, a resident of Gatenga sector of Kicukiro District is a student who participated in a village outreach session that took place at Nyarurama Health Post in Nyarurama cell. Uwizeyimana had been suffering from sight complications which affected her studies. "Whenever I would read, my eyes would start tearing up and make it difficult for me to read. I was always wondering how my family could afford to take me to the hospital but I am thankful to Vision for a Nation Foundation for the treatment. The spectacles they have given me have solved my problem because I can now read easily” she said.

Quality eye care at a minimum cost

Following the partnership between the Ministry of Health and Vision For a Nation Foundation, citizens with refractive Errors allergic conjoctivitis and bacterial conjoctivitis can now use the Community Based Health Insurance (Mutuelle de Sante).

"These eye problems are covered by mutuelle de santé, because people are received and treated in the same way as when they visit health centers seeking treatment for other illnesses. The only time that citizens have to pay is when they are found to have refractive error which is usually corrected by glasses and even then the cost is only one thousand Francs (Rwf. 1,000)” Uwihoreye explained.

Francois Gatsinzi, head of Gituza Health Centre in Gatsibo sector of Gatsibo District, commends the village outreach program for creating awareness among the general population about how they can look after their sight.

"At first we had been offering these eye care services at the health center but people did not understand what was going on; they did not differentiate daily health center services and eye care services. Today however, I can see that people are enjoying these services and are coming for regular check ups. Compared to other health care services provided in this health centre, eye care services are the most sought after receiving more than 200 people per month ” he said.

Francine Uwizeyimana, one of the Nurses working at Gatenga Health Center in Kicukiro District, who is trained on eye treatment and is involved in the village outreach program says that since the outreach visits began last year they have received more than 700 people in the Health Centre.

"Cumulatively, 80 per cent of people we have received have allergic conjunctivitis while more than 80 per cent of people above 40 years have near vision problems. When you look at these statistics, you immediately realize that these services were needed by the community. The village outreach has created awareness about availability of these services and encouraged people to seek treatment for eye problems” she stated.

Sustainability and continuity of the program

"Based on the training that we did, current situation, our partnership with Rwanda Biomedical Center and the Ministry of Health, this program will be sustainable” Abdallah said. A curriculum on eye care and treatment has been integrated in the schools of Nursing in Rwandan Universities. This is an important aspect in ensuring sustainability in providing quality eye care services for Rwandans. "Today those who are graduating have knowledge about eye care treatment. In past we had a big challenge of turnover where we used to train nurses and after sometime they would leave and pursue other jobs and or go into private businesses. With more skilled Nurses graduating yearly, we are going to address shortage of Nurses in Health Centres” he explained.

Overall statistics show that up to September 2016, through Health centers and village outreach, 864,082 people had been screened; 397,372 were given eye drops, 80,387 were given reading glasses, 7,809 were given adjustable glasses, 115,920 were referred to hospitals for specialized treatment while 4,366 villages were covered via village outreaches.