WorldView Magazine - Fall 2009 - (Page 14)

Health TURNING A bLIND EYE Why should we care that women account for almost two-thirds of the blind people in the world? by Paul Courtright, DrPH eople, including some ophthalmologists, are often surprised to learn that about two-thirds of the 45 million blind people in the world are women. What is the evidence? Is it a global issue, or limited to just a few isolated areas? Most importantly, what can we do about it? In developing countries being female is an important factor restricting awareness, access, and acceptance of sight-restoring eye care services. This inequity could be changed. The evidence base for understanding gender issues in eye care has only been generated in the last ten years, starting with a systematic review of all population-based blindness surveys. This review showed that blindness is about 40% more common in women compared to men, regardless of age. In the 50+ age group women were consistently more likely to be blind P than men. The recognition that women accounted for about 64% of the total blind initiated a major effort to understand why—and then address the reasons. It became clear early on that socio-cultural differences between men and women were responsible for reduced access to services by women in most developing countries. Culturally determined roles of men and women (and boys and girls) contribute to their response to the onset of vision loss and their options for accessing treatment. This is compounded by the fact that, in most countries, women live longer than men and vision related disorders increase with age. Globally, about 80% of blindness is preventable or treatable, with the major cause (about 50%) being cataract, followed by glaucoma, corneal diseases and age-related macular degeneration. Although childhood blindness makes Marceline Finda arumeru women called “sentinals” share information about eye outreach services with their Tanzanian communities. up only about 6% of global blindness, it is a priority because of the lifetime of blindness that a child will face. So, what has worked to reduce gender inequity? Evidence from countries as diverse as Egypt, Tanzania, Nepal, India and Pakistan suggests that there are three key approaches, with some variation country-tocountry, or setting-to-setting. First, in most developing countries, engaging husbands and sons (who make most health care decisions within families) on behalf of women and girls is critical. It is the role of the health care system to provide counseling to families, whether it is to enable an elderly woman to obtain trichiasis (eyelid) surgery for trachoma or for a young girl to have surgery for congenital cataract. Counseling has generally been weak in Asia and Africa, but its importance is being increasingly recognized. Some pro-active eye care programmes in Asia and Africa have hired, trained and use dedicated counselors on a routine basis, rather than assuming that already overworked nurses will carry out this important function. Second, weak transport systems in much of the developing world mean that it can be difficult to travel from a rural community to a larger town to get surgery. For women, this is compounded by cultural and social constraints that make it virtually impossible for a grandmother to flag down a minibus, get into town, change to another minibus and arrive at the hospital. Eye care programs that are keen to improve gender equity have adopted the strategy of teams in the field screening for eye disease and then bringing those ready for surgery back to the hospital. One only needs to compare hospitals with this type of outreach approach to those without it 1 Fall 2009

Table of Contents for the Digital Edition of WorldView Magazine - Fall 2009

WorldView Magazine - Fall 2009
Contents
President's Letter
Your Turn
Are You Connected Yet? Join Africa Rural Connect
Group News Highlights
Why Investment in Health Is Critical Now
New Hope and Lessons from Rwanda
Turning a Blind Eye
A Question of Capacity
CN U HLP ME? I HAVE A ??
When Water and Sanitation Are a Priority
Could “Peace Care” Lessen the Global Burden of Disease?
One, Two, Three
Translating International Health to Health Care at Home
Turning Tragedy to Opportunity
Costa Rica: Finding My Religion
St. Lucia: Learning about Hunger
Seven Dusty Notebooks
Peace Corps Service 2.0
The Peace Corps Community Making a Difference
Community News
Advertiser Index

WorldView Magazine - Fall 2009

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