Abstract
Purpose :
1% of Malawi’s population is bilaterally blind, 80% by treatable conditions. The ratio of eye surgeons in sub-Saharan Africa is <10-5 the level in developed nations, and glaucoma prevalence >5-fold higher. With widespread poverty, energy blackouts, paucity of surgeons , any prospect for evolving subspecialty level care within the existing healthcare system appears untenable. We attempt to bypass these barriers by creating state-of-the-art facility in a self-sustaining site 40 minutes from the national capital.
Methods :
With generous donations from industry, Child Legacy International (CLI; www.childlegacy.org), Sponsel Foundation,Right to Sight, and the International Society for Glaucoma Surgery (ISGS), have established state-of-the-art clinic (Fig 1) and operating rooms (Fig 2). Eyes of Africa Center of Excellence (EOA Center) is equipped to provide high standard care five days a week, staffed by an Ophthalmologic Clinical Officer (OCO) and Ophthalmologic Nurse (ON) with EMR. Wind and solar power provide electricity and clean water 24/7. Patients requiring laser or surgery are scheduled to see an ophthalmologist. 1/3 of patients seen in any day may be patients brought to the facility by the MD; 2/3 must be OCO-scheduled indigent patients.
Results :
National University resident rotations with mentor supervision is scheduled. SLT, YAG, diode, and argon lasers, OCT, A-scan, FDT, CS, dual lanes, quality slit-lamps, phacos, posterior vitrector, Zeiss xyz/zoom operating scopes are all functional and in situ. Full time supervisor ophthalmologist is to be appointed in 2017. Local ophthalmologists and multinational eye teams from ISGS are scheduled to work together in the state-of-the-art diagnostic and therapeutic facilities. NIH-funded genetics research is under approval. Prospective studies of SLT for POAG, and refractive programs are under IRB review.
Conclusions :
Malawi’s best clinicians can now apply modern diagnostics and perform surgery at high standard with reliable energy supply. International teams of expert surgeons, technicians, nurses and optometrists will mentor and learn from local experts and trainees to help jump-start the Malawi eye care system.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.