STRATEGIES FOR CULTURALLY APPROPRlATE EYE CARE SERVICE DELIVERY TO INDIGENOUS POPULATIONSN. Verma
Papua New Guinea (PNG) is a third world country that has been described as the last frontier on earth. In 1994, there were an estimated 40, 000 economically blind people, the commonest cause of which was cataract (77%) serviced by three ophthalmologists carrying out intracapsular cataract surgery. A plan to combat blindness was put in place resulting in the training of 9 national ophthalmologists who were well trained in Extracapsular cataract surgery with PC IOL implantation. Small incision cataract surgery is being introduced on a mass scale. More than half of the backlog of cataracts has been wiped out through mobile cataract patrols.
The neighbouring Northern Territory of Australia is characterized by a large landmass inhabited by a scattered indigenous population and a relative lack of skilled manpower. Diabetes and cataract are the predominant cause of visual disability. A blindness control program similar to that in PNG is being implemented. Now the resident population of this state enjoys the benefits of lessons learnt in a third world country to tackle its blindness problem. Telehealth networks, multiskilling of middle level health personnel and mobile eye patrols are some of the strategies that are been employed to address the problem.
The philosophy, strategies, financial implications as well as the results in both situations are compared. The most striking conclusion of the comparison of the two countries was that funding was not the single most important factor for a successful, culturally appropriate eye care delivery program.