By James R. Broyles, Peter Glick, Jianhui Hu, Yee-Wei Lim
Cataracts account for roughly 1/2 all circumstances of blindness around the world, with the overwhelming majority in constructing international locations, the place blindness and visible impairment can decrease existence expectancy and monetary productiveness. almost all these circumstances will be cured through quickly, reasonably cheap surgeries, yet a scarcity of expert surgeons makes it not likely that the necessity for such surgical procedures — envisioned to arrive 32 million instances globally through 2020 — could be met below present practices. HelpMeSee Inc. (HMS) is constructing an method of surgical procedure education and supply that comes with use of high-fidelity simulator expertise and linked curricula for high-volume education, improvement of a approach of self sufficient deepest practitioners, and coaching the place helpful of people with no clinical levels. RAND researchers made up our minds that this system has the aptitude to scale up surgical capability quickly and that less than positive assumptions, the HMS application may well principally shut the backlog of surgical circumstances within the 4 significant areas studied, leading to 21 million circumstances of cataract-caused visible impairment in 2030, in comparison with 134 million instances lower than the established order. this system additionally offers to have huge affects on overall healthiness and productiveness, and the expected expenses according to 12 months of incapacity avoided recommend that the intervention will be hugely reasonably-priced in all the areas researched. in spite of the fact that, a couple of major demanding situations have to be met, quite within the components of outreach, distant tracking of autonomous practitioners (especially non-doctors), and public and criminal reputation of non-doctors as surgeons. it is very important conscientiously pilot and computer screen the procedure sooner than absolutely scaling up.
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Extra resources for Cataract Blindness and Simulation-Based Training for Cataract Surgeons: An Assessment of the HelpMeSee Approach
Training can be done in six to eight weeks for this group, requiring 120 classroom hours, 100 simulator hours, and 100 live surgery hours. • While the first two groups of trainees are ophthalmologists, the third group will include many who do not have significant previous ophthalmic experience or knowledge. These can be general surgeons or other doctors who want to change specialties, or other medical professionals such as nurses with ophthalmic experience. They may also be individuals with no medical background at all but with adequate education (university) and other skills.
As in Aravind and Tilganga, the quality of cataract surgeries performed by Project Vision is high. , 2007). The startup costs of each CEC are covered through donations and, increasingly, also through central and local government matching funds. Once in operation, however, CECs are expected to be financially viable based on low unit costs and revenue from patient fees. , 2009)— high by South Asian and African standards but more easily within reach of most Chinese. It is estimated that a CEC can break even at 1,500 surgeries per year (Congden, 2007); the typical plan is for a center to perform 500–1,000 cataract surgeries in the first year, 1,000–1,500 in the second, and 2,000 annually thereafter.
The striking fact about blindness in developing countries is that half or more of the cases are curable. Cataracts—which usually can be cured surgically—are the leading cause of blindness in the developing world, responsible for about 50 percent of the blindness (Lawani, 2007) (see box). , 2006), although this may partially reflect the rapid assessment techniques applied in these studies. As noted in the Introduction, rapid and inexpensive surgical procedures for removing cataracts and restoring sight (described in the next chapter) have very high success rates in developing country contexts.