The project Vision For the Future International: Rwanda is designed as a multi-year, multi-stage program with specific aims for each stage. The primary objectives are (1) elevate the state of vision care for children across Rwanda through direct clinical care, (2) educate children and parents on the necessity of preventative care and availability of vision care through education (3) creation of optometry as a recognized profession in Rwanda.
Books and Beyond, Indiana University and Books and Beyond, USA were started as literacy initiatives to help combat the book famine in Rwanda. Since 2008 these organizations have provided 20,000 books to Rwandan school children. A few years ago Nancy Uslan, (Indiana University alumna and facilitator/driving force of Books and Beyond), realized she did not see any child with glasses. If a child could not see clearly how could they read the books that were brought to them? How could they see the chalkboard during class? This insight resulted in her contacting the Indiana University School of Optometry and Eye Care 4 Kids to see if a collaborative project could be created. Don W. Lyon, OD, MS, [Chief of Pediatrics/Binocular Vision Services at Indiana University School of Optometry, which is a prestigious research University and School of Optometry, known for its exemplary clinical care and research into vision], was contacted about the project and immediately knew he was interested in working with Nancy on this project. Nancy also contacted Joseph G. Carbone, ABOC, [President, Chief Executive Officer and Founder of Eye Care 4 Kids, a non-profit organization which has assisted over 250,000 low income, underserved children receive eye exams and glasses], who also immediately expressed interest in this potential project.
Working together as a team these three individuals from different backgrounds designed a fact finding mission to Rwanda in July 2016. During the trip the team met with the Director of Musanze Hospital, Dr. Violette Ayingeneye. The purpose of this meeting was discuss the state of vision care in the district and to inform hospital administration of the proposed program for summer of 2019. Next the team visited two schools in Kinigi, in the Musanze district of Rwanda, (Bistante and Kabwende). Here the team spoke with the Headmasters, (Ndahayo Veuant, Ignace Nizeyimana, and Clement Nkuriyingoma), about the program. Each of the Headmasters were highly supportive of this initiative and welcomed the team to come back next summer. This agreement was with the understanding the Honorable Minister of Health, and the Honorable Minister of Education approve the plan. Next the team went to the US Embassy in Kigali to meet with Amber Lucero-Dwyer, Senior Development and Outreach Communications Specialist and John McKay from USAID. Here the team discussed the program and were given information on the state of health care in Rwanda, and the steps that would be needed to be completed for such a program to occur.
The team was able to get a meeting with the Honorable Minister of Health, Dr. Agnes Binagwaho and Irene Bagahirwa. At this meeting the team again discussed the proposed program and the Honorable Minister gave the program her initial approval. During the discussion the topic of optometry in Rwanda came up. It was discovered that there are approximately 13 ophthalmologists for a country of 11 million and optometry is not a recognized profession. The Honorable Minister directed the team to speak with Dr. Phillip Cotton, Vice Chancellor of the University of Rwanda College of Medicine and Health Sciences about the possibility of starting an optometry program at the University. That meeting was well received and discussion was started on gathering information about a program being created within the college. Also, during the meeting it was discussed utilize students from the college to assist with the pediatric eye exams.
As one can see from the above introduction, the fact finding mission to Rwanda was a success. Currently the team is working through the logistics and funding issues to get the trip next summer planned and completed.
The team would like to come to Rwanda late June, early July 2017. This time frame works for us as all of the team members are available at that time frame, but more importantly the children are still in school. We are planning for a two week trip in total. Exact dates will be finalized based upon the schedule of the school children.
The team will consist of the following individuals:
- Mr. Joseph Carbone, Dr. Lyon, and Mrs. Nancy Uslan as primary contacts for the program
- Optometrists and optometry students from Indiana University School of Optometry, (8-10 optometrists and 4-6 4th year optometry interns)
- Members of Eye Care 4 Kids, (10-12)
- Ophthalmology interns from the Rwanda University, (8-10)
- Optician interns from the Rwanda University, (4-6)
The eye examinations will take approximately 10 days to complete. There will also be days of set-up and clean up at the beginning and end of the visit that will not require the children to attend. The team will work out of one of two locations, (1) Bisante School or (2) LaBabou Gorilla Lodge. If the team works out of Bistante school we will utilize the computer lab to house the testing that needs electricity, and a couple of classrooms to complete the examinations. The benefit of this location would be that we would only need to transport those children from Kabwende school. We would minimize the disruption in the education of the students during this time. If we do house the equipment at Bisante we would require additional security to watch the equipment while we are not there. We would also need transportation for the team to and from the hotel(s) each day. If the team was able to secure the Labaou Gorilla Lodge then we could set up the equipment in the soon to be completed dormitory setting they have. The team would stay on site and would not need transportation, however, we would need to transport the students to the site each day. The Headmasters at both schools preferred the second option, but they did indicate if we needed to work at one of the schools they would work with the team to maximize space and minimize disruptions of the students’ education.
The comprehensive examinations will comprise of the following clinical tests; (it should be noted that all of these tests are routinely performed in the United States and across the world in optometry and ophthalmology).
- Visual acuity distance and near Measurement of depth perception
- Measurement of pupil function Measurement of ocular alignment and accommodation
- Blood pressure Retinoscopy and refraction, (to determine need for glasses)
- Assessment of external eye health Dilation of pupils
- Assessment of Internal eye health Post cycloplegic refraction
The team will record each of the findings on exam sheets and will make available any and all information that is needed by the health care system in Rwanda. We want this to be a collaborative program.
Indiana University School of Optometry and Eye Care 4 Kids will work together to guarantee funding primarily for each organizations expenses, (transportation, accommodations, food, clinical equipment, supplies, and medications). We would like to work with the offices of the Minister of Health and Education to see about providing transportation for the students and possibly the eye care team. We are also interested in seeking funding for additional security. The first step is for all parties to agree to this strategic plan for 2017. Once we have approval then the search for funding can earnestly begin. It should be noted that we are already in conversations with a few corporations that are extremely interested in this program and we do not foresee any significant challenges in funding this program for 2017.
This project started out as a literacy program and one person taking notice of a potential problem for the children of Rwanda. If they cannot see clearly then are they able to reach their full academic potential, or is an undiagnosed vision problem a barrier to them? While at this stage the program is designed to work with only a few thousand children it has the potential to impact the entire country and generation of Rwandans. It is the goal of this program that the children of Rwanda will be able to see their future clearly, and continue to enhance the country.