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Grameen Kalyan (GK), another Grameen company, meaning Grameen Well-being, undertakes programs to promote the well-being of the members of Grameen Bank (GB). It operates a health program (HP) which comprises of 20 health centers each with its own qualified physician, an office manager, a female paramedic/nurse, a laboratory technician and five female health assistants. Every health center has the capacity to serve a population of 30-35 thousand people. It provides services to both Grameen members and other villagers. This HP was one of the few ways through which Grameen tries to reduce vulnerability of the poor which are due to ill health and income erosions.
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Grameen Kalyan Staff with Cataract Patients
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Recently the HP has added cataract blindness program, with trained ophthalmologists and support staff, to its existing general healthcare program.
The main objectives of the cataract blindness program are to bring this state of the art technological facility right at the doorstep of the rural people. It introduces outreach centre based operation, makes efforts to reduce cataract backlog of the area and ensure that the project runs in a sustainable manner. GK has made cataract operation very inexpensive for the poor.
The charges of operation are low both for the general patient as well as the patient who is GB borrower. For cataract operation with IOL implantation, it costs a GB borrower an amount of $27.58 while a non-Grameen patient pays $60.34, including the cost of the lens. Likewise, the charge for other operations for the former is $6.89, while the latter pays a reduced charge of $10.34.
Generally more than 60% of people suffer from malnutrition in rural areas which leads to nutritional blindness and childhood mortality and morbidity. Blindness from cataract, particularly in old age, makes the earning member handicapped and a burden for the family. It is a very common eye disease and surgically curable. In Bangladesh it is estimated that nearly 1% of the total population suffers from cataract, while it accounts for 40% of total blindness in the world. On an average, 70% of the total cases are operated in outreach center surgery or in medical institutions while the rest is added to the cataract backlog every year. GK felt that it could contribute meaningfully in reducing the number of cataract blindness by utilising the network of HP. This became feasible when Mr. Mike Lynskey, Executive Director of Fred Hollows Foundation (FHF) of Australia and Dr. S. Ruit of Tilganga Eye Center (TEC), Nepal met Professor Muhammad, and the Managing Director of GK. They agreed to provide technical support to GK in initiating cataract prevention program.
In November 2001, a team of two ophthalmologists and two ophthalmic assistants were employed and were sent to TEC, Nepal where they received basic surgical training in standard operating procedure, theatre processes to enable high volume surgery at low cost and eye program planning to conduct outreach activities.
GK established an eye centre at Alenga in Tangail District two hours drive from the capital when they had a trained and well-equipped team. They conducted OPD at the project site and visited existing health centres and GB Branches.
The team started its activities on 6 February 2002. By May 2003 the team treated 8740 eye patients (5178 female, 3562 male) in different health centers. Among those 1,420 cataracts patients have been identified and advised for extra capsular cataract extraction and posterior chamber intra-ocular lens implantation (ECC E+PC IOL), 1209 went through refractive error correction procedure, and 109 received minor surgery.
The team started its low cost (less than 25% of the market value) high volume ECCE+IOL operation in 17 April 2002 at Alenga operation theatre (AOT). Till May 2003, they operated 592 cases of cataract from different areas at AOT and mega camp.
The success of the program can be seen from the fact that of 85% blind patients treated 57% achieved good vision and 33% achieved borderline vision according to visual acuity analysis.
From Grameen Kalyan report
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