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Nurses save children’s sight in KwaZulu-Natal

Research in KwaZulu-Natal has revealed that many children lose their sight simply because they do not get appropriate treatment at the right time.

“Early detection is key to preventing blindness so that the visual pathways between the brain and eyes can develop correctly. Should an eye problem go undetected, by age six it may be too late for the child’s brain to learn to ‘see’, even if the eye problem is corrected’” says Dr Dharmesh Parbhoo, paediatric ophthalmologist at the ORBIS Paediatric Eye Care Centre at Inkosi Albert Luthuli Central Hospital, Durban.

To remedy this situation the KwaZulu-Natal Department of Health has been working in partnership with ORBIS Africa, a sight-saving not-for-profit organisation, to train primary health care nurses in the province.

“Throughout South Africa primary health care nurses are often the first point of contact medically, yet nurses only receive basic eye training,” said Prasidh Ramson, Programme Manager for ORBIS Africa. “Their limited expertise meant that some children were only being referred for eye treatment at a late stage, often too late to fix the problem.

“ Understanding that a simple eye test could set in motion a life-changing intervention inspired a group of ophthalmic nurses and optometrists from the KZN Department of Health to team up with ORBIS Africa to develop a new nurse training course.

Ophthalmic nurses Rasheed Chiloane, Sbongile Ngubane, Kenneth Mthunzi, optometrists Sifiso Gwala and Terrence Hammond and Sindi Mthethwa (Deputy Manager: Non Communicable Diseases, Geriatrics and Prevention of Blindness in the KwaZulu-Natal Department of Health) volunteered their time to train primary health care nurses throughout the province.

This team worked with ORBIS, and consulted with the Nelson R Mandela Medical School’s Department of Ophthalmology, to develop an innovative two-day training course and resource pack that equips primary health care nurses to detect common eye problems including strabismus (squint) and cataract. It also enables them to better identify what is treatable at a clinic level and what should be referred to a specialist doctor.

The resource pack, which is given to every nurse that undertakes the training, includes a training manual, an occulder, pen torch and a Snellen ‘E’ vision testing chart. It has been received so well that ORBIS is looking at how to roll out the training and materials nationally and on a global level.

KwaZulu-Natal is the first province targeted. To date over 200 nurses have been trained in seven of the 11 health districts (Illembe, eThekwini, Ugu, Umzinyathi, Umgungundlovu, Amajuba and Uthungulu in Richard’s Bay). The aim is to cover the entire province by the end of 2013.

ORBIS has been working with the KZN Department of Health since 2010 to improve paediatric eye care services at a primary, secondary and tertiary level. The ORBIS Paediatric Eye Care Centre at Inkosi Albert Luthuli Central Hospital, which opened in late 2011, is at the core of the strategy, providing specialised treatment and surgery for blinding conditions that are common in South Africa, such as paediatric congenital cataract, glaucoma, retinoblastoma and uncorrected refractive error. Although proud of this high-tech facility and its dedicated team ORBIS knows it can only be effective as part of a comprehensive blindness-prevention strategy. “While it is important to have a specialised paediatric eye care centre it is equally vital for children in the community to be identified early enough” said Ramson. “By enabling primary health care workers, parents and caregivers to better identify potential eye problems early, more children will receive the treatment they require in time to save their sight.”

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