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WORLD SIGHT DAY

We need to do more to prevent blindness

PARVEZ BABUL
SOKINA (35) is a widow of Baniajuri village in Manikganj. Her husband Belayet died of tuberculosis two years ago. He used to serve his family by working as a gram police (member of a village defence party). After the sudden death of her husband, Sokina saw no way to survive with her two children. As a result, Sokina had to start working as a maidservant at a salary of taka two hundred only per month, even without food. But she was unable to serve her family with that very small amount of money. As necessity knows no law, Sokina sent her son Sagor (10) to work as a hotel boy, ending his studies in class four. Food was given him in lieu of wages from the hotel, but no money.
Sokina's daughter Nazma (12) had been studying in class five. But getting an offer from a person to marry Nazma, Sokina eventually agreed with the proposal and arranged her daughter's marriage. Nazma could not continue her education. After two months of marriage, Nazma's husband demanded fifty thousands taka as a dowry. Of course Sokina was unable to pay that and her son-in-law disappeared. Last month Nazma informed Sokina that she has been pregnant for one and a half months. So, definitely this is a trouble upon trouble! Due to these unbearable sorrows, Sokina lost her common sense of what to do, and cries silently without noticing others.
In fact, these types of sorrowful real stories are very common for poor women and children in our country like Sokina
and Nazma.
Compounding the poverty that has pushed them to this level of indescribable inhuman situation, is that due to micro-nutrient deficiencies, they are descending towards blindness (visually impairment).
As is common, Sokina has been suffering from the problem of nightblindness due to vitamin A deficiency. She cannot see at night. I asked her what she eats. Sokina replied that the family eats kochu and loti (wild plants) and sometimes dal (pulse) with rice, as she cannot buy vitamin A-rich vegetables, eggs, fish, etc. Thus Sokina is slowly going blind and the same consequence is waiting for her anemic pregnant daughter Nazma.
So, it is very clear to all of us that the existing abject poverty of our country is throwing the needy into an unwanted hell where their sorrows, sufferings, hunger, and diseases are limitless and correlated with one another. 30,000 children are dying every day due to poverty in developing countries like Bangladesh, and most of the poor people in third world countries are women and children.
Unicef has pointed out that poverty contributes to malnutrition, which in turn is a contributing factor in over half of the under-five children's deaths in developing countries.ÊSome 300 million children go to bed hungry every day. Only eight per cent of those children are victims of famine or other emergency situations.
But more than 90 percent children are suffering from long-term malnourishment and micro-nutrient
deficiency. We should remove the problem of contaminated water and arsenic to make availability of fresh water, because contaminated water causes 80 percent of our diseases, along with diarrhoea. Diarrhoea causes malnutrition. Malnutrition causes night-blindness. As it turns out, the majority of our problems and diseases are inter-linked.
If we want to remove poverty, ensure food security and to provide health facilities, especially to women and children up to grassroots level, we will have to work very urgently. Otherwise, the goals of PRSP and the MDGs will be treated as only lip service.
Sokina and her daughter Nazma are aware through television and local people that green leafy vegetables prevent vitamin A deficiency and nightblindness. That's why Sokina suggested that if women and children get training and seeds, they can grow homestead vegetables and food, which will be helpful for them to earn money, as well as getting needed vitamins to prevent night-blindness to keep their eyes well.
Helen Keller International (HKI), Bangladesh has been implementing homestead gardening/food production projects in partnership with the government and NGOs since 1988.
Surveys of HKI revealed that children of Bangladesh eat only 46 grams of leafy vegetables daily compared to the recommended intake of 200 grams. Research and evidence shows that a homestead garden can provide required nutrition for six members of a family. HKI highlighted that prevalence of vitamin A deficiency is very high in Bangladesh in the case of pregnant women, lactating mothers, and children.
Three approaches are urgently needed to improve vitamin A status. These are: 1) Vitamin A supplementation; 2) Food fortification with vitamin A and other micronutrients; and 3) Diversification of diet.
Vitamin A deficiency is a major health problem in Bangladesh. Postpartum vitamin A capsule supplementation is promoted to boost the vitamin A stores of women after pregnancy and to increase the vitamin A content of breast milk. But distributing vitamin A capsules to the women and children in our country covers less than five (among women) and about fifty percent (among children) only. One hundred percent women and children needs to be covered by distributing vitamin A capsules urgently through concerted efforts with the stakeholders
and increasing awareness.
So the seeds of vitamin A rich vegetables and a very small amount of money as a subsidy can help to create homestead gardens and a healthy lifestyle for the poor. Thus it can help the people save their eyesight. The government, concerned donors, as well as the NGOs, should come forward to take and initiative to implement more projects on homestead food production.
We should remove the vicious circle of malnutrition through eradicating poverty, producing homestead vegetables and foods, and ensuring food security. Sustainable solution is needed earlier to solve the problems of backwardness in the society such as illiteracy, superstition, etc.
The visually impaired or blind have the right to get proper treatment from the state. Ministry of Health, Ministry of Social Welfare, Ministry of Education, Ministry of Women and Children affairs and relevant sectors should ensure to provide necessary treatment, education, Braille text books, rehabilitation and employment to the permanent blind. The right to see is a human right. So, the blind should get back their sight to include them in the mainstream of development through
self-reliance. Blindness is a public health problem of Bangladesh. More attention is needed to control blindness soon. The terrible truth is that every five seconds one person goes blind and every minute a child goes blind in poor countries like our Bangladesh.
If national and international efforts to avert blindness are not intensified, the number of people with severe visual disability will be double by the year 2020. That's why World Health Organization (WHO) designed the Vision 2020 program: The Right to Sight, which was launched on February 18, 1999.
Objectives of Vision 2020 program is to: = Increase awareness of blindness as a major public health issue.
= Control the major causes of blindness.
= Train ophthalmologists and other personnel to provide eye care.
= Create an infrastructure to manage the problem.
= Develop appropriate technology.
Vision 2020 is an international program founded with active participation of UN agencies, governments, eye care organisations, health professionals, philanthropic institutions and individuals working together in a global partnership to accomplish the goal by the year 2020. Among others, Helen Keller Interna-
tional (HKI) is one of the founding members of Vision 2020. HKI is also one of the implementing partners of the Seeing is Believing program. The government of Bangladesh signed onto the Vision 2020 program on November 30, 2000.
WHO mentioned that 80 percent of the blindness could be prevented taking necessary steps timely. In accordance with the blindness and low vision prevalence survey of Bangladesh, 85 percent of blindness occurs due to cataracts. So, strengthening our determination using the means we have, can show the light to the blind.
National eye care policy (2005) of Ministry of Health of Bangladesh and Bangladesh National Council for the Blind highlighted that about 40,000 children are blind in Bangladesh. Six million people have been suffering from low vision and 150,000 people are getting blind newly every year. More than 12,000 children are suffering from unnecessary blindness due to unoperated cataract and want of surgical care.
10,000 children are blind due to corneal scarring, which could be entirely prevented through effective primary health care and primary eye care services in the community. Community based preventive measures are required to prevent blindness, which is related to Vitamin A deficiency, diarrheal disease, malnutrition, measles, etc.
Cataract is treatable, but the fact is: the poor people are unable to pay the cost of treatment and operation. The majority of eye patients have been suffering for a
long time because they do not have money. There is also a superstition that blindness is a curse instead of a disease. Within the poor communities, the visually impaired are doubly disadvantaged. So the demand of the day is that eye treatment must be totally free of cost for the poor and to make sure that they get treatment in each Union Council level health centre (because the distance of upazilla health complex is a big factor in not getting treatment).
Findings of several studies noted that the majority of the female population do not receive health services due to poverty, lack of decision making power, negligence, non-cooperation of male members, ignorance and some other socio-economic factors. That's why children and women should be given first priority in offering primary eye care services and treatment with a sympathetic mind.
In closing, let us not forget that October 15 is World White Cane Safety Day. We should make awareness among the people about the importance of using white cane and its users. The sighted people ought to offer helping hands to the visually impaired. The white cane is helpful to make the people alert to fulfill the humanitarian appeal to our fellow men and women.
We can recall the quotation of Helen Keller: "Every one of us is blind and deaf until our eyes are opened to our fellow men, until our ears hear the voice of humanity."
Parvez Babul is a journalist and columnist.