1.2 billion people worldwide cannot see properly simply because they need glasses. Sierra Leone is one country where access to eye care is challenging, as they have a population of 7 million but only 3 qualified optometrists.

How easy is it for you to see an optician? Just a quick trip to the high street? Now imagine what it is like in Sierra Leone.

Our mission is to enable people living in poverty to access affordable glasses and eye care. To make this a reality in Sierra Leone, with thanks to The Clothworkers Foundation, we have been piloting a Primary Eye Care project.

Primary health care, as defined by WHO, is the “whole-of-society approach to health and well-being centred on the needs and preferences of individuals, families and communities.  It addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing.”

One of the key recommendations coming out of the WHO’s 2019 World Report on Vision is to “make eye care an integral part of universal health coverage”, and it emphasises the need to “prioritize primary and community care services”.  Our project, which is being piloted in Kenema district, Eastern Province of Sierra Leone falls in line with these recommendations.

The project has trained 16 government employed health workers using a Primary Eye Care training manual developed by the WHO specifically for the Africa region, to provide basic eye care from the Peripheral Healthcare Units (PHUs) which provide the primary health care services in Sierra Leone.  We also trained 240 community health workers to identify people with eye conditions in the community and refer them for further examination and treatment.

The aim of the project is to improve eye health services for and spectacle use by the wider population, but in particular the most vulnerable groups, as well as increase knowledge of basic eye health issues among communities.

This year awareness raising activities were carried out across the 16 chiefdoms that make up Kenema district. Communities discussed the negative impacts of herbal remedies previously used, the availability of new and local eye care services, and how glasses work. We also used radio messages to raise awareness and convey the health messages, to an estimated listenership of 42,000 people.

Though progress with the pilot has been slow due to Covid-19, in the first 3 months following the training the health workers treated 1,065 patients with eye drops for eye infections, and 301 patients were issued with reading glasses or sunglasses.  A further 64 were identified as having more complex eye health needs and were referred to Kenema district hospital for further investigation.

To read more about our Covid-19 response in Sierra Leone click here.

Once Covid-19 restrictions are lifted work will continue to provide patients with the eye care and glasses they need, and more communities will be engaged to raise awareness of eye care issues, services and the importance of wearing glasses. We will continue working in partnership with the government and health ministry to roll out this project across the rest of Kenema district.

Improving eye care at the community level is important as it improves services in more rural areas and means people do not have to travel as far to get the services they need. Improving front line eye care prevents worse eye health issues from occurring and, as a result, reduces the strain on the limited services provided by hospitals.

Though Sierra Leone may struggle with its number of qualified optometrists at the moment, by focusing on Primary Eye Care, on improving the eye care knowledge and skills of health workers already employed, we can make sure people are getting the eye care they need.