Guatemala Brillando - How We’ll Get This Done

Nearly 75% of people who are blind in Guatemala suffer from preventable or curable causes. There are an estimated 2 million people with vision loss. Of these, 94,000 people are blind.

In partnership with Visualiza, “Guatemala Brillando” or “Brighter Guatemala” is a firstof-its-kind plan to systematically eliminate avoidable blindness throughout Guatemala. We are positioned to achieve it in just 10 years and the blueprint can be scaled across the world. Within these 10 years, Guatemala Brillando is estimated to develop 30 Vision Centers (VC) and 5 eye hospitals across the country. Today, there are 10 Vision Centers and plans to open a new hospital in the Quiché region.

New Children’s Eyecare Program in India

Providing quality refraction services on a continued basis is a challenge as it requires a dedicated team and continuous monitoring and follow-up. This project aims to focus on the need for refractive error services for children in the Drishti Sehi Duniya area of India via Vision Centres (VCs) and the base hospital. The proposed project will strengthen VCs, and teams will be based at VCs. 

On the day of examination at VCs, each child will undergo a complete eye check-up.  A prescription will be provided, and children can choose trendy frames. The delivery date will be three days from the refraction. Annual follow-up visits ensure that children requiring a new or changed prescription are covered, giving all children regular opportunities for eye checks.

Estimated Outputs

• Screening of 129,600 children

• Coverage of over 700 schools

• Orientation of 1,500+ school teachers

• Training of 3,000+ Vision Ambassadors

• Provision of 4,500 free or subsidized spectacles to children (estimated to meet the needs of

• approximately 3.5% of screened children)

• Performance of 75 surgeries

The Retinopathy of Prematurity (ROP) project employs a comprehensive approach to address the needs of premature infants in NICUs across Coochbihar, Darjeeling, and Jalpaiguri districts. Key components of the project include:

• Utilization of ROP fundus cameras and telemedicine services in level 3 and level 2 NICUs. 

• Deployment of a trained technical team. Assessment of ROP severity and determination of necessary treatments.

• Provision of laser therapy, injections, and vitrectomy treatments to infants diagnosed with severe ROP. Referral of identified cases to base hospitals for medical, surgical, and rehabilitative services.

• Training of 350 nurses and pediatricians in local NICUs on ROP identification and management protocols.Organization of quarterly Continuing Medical Education (CME) sessions for local pediatricians, neonatal care specialists, and gynecologists to enhance awareness and expertise in early ROP detection and preventive care.

Estimated Outputs

• Screen 5,800 babies for ROP

• Provide laser, injection, and vitrectomy treatment to 327 babies

• Train 350 nurses and pediatricians for ROP awareness
  

Accruals and Fiscal Year End 

We processed several agreements/payments throughout May and June and submitted our accrual sheet to the finance team. Programs worked hard to end the year strong and on budget. 

Conference Participation 

Chundak, Heidi, Heidy, Katie, Kieran, and Suzanne represented Seva at IAPB’s 2030 Insight Live event convened in Mexico City at the end of June.

Kuldeep, Arun, Saikat, and Shradha all represented Seva at the VISION202 India Conference in July. Kuldeep also represented in his capacity as treasurer for Vision 2020 India. Njoki attended the Africa Ophthalmic Congree in Kigali, Rwanda from July 26-28. 

Programs on the move 

Many team members traveled together in May. Katie, Claudia, Jennifer visited Sacred Circle in Utah. Njoki and Heidi visited KCCO in Tanzania. Heidi, Kuldeep and Ravindra traveled to Cambodia to assist with the Seva Cambodia office move in June. Parami, Rolando, and Giri also spent time in Cambodia at the end of July onboarding new staff and setting up the office. Heidi spent July with the Visualiza team in Guatemala. Njoki spent a week with current and potential partners in Malawi. Kuldeep and Shradha visited a number of partners across India.

Training

Arun launched the Eyexcel Advanced Workshop at SNC, Chitrakoot in June. The following month, he held the Management Development Program at HV Desai in Pune. He also represented Seva at the first Eyexcel Global Workshop under the Dr. Suzanne Gilbert Training Academy which was completed on July 25th. 

New Seva Cambodia office in Phnom Penh 

Seva Cambodia opened its new office in Capital City Phnom Penh. Previously, they were based in the Battambang Province. The Phnom Penh office will allow the team to better represent the work that is happening with our Ministry of Health partners. It is also more centrally located to our program work, which have expanded beyond the northwest part of the Cambodia. We are now positioned to do more networking and work closely with the government and other healthcare organizations, as well as organizations working in other sectors. This will further strengthen program capacities.   

Budget Budget Budget

From January – April, the program team spent time reviewing their work and preparing the budget for fiscal year 24-25. This year, the team incorporated budget descriptions to bring greater context as to why we are proposing these activities/projects. 

Updates from Cambodia

Seva provided replacement of cataract instruments to Battambang, Banteay Meanchey, Pursat, Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital.

Supported to have Reverse Osmosis (RO) Water System in Banteay Meanchey and Pursat eye units, Angkor Hospital for Children, and Caritas-Takeo Eye Hospital for quality improvement in eye care.

Printed and provided medical emergency posters with frames to partner eye units/hospitals (Battambang, Banteay Meanchey, Pursat and Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital). These posters will be helpful for staff to follow the procedures in case of emergency.

Programs Operations Team met at the Seva office in June + more updates

 Seva brought the Program Ops team to Berkeley in June to meet for the first time since 2019. They focused on program planning for the coming fiscal year

Lavelle Fund for the Blind awarded Seva $1M to establish a Regional Training Center in support of Guatemala Brillando

Katie McMillan began working with Seva as the Technical Product Manager. She will take a lead role propelling our technology driver forward

IAPB organized its annual meeting in Singapore. Arun, Brad, Chundak, Jerry, and Suzanne presented Seva's work at various sessions

Seva co-sponsors International Agency for the Prevention of Blindness 2030

InSight Live Singapore

Seva had a strong presence at this in-person and virtual meeting convened during June 25 and 26 at the Singapore Eye Research Institute. In person talks were given by Seva consultant Dr. Jerry Vincent on fragile communities “From Crisis to Action” (with focus on Rohingya community) with commentary by Chundak Tenzing and Suzanne Gilbert on Technology for Access to Services (presented on the Vistaro IR retinal camera). Virtual presentations were given by Seva’s Arun Acharya and Dhivya Ramasamy to the IAPB Human Resources group and by Radhika Krishnan to the Diabetes Retinopathy working group, and by Consultant Brad Wong during a session on eye care financing. The newly formed Indigenous Peoples Special Interest Group met in Singapore with Seva’s Jennifer Leo joining virtually. The meeting was attending by 350 participants from over 40 countries.

Suzanne and Chundak note the value of getting to connect with representatives from more than a dozen Seva partner institutions while catching up in general on what is happening with WHO, Ministries of Health, and other eye care NGOs.

Updates from Nepal

This year’s target was to reach 3250 volunteers. Our partners have been successful in reaching 3605 Femal Community Health Volunteers, teachers and mothers’ groups.  This last quarter alone, partners reached 2622 volunteers. 4 Vision Centers became operational this quarter.

Updates from India on training

April: 37 Dr and AOPs (9 Women) from 10 Hospitals (India and Nepal) completed 5-day Eyexcel to help trainers train young trainees who deliver quality eye care services in underserved communities

May: 68 Dr, Admin and AOPs (25 Women) from 14 Hospitals in Nepal completed Eyexcel, Quality and Management Development workshop to deliver high-quality eye care in Seva partner hospitals

June: 35 Dr, Admin, AOPs (13 Women) from 12 Hospitals across India, Nepal and Cambodia completed the Observe-Understand-Change Workshop to improve Quality and Safety systems

Observe, Understand, and Change

Observe, Understand, and Change is a training program conducted twice a year, sponsored by Seva Foundation in partnership with Zamindar Microsurgical Eye Center, Bangalore, India. In June 2023, the third batch of participants (about 40) from three countries (India, Nepal and Cambodia) observed the standard operating procedures implemented at the center, followed by a group discussion. Participants then shared the current practices at their respective centers and presented the desired changes for improvement to maintain minimum standards for patient safety. The following video clip shows the program.

Financing 2 Eye Care Articles

Given there is limited high-quality data for global economic estimates in eye health, particularly for low-income and middle-income countries (LMICs), two years ago Seva started an initiative to bring the spotlight on the ‘cost of community and primary care in the eye health’ and ‘The economic and social costs of visual impairment and blindness’ with the aim to generate the firsthand evidence. As an outcome of these efforts led by Seva, two separate studies have been published by leading peer-reviewed journals.

- ‘The economic and social costs of visual impairment and blindness in India’ published by the Indian Journal of Ophthalmology

- ‘Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost- effectiveness at scale’ published by The Lancet Regional Health - Southeast Asia – This is one of its kind study (in terms of scale and geography) to highlight the evidence on major eye health interventions championed by leading Seva partners (including Vision centers, School eye screening, eye camps, and door-to-door screening.)

Quality Workshop News

A workshop titled “Quality- Journey towards Patient Centric Care” was organized by Seva Quality Team. 34 participants representing all parts of Nepal received refresher training. These participants included Quality Champions from Seva and non-Seva partners. The workshop reviewed the existing quality initiatives, discussed the good practices, and drew a roadmap and action plans to ensure quality emphasizing on people-centered eye care in Nepal. We’re excited to have additional workshops lined up for December and January in India for hospitals across the Asia region.

Seva Foundation received 4 National Awards

Seva Foundation received 4 national awards from the Government of Cambodia, signed by the King and the Prime Minister. These Awards were conferred in recognition to Seva’s contributions in Eye-Care Services since 1999. It also recognized Seva’s special contributions in recently promulgated National Strategic Plan for Blindness Prevention and Control (NSP-BPC 2021-2030) and the Provincial Roadmap on Blindness Prevention and Control 2021-2030.

Vistaro Camera: The Camera that Saves Lives

Vistaro image quality compared favorably vs more expensive high end cameras.

Seva-Remidio team visit to Mozambique reinforced training on use of Vistaro and update on HIV and eye conditions.

Staff of YRG Care Center in Chennai were training in vision testing to enable adding visual acuity to patient monitoring.

Using evidence for program improvement

Seva published a Case Study on the Operations Research program and an article on small scale research in the Community Eye Health Journal. Three of the four Seva research teams published their project results or had their paper accepted. Conducted a survey of GSI mentors and selected other mature institutions to determine priority issues on use of routine administrative data. Seva's Introduction to Evidence Informed Practice course design & materials were completed. Strong interest by WHO and International Agency for the Prevention of Blindness in promoting the Seva course

Eyeglasses for Everyone

Seva joins Aurolab for strategic planning on affordable, quality eyeglass lenses

Aurolab inaugurated its Optical division, thus underscoring the commitment to quality, affordable eyeglasses. David Green and Suzanne Gilbert conducted a learning saloon on Opticals with the Board. Seva consultant reports are contributing to business planning and selection of manufacturing technologies. With Seva involvement, Aurolab has hired additional staff to head up Opticals sales & marketing. WHO and major global eyeglass providers are following this Opticals project with interest. 

Data, anyone? 

After two years of virtual research skill learning, Seva partners finally got to have an in-person data analysis workshop at Seva partner India Institute of Public Health - Hyderabad. The two week training built upon multiple online workshops and preparatory use of the Stata software so teams arrived ready to work. Research teams from Nepal and India are using the newfound skills to analyze results of their randomized control studies to improve service delivery. Services for kids, Vision Center patients, and people with Diabetes will be improved as a result.

Quick update on operations over the last quarter

More than 60 participants from 7 hospitals across Latin America gathered for EYExcel LA, a workshop designed for trainers to improve their training methods and results.

Through collaboration with Standard Chartered Bank, Seva and partners are establishing 65 new vision centers with partners in India. So far, 8 VCs started operating through this initiative.

As a result of our Call for Ideas, Seva began working with two new partners to bring eye care to Native Communities. The Minnesota Vision Health Task Force, created to build a comprehensive system of eye care in Minnesota, and to support and sustain capacity building for eye health within Native communities. This is a partnership of local health, education, and non-profit organizations aiming to prevent vision loss and blindness by aligning strategies that create equitable access to vision health care across Minnesota. Through a partnership with Seva, this program is focused on providing eye screenings care to Native school children within the state of Minnesota.  The Tundra Health Initiative provides access to eyecare in rural villages in western Alaska. This involves making trips, by air, to communities scattered throughout the region. During trips, vision screenings and services are provided. With support from Seva Foundation, Tundra is working in increase access to eyecare for remote communities Native communities in the areas around Nome, Alaska.

Domestic travel started up again this quarter with international travel starting up in July. We're excited to combine virtual meetings and discussions with some in-person consultations and exposure visits for staff and partners.

Vistaro Camera

Seva's Vistaro retinal camera went into high gear testing this past quarter with devices in use in Thailand, India, Ukraine (yes, Ukraine!!) and most recently, Mozambique. This second version of the camera already offers ease of focus and other functionality that improves over the original model. Remember, this device is designed for use frontline HIV workers who have never done an eye exam. Inputs from HIV clinics and eye departments inform Remidio Technology's design of version 3, to come out early 2023 for wider testing and examination data collection. Pleased to note that the large HIV center Seva is partnering with in Chennai requested eye exams for its very special patients: children who as babies contracted HIV from their mothers. Our friends at Aravind Eye Hospital, Chennai sent a team to examine 80 people including kids and their caregivers, with arrangements for follow up care at the eye hospital. For many of the children, this was their first eye exam. 

Organizational Development Training

An organizational development training program for SCEH (Dr. Shroff’s Charity Eye Hospital, New Delhi, India) was developed by Arun Acharya (Global Training Specialist, Seva Foundation) after consulting with their top management, HODs and Administrators.  

This program was needed to fill the gap in the number of skilled management personnel who could lead quality and process improvement projects. The purpose was to train their high potential employees such that SCEH becomes a Centre of Learning and Excellence in terms of high-quality patient-centered eye care. 

This initiative is part of the GSI as a global platform initiative and fuels one of Seva’s core drivers I.e., “Training and Job creation” 

“What is the Quality of the Surgery Being Performed?”

Seva’s Response to COVID-19, SOP Starter Kit

The COVID-19 SOP Starter Kit was developed by dedicated Nepali medical and paramedical personnel under the leadership of Dr. Samina Zamindar. This Starter Kit focused on outpatient care at the beginning of COVID-19, providing the eye hospitals with the groundwork in COVID preparedness, so our partner hospitals could easily adapt these SOPs into their own hospital operations. As the authors’ hospitals test and further refine these SOPs based on real-life applications, Seva will update and republish them accordingly.

Safety and Quality

The agreement with Medical Council members have been signed and finalized. Some of the members have started the mini grant project activities. Interested team members from N. India have been registered to participate at Dr. Zamindar eye center, Bangalore, in two days of Quality related workshop followed by three days of observation as per the requirement of the attending trainee.

Three Bucket System — Community Eye Health Journal

The article from The Community Eye Health Journal is supported by the Conrad Hilton Foundation, Sightsavers, CBM, Orbis, The Fred Hollows Foundation, Tijssen Foundation, Seva Foundation, BHVI and the International Trachoma Initiative.

The Community Eye Health Journal (international edition) is a quarterly publication sent free to over 22,000 health care providers worldwide, mainly in low and middle-income countries. The aim of the journal is to ensure that up‐to‐date and relevant information reaches eye care workers of all levels in the countries where the burden of eye disease and blindness is greatest. Journal readers often have little access to other sources of information. Our peer-reviewed articles are written by experts in the field and combine clinical issues with public health approaches, such as research, planning, management, training, technology, sustainability and advocacy.

All Call Thursday’s But Monday Workflows

Each week I sponsor what is called the ALL CALL. Recently, the Program team shared their new information management platform with the rest of the Seva team. If you want a 'peek' behind our management cupboard enjoy this insight into a portion of our weekly ALL CALL session!

Africa Landscape Analysis

Seva has been working in Africa since 2001. We started first in Tanzania through our partnership with KCCO in 2001. As we consider the vast eye care needs in the region, we recognized that there was more work than one partner alone could achieve. When we began working in India, we worked with Aravind. But in order to have the intended impact we needed to have to achieve our mission, we built our network of committed partners. Now we are fortunate to work with a diverse network of more than 50 partner clinics in India. That approach has happened in all of the regions we work in.

Given the vast needs across the continent and to achieve our mission, we want to build upon the work that is already happening. We are starting with people and partners we know as we look to diversify. At this time, we are not looking to expand into new countries but rather leverage and deepen our commitment in countries where we are already working, specifically those in eastern Africa. Allowing us to strengthen our overall investment. We are focusing on locally-led, clinical health providers.

Specifically we:

• Added a new partner hospital in Tanzania last year supported by Kilimanjaro Centre for Community Ophthalmology (KCCO) and in coordination with the Ministry of Health

• Decided to sunset our work in Benin by end of 2023

• Are finalizing a new two-year agreement with KCCO

• Began working with Centre Tertiaire de Sante Oculaire De L'enfantin Burundi, the local organization that Dr. Levy established

Beyond these initial steps, our work has been in stasis as we prioritized staffing for the Implementation team (successfully recruited three positions, including one new position to manage our work in Latin America) and are focused on realizing our bold solution for the Latin American region. We also decided not to make new major investments in the African region while travel and in-person consultations have been stopped or limited due to the ongoing COVID-19 pandemic.

During the coming fiscal year, Seva is positioned to refocus on this region. The Africa Landscape analysis Seva commissioned last year, will be used as a reference for undertaking this work.

IAPB’s Eye Health Hero and Future Leader, Kuldeep Singh!

Introduced at the 9th General Assembly in 2012, the Eye Health Hero program is a recognition of front-line staff whose work in the field and engagement in the community makes a real difference in aiding vision and restoring sight all around the globe.

Each hero is named by an IAPB member organization or their partners to recognize those exemplary workers whose efforts are seldom in the limelight. They are the change-makers, innovators, and emerging leaders from all areas and backgrounds in eye health. Eye Health Heroes are managers, community workers, health professionals, or government officials, those working in clinical, hospital, research, INGO/NGO, business, and public policy settings their efforts and stories deserve to be shared.

Spotlight on Training!

Seva staff celebrated the final ceremony for an Organization Development Program for Dr. Shroff's Charity Eye Hospital, Delhi in January 2022. Purpose: To build in house workforce capabilities in Eye Care Management focussing on 5 key themes that are aligned to SCEH Values:

1. Effective Interpersonal Communication Skills

2. Quality Consciousness (Customer-Focus)

3. Planning and Prioritizing, Organizing Skills

4. Implementation, Initiatives, and Challenges

5. Analytical Skills

The end outcome was to upskill participants as future master practitioners and trainers and thus build the SCEH workforce in delivering High-Quality Eye Care.

Participants: 18 senior eye care workers (2 Females, 16 Males); (Optoms, Nurse, Administrators, Eye Bank Manager, Quality Lead, Stores in charge, Finance Managers, HR, Outreach program manager, etc.). Also, indirectly their department heads (Clinicians, GMs, Assoc. Director, Optometry, and Exec Director) were involved in SMART goal settings, Feedback, and project planning and delivery.

Duration: ~18 months (Planned for 12 months - delays due to covid). 2-4 hours per week, ~150 professional development hours per participant.

Methodology: A blended online workshop that included

1. Social learning - Peer to peer in small groups

2. Didactic learning - Instructor-led training by Arun Acharya

3. Project-based learning - by solving real-world problems using SMART goals.

Outcome: An Executive Summary Report will follow in Feb 2022 (watch this space!) In the interim, I am elated to inform you that this program has led to the creation of a series of training assets (Slides, Videos, Action Learning Projects, and Mind Maps) that will form the foundation of a competency framework for future eye care workforce development across Seva GSI Partner Network

Arun Kumar Acharya

Global Training Specialist | Seva Foundation

April 2022

Seva Wins Kristof’s Holiday Impact Grand Prize!

“It feels miraculous to watch people regain their sight, but it's a miracle that we can all make happen. Seva Foundation, the Grand Prize Winner of this year’s Holiday Impact Prize, is transforming people’s lives for as little as $50 per cataract surgery. Seva works in more than 20 countries abroad and in Native American communities in the United States, and nothing is more joyous than seeing the impact of its work on people who had thought they would never see again.”

— Nicholas Kristof

The Life You Can Save - The Votes are In!

Renowned philanthropist Peter Singer gave away $100,000 to three of The Life You Can Save's recommended charities based on a public vote and after thousands of votes were cast, we are pleased to announce Seva was one of the three charities that received the most votes: Here are all the recipients.

1. Fistula Foundation, a global leader in treating obstetric fistula — a devastating childbirth injury that leaves women incontinent, humiliated and often shunned by their communities — received the most votes and will receive US$50,000.

2. The Seva Foundation, a global nonprofit eye care organization that transforms lives and strengthens communities by restoring sight and preventing blindness, came second and will receive US$30,000.

3. GiveDirectly — a nonprofit that provides unconditional cash transfers using cell phone technology to some of the world’s poorest people, as well as refugees, urban youth and disaster victims — was third and will receive US$20,000.

April 2022

Seva Foundation Vision Report - Part I of a four-part report

Seva is committed to ending avoidable blindness in our lifetime. This is the first of several reports that take a deep dive into the economic burden of blindness and its negative impact on one of the world’s largest economies. By the end of 2021, we will release the solutions - what will it cost to provide the bold solutions required to secure sight for all.