Tuesday, October 17, 2006

Good eye care can help your sight

WORLD White Cane Safety Day is being observed today. The purpose of observing the day is to stimulate the general public to better understanding of blindness/visual impairment and to make them more aware of the white cane as a mobility aid. The white cane works as a tool as well as a symbol for the blind.

The blind people use it to alert themselves of obstacles in their path and as a symbol to alert people of their blindness. But safety should not be confined to roads alone. It has much wider connotation. This is why it should be the policy of the government, non-governmental organisations (NGOs) and the civil society to encourage and enable the blind to participate fully in the social and economic life and also to engage them in remunerative employment to make them empowered.

The blind or the visually impaired children or adults have the same right as the general people to the full use of streets, public buildings, transportation, amusement, i.e., in everything. The public and private transport authorities, drivers, helpers, conductors, supervisors and countermen should get briefing and acquire practical knowledge about the white cane user, what type of help is needed and how to offer that to the blind.

To keep the footpath clean, manhole covered and to put dustbin in appropriate places are the related responsibilities of the City Corporation authorities, Union Council Chairpersons, Members, Ward Commissioners and conscious people for safe movement of the blind. They need to be aware about the white cane to bring the blind in the mainstream of education, equal rights, empowerment and development.

So, a social awareness is needed to prevent blindness too as prevention is better than cure and it would help save sight and lives of thousands of children and adults in our country.Inventing white cane: James Biggs of Bristol claimed to have invented the white cane in 1921. In 1930, a Lion's Club member watched a blind man attempted to make his way across a busy street using a black cane. After realising that the black cane was barely visible to motorists, the Lion's Club decided to paint the cane white to increase its visibility to oncoming motorists.

In May 1931, the BBC (British Broadcasting Corporation) suggested in its Radio broadcasts that blind individuals might be provided with a white stick, which would be universally recognised as a symbol of indicating that somebody was blind or visually impaired. The then president of USA, Lyndon B. Johnson went down in history as the first to proclaim October 15 as 'World White Cane Safety Day'. In fact, children and adults become visually impaired or blind for some of our ignorance, poverty, lack of awareness, proper attention, preventive measures, adequate nutrition, optimal diet, food security, sanitation, due to vitamin A deficiency, diarrhea and measles.

Besides, low calorie intake by the girls than boys, unavailability of free of cost eye-care facilities and treatment at the doorsteps of the poor, less education and scarce participation of girls and women in decision making and their slow or no empowerment are some of the contributing factors. Helen Keller International highlighted in its report that malnutrition is a leading cause of childhood blindness and mortality. Yet combating it is one of the most cost-effective health interventions.

Homestead gardens, food fortification and other strategies should be the components to prevent blindness. Generally, the blind or disabled are treated as double burden. That is why, in principle we should prevent blindness, restore sight of the blind through proper treatment or operation. Thus the rate of blindness and using white cane can be low. So, let our children and people take care of eyes everyday-- keep the blindness and white cane away.

National Eye Care Plan of Bangladesh (2005) mentioned that the World Health Organisation (WHO) estimates, 40,000 children are blind in Bangladesh. Cataract is the leading cause of childhood blindness. Over 12,000 children are suffering from unnecessary blindness due to un-operated cataract and in need of surgical care from well-developed eye care facilities.

On the other hand, 10,000 children are blind in our country due to corneal scarring, which could have been entirely prevented through effective primary health care and eye-care services in the community. About 300 children are blind for every million population and 100 of them are blind from cataract. Between 100 and 200 bilateral cataract surgeries per million populations are needed to restore eye sight of these children.

Cataract is a major treatable cause of childhood blindness, which can be avoided with intervention strategies in line with the priorities set by the VISION 2020--'the right to sight' of the WHO. Community-based preventive measure is required to prevent 25 per cent of all childhood blindness, which is related to vitamin A deficiency disorders, diarrhoeal diseases, malnutrition and measles. Dear reader, for this write-up this scribe has interviewed a blind boy with congenital cataract, named Arif of Mirzapur, Tangail.

Logically he represents the status of thousands of blind children in Bangladesh. After collecting his name and address through Child Sight Foundation, I, along with my cousin Daizy, went to see and speak to Arif from Dhaka to Mirzapur on September 19. It was 11.30 AM. The sunshine was reflecting on the water of the river Bongshai. Some boats were crossing the river, the boatmen were happy to get favourable wind to hoisting the sail to reach their destination quickly and happily. Watching the lovely scenery of the village Chukuria of Jamurki union at Mirzapur sub-district of Tangail and getting cooperation of the people there, we were very much impressed.

Luckily we got Arif at his class of Chukuria primary school. Arif's teacher Ms Sufia Khan informed us that Arif reads in class two. Though he is blind due to congenital cataract, but he is meritorious and can memorise the text listening to the teachers and answer to the questions in the examination verbally. At the age of four, Arif faces difficulty to move freely and normally. Moving a few steps forward, he falls on the ground.

His father, day-labourer Usuf Ali noticed that Arif does not see anything but darkness with his eyes! He felt tense, but could not arrange funds money to take Arif to visit an eye specialist. He took Arif to a kabiraz (an ayurvedic physician) and applied some medicine in Arif's eyes, but did not improve the condition of eye sight.

As the school is adjacent to Arif's home, his parents helped him to go to school. Realising the disease seriously, Arif's teacher Ms Sufia Khan gave Tk 500 and students of the school contributed more than Tk 100 for Arif to get better treatment by a doctor at Mirzapur. Ms Sufia advised Arif's father accordingly. Examining the eyes of Arif, the doctor diagnosed the disease as congenital cataract.

He prescribed an eye ointment and advised for operation, but demanded Tk 10,000 as the operation cost. But Arif's landless parents do not have any means to collect the money. As a result Arif is going to be permanently blind. But smart and optimistic Arif said, "I want to continue my study aiming to be a doctor (eye specialist) and to offer free treatment to the poor patients like me as nobody gets blindness". Child Sight Foundation (CSF) collected nationwide data on childhood blindness and Arif was also included in that survey (2003).

Dr. M.A. Muhit of CSF said: "31 percent of the childhood blindness is due to cataract. We need many things to help avoid this unnecessary blindness: Such as making awareness that cataract is treatable through operation, but for the lack of free of cost treatment and operation facilities -- especially for the poor children and due to shortage of pediatric ophthalmologists -- they will be permanently blind if effective measures not taken timely.

After being blind they cannot be enrolled in inclusive education because of inadequate Braille teaching institution, supply of Braille books and negative attitudes of the society towards them, hindrance to their proper education, to be self-reliant, rehabilitated, empowered and helpful part of mainstream of development". What is Cataract: Cataract is the clouding of the normally clear lens in the eye.

While the cause of cataract is unknown, it can be effectively treated by surgery. The number one cause of blindness worldwide, nearly 20 million people are blind as a result of cataract, and 100 million are in need of sight-restoring surgery. Globally, there are 190,000 children who are blind from cataract. Cataract in children may be present at birth (congenital cataract) or may appear anytime during the first five years of life (developmental cataract).

A recent national study in Bangladesh showed that one in every three blind children is blind from congenital or developmental cataract. There are as many as 1.5 million blind children in the world, of which one million live in Asia.New borne babies and children can get cataract, because it is not limited among the adults only. An infant may have birth with congenital cataract or she/he may get developmental cataract during first few years of life.

Cataract can run in families, and more than one child in the same family can be affected. If any one notices a white spot in child's eye(s), or if the child cannot see properly, should take her/ him to the hospital earlier. Never use any kabirazy zharfuk (means of exorcism), natural (quack's) treatment. Though I returned from Chukuria to Dhaka on the same day (my cousin Daizy stayed in Tangail), but still Arif's voice reminds me of him as he recited a poem of our national poet Kazi Nazrul Islam: "ami hobo sokal belar pakhi, sobar age kusum bage uthbo ami daki…" ("I will be the bird of morning time, to wake up calling at the garden of flowers first of all…").

But the sadness is that Arif cannot see his beloved parents, teachers, class mates, books, green and beautiful village Chukuria, nice birds, flowers, tides of river Bongsai. He does not have the scope to visit his friends even on their birthdays and Eid day because he is incapable of moving alone without the help of others, but a free of cost operation can restore eye sight of Arif and thousands of visually impaired or blind children like him.

Worldwide acclaimed blind and deaf person Helen Keller says: "God has given us a task, which we can perform better than anyone else. We must find out what that task is, and how to do it in the best way possible".


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