Blindness in Africa is a widespread problem. The ORBIS Flying Eye Hospital has brought its blindness prevention and treatment skills to numerous countries in Africa, such as Ethiopia, Uganda, Ghana, Nigeria, Cameroon, Tanzania, Mali, Malawi, Botsana, Kenya and Burkina Faso. ORBIS opened a permanent office in Ethiopia in 1999 and began long-term, hospital-based programs in Ethiopia at that time.

The latest figures from Ethiopia indicate that 1.2 million Ethiopians are blind and close to 2.8 million have low vision. Because only 82 ophthalmologists are available for a country of 75 million population, eye care services are extremely limited throughout the country, particularly in rural areas.

ORBIS is working in Ethiopia to address the country’s high prevalence of avoidable blindness, as well as the country’s limited human resources and infrastructure. Key strategies include:

• Strengthening existing national institutions and eye care agendas
• Establishing eye banks
• Addressing the acute eye care needs of the rural population
• Aggressively tackling the infectious disease trachoma, a painful and ultimately blinding condition that disproportionately affects women and children

During CY 2006 (March-December 2006):

• 249,586 people were screened for refractive error or examined for eye disease
• 392,259 people received eye care treatment
• 21,499 surgeries were performed — figures that include 775 children
• 6,875 doctors, nurses and others were trained
• More than 3.4 million people were informed of ways to prevent blindness

ORBIS has achieved numerous “firsts” regarding blindness in Ethiopia:

• ORBIS established Ethiopia’s first pediatric ophthalmology center. The children’s eye care center is located at Menelik II Hospital in Addis Ababa.
  
  
• ORBIS developed an innovative rural eye care services delivery model in southern Ethiopia to address the leading causes of blindness in the area -- cataract, trachoma and refractive error -- where there were no ophthalmologists. This was the first large-scale rural eye care initiative implemented in the southern half of the country.
  
  
• ORBIS was the first to distribute the antibiotic azithromycin to rural populations in Ethiopia in order to treat trachoma, the leading cause of infectious blindness worldwide. Ten million adults and children across Ethiopia suffer from this highly contagious but preventable and treatable disease. More than one million people over age 15 are affected by trichiasis, the potentially blinding complication of trachoma in which the eyelids turn under, causing the eyelashes to painfully scrape against the cornea.
  
  
• ORBIS established Ethiopia’s first and only eye bank.
  
  
• ORBIS was the first to introduce to Ethiopia extra capsular cataract extraction with intraocular lens implantation, and later small incision cataract surgery (SICS). These techniques have greatly improved the quality and availability of cataract surgical services in Ethiopia.
  
  
• In an effort to address the need for skilled eye care professionals in the country, ORBIS trained the first pediatric ophthalmology, oculoplasty and anterior segment specialists in Ethiopia.
  
  
• ORBIS was the first in Ethiopia to initiate accredited training for optometrists and a category of para-professional called “cataract surgeon.”
  
  
• ORBIS introduced Cyber-Sight, ORBIS’s telemedicine initiative, to provide worldwide, Internet-based ophthalmic patient consultation for free to any qualified partner in Ethiopia.
  
  
• Ethiopian doctors received training on virtual reality surgery simulators for the first time during ORBIS Flying Eye Hospital programs.
  
  
• Through ORBIS, Ethiopian ophthalmologists can now receive continuing medical education credit through the American Academy of Ophthalmology for online work completed by Cyber-Sight partners and for virtual reality surgeries conducted on surgical simulators.

The ORBIS Ethiopia office oversees projects in both Ethiopia and Tanzania and helps coordinate training in neighboring countries. ORBIS partners in Ethiopia and Tanzania include:

Department of Ophthalmology, Medical Faculty, Addis Ababa University • Federal Ministry of Health/National Committee for the Prevention of Blindness • University of Gondar • Grarbet Tehadiso Mahiber • Hawassa University • Kilimanjaro Center for Community Ophthalmology ( Tanzania) • Addis Ababa City Health Bureau/Menelik II Hospital • National Scientific Equipment Center of the Ethiopian Science and Technology Agency • Ophthalmological Society of Ethiopia • Health, Education, and Finance and Economic Development bureaus of the Southern Nations, Nationalities and Peoples Region

Fact File

Population	75 million1
Population under 15	45%2
Population living below national poverty line	44.2%3
Life expectancy	47.84
Literacy rate	36%5
Rural population	84.36
Percentage of total ophthalmologists working in rural areas	37.8%7
Approximate number of practicing ophthalmologists	828
GDP per capita	$1149
Health expenditure per capita	$5.610
Health expenditure as % of total government expenditure	5%-6%11
Prevalence of blindness*	1.6%12
Blind population*	1,200,54613
Prevalence of low vision**	3.7%14
Population with low vision**	2,776,05415
Prevalence of blindness under 15 years	0.12416
Leading causes of blindness	Cataract (49.9%), trachomatous corneal opacity (11.5%), refractive error (7.8%), other corneal opacity (7.8%)17
Leading causes of childhood blindness	Corneal opacity mainly as a result of measles/vitamin A deficiency, refractive errors18
Ophthalmologists per million population	1.0919

Footnotes

*Blindness is defined as visual acuity of less than 3/60 or a corresponding visual field loss to less than 10 degrees in the better eye with best possible correction.
** Low vision is defined as visual acuity of less than 6/18 but equal to or better than 3/60, or a corresponding visual field loss to less than 20 degrees in the better eye with best possible correction.