This was a remarkable day and despite being tired and dirty, I enjoyed every minute of this experience in the amazing country of the Democratic Republic of Congo. I am leaving the Congo tomorrow morning to join the others.
"A small sliver of deep orange spread rays of light upward to meet with darkness. Within a few minutes, the eastern sky was illuminated with light. Fluffy, white clouds could be seen floating below. My thoughts wandered to a place in time, five years earlier. I was at work when someone asked me, "Do you want to go to Africa?" "Yes, I've always wanted to go to Africa," was my reply. "The work in Kamina has just begun."
Blindness is a global health issue. In 2006, the World Health Organization (WHO, 2006) reported that there are approximately 314 million people around the world whose vision is impaired due to eye diseases or uncorrected refractive errors. Of this figure, 45 million people are blind and more than 90% of the world’s visually impaired people live in developing countries. Blindness is caused by preventable problems such as cataracts, glaucoma, refractive errors, and river blindness. The leading cause of blindness in the world is due to cataracts and the second leading cause of blindness is due to glaucoma (WHO, 2004). Holden (2003) explains that uncorrected refractive error is among the most common causes of visual impairment and is a leading cause of treatable blindness.
The Population
A significant health issue among the Congolese population in the Democratic Republic of Congo is the problem of blindness. The health of the Congolese population of the Democratic Republic of Congo is affected by cataracts, glaucoma, refractive errors, and river blindness.
The growing population of the DRC is expected to impact the risk of blindness. The population of the DRC is continuing to rise each year. According to the World Health Organization (2006), as populations grow and age, an increasing number of people will be at risk of visual impairment. In 2003, the total population of the DRC was 52.77 million with a projected increase to 74.2 million in 2015 (United Nations Development Report, 2004). The Office for the Coordination of Humanitarian Affairs (2006) reports that out of 1,477,327 internally displaced people in the DRC, there are 175,815 displaced people living in the Katanga Province.
The Congolese community in the North Katanga Province is a vulnerable community that is affected by poverty, presence of displaced persons that place additional strains on resources, and lack of trained people to identify and treat eye conditions. The DRC is one of the poorest countries in the world with over 75% of the population living on less than $1 a day (DFID, 2008). Additionally, the Human Development Index (HDR, 2008) of the DRC is 0.411, which gives the country a rank of 168 out of 177 countries. The Human Development Index measures the average progress of a country in human development and looks at a broad definition of well-being to view human progress and the relationship between income and well-being. The Human Poverty Index measures severe deprivation in health. The Human Poverty Index for the DRC is 39.3 and ranks 88 among 108 developing countries (HDR, 2008).
Trained individuals are needed as part of the country’s infrastructure to identify and treat the population affected by diseases that cause blindness. Sadly, it is estimated that there is less than one trained ophthalmologist per 1,000,000 people in the DRC (Lewallen & Courtright, 2001).
The Project Focus
The approach to address the health issue of blindness in the DRC is a preventative approach enhanced by the need for community empowerment. Eighty percent of blindness is preventable or curable (SightFirst, 2005). Early detection and treatment of eye diseases are the best methods for the prevention of blindness. Prevention focuses on health and the development of programs that promote health within a community (Reagan & Brookins-Fisher, 2002). My rationale for choosing a preventative approach to address the health issue of blindness lies in modeling the vision initiatives in the DRC after the vision initiatives used by the International Lion’s Club (SightFirst, 2005) and the vision initiatives executed by VISION 2020 (WHO, 2006). Community empowerment is essential for a successful program involving a vision initiative to prevent blindness. Community empowerment in the DRC will be centered on the village healthcare workers to collaborate with others to meet the visual needs of the community by offering a teaching plan to prepare community-based service providers to assess vision, provide eye health education, refer patients to eye doctors and, if eyeglasses are needed, dispense glasses from a small, on-site dispensary. Community empowerment leads individuals and groups to develop strategies that help identify problems and solutions through collective action (Laverack, 2006).