Developing pediatric eye care program in Nepal: Insurmountable Mountains can be reduced to mole hills. The Orbis experience in Nepal.

BackgroundNepal straddles the Himalayas and its geography has posed challenge to delivering eye care in children. This manuscript describes the pediatric eye care facilities developed, and children examined and treated under the Orbis Internationals childhood blindness initiative. MethodsBetween 2010-2017 Orbis International had supported the Nepal Netra Jyoti Sangh (NNJS) and Tilganga Institute of Ophthalmology (TIO) to develop pediatric eye care centers in major hospitals, along with their outreach. This manuscript looks at the impact of that intervention. Reports of Nepal Netra Jyoti Sangh, Tilganga Institute of Ophthalmology and Orbis International were studied, along with publications on ophthalmology from Nepal. Eight child friendly pediatric eye care centers were set-up, pediatric eye care teams were trained, an outreach program especially for childrens eye problems was designed and outcome monitoring and research promoted. ResultsBetween 2010-17 1,281,153 children had been examined by 8 pediatric eye centres (average 20,018 per hospital per year, range 10,729 -39,485) and the average outpatient per month per hospital was 1668 (range 894 - 3,290). Between 2010 - 2017, 42,430 children had been operated upon by 8 hospitals (average 663 per hospital per year, ranged from 96 - 1,465) and the average pediatric eye surgery per month per hospital was 55 (ranged from 8 to 122). In the years 2018 & 2019 (21 months) post-project, all the 8 hospitals had operated on 14,252 children (average of 1,782 per hospital, range 185 - 4438) and the average pediatric eye surgery per month per hospital was 85 (range 9 to 211). 19 publications on pediatric eye care were published in indexed journals. ConclusionOrbis childhood blindness amelioration initiative in Nepal resulted in more than a million children examined, and >50,000 children underwent eye surgeries in the 8 pediatric eye care centres and the good service continued after the project was over.