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«Role Of Rotary International - Providing Ophthalmic Health Care Facilities In Cuttack City Of Odisha Paper ID IJIFR/ V2/ E11/ 046 Page No. 4235-4242 ...»

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Survey Paper July 2015

Volume 2 Issue 11

International Journal of Informative & Futuristic Research ISSN (Online): 2347-1697

Role Of Rotary International - Providing

Ophthalmic Health Care Facilities In

Cuttack City Of Odisha

Paper ID IJIFR/ V2/ E11/ 046 Page No. 4235-4242 Subject Area Sociology

Key Words Prevalence, Cataract, Glaucoma, Eye Check-Up Camps, Cataract Operation Received On 15-07-2015 Accepted On 26-07-2015 Published On 28-07-2015 Research Scholar, Sameet Sarita Sarangi 1 Department of Sociology Utakal University, Bhubaneswar- Odisha Abstract Eyes are the most treasured organ of human beings. Blindness is one of the significant social problems in India with 7 million of the total 45 million blind people in the world residing in our country. Ocular morbid conditions are responsible for partial or total blindness. Loss of sight of a person should not remain just a statistic but a personal tragedy, not only for the individual concerned, but for all of us who claim to be concerned. Blindness and visual impairment by its sheer magnitude forms an enormous problem, not only in human suffering, but also in terms of economic loss and social burden. Blindness, with its social and economic consequences, represents a significant public health problem in many parts of the world. Some of the ocular morbid conditions are cataract, refractive errors, Xerophthalmia, Pterygium, Strabismus, Dacryocystitis, etc. The important causes of blindness are cataract, followed by glaucoma and age-related macular degeneration. John Pears Memorial Rotary Eye Hospital and Research Institute was established in 1992 by Rotary club of Cuttack with support of Royal Commonwealth Society for Blinds U.K (known as Sight Savers International) under Rotary International’s 3H (Health, Hunger and Humanity) Programme. The Institute holds screening camps in rural areas regularly and selects patients for operations and transports them to the Base Hospital for Cataract Surgery apart from attending outdoor patients on daily basis. This article attempts to study the role of JPM Rotary Eye Hospital in providing eye care facilities to the people at free of cost.

1. Introduction Health is the top most priority in every individual‘s life. Its importance is evident in old saying, ―Health is Wealth‖. Health is not only basic to lead a happy life for an individual, but also

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necessary for all productive activities in the society. The whole development cycle of a person depends upon his intellectual calibre, curiosity and constructive thinking, but all these qualities depend upon his good health. Eyes are most precious of our sense organs. About 285 million people are visually impaired worldwide. 39 million are blind and 246 million have low vision. 80% of all visual impairment can be prevented, treated or cured. About 90% of the world's visually impaired people live in developing countries where ocular morbidities are major public health problem.( Resnikoff S. et al.:2002) The overall prevalence of ocular morbidities in India is reported to be high. It has been reported to vary from 20 to 90%. An ocular morbid condition is defined as a condition in study subject, recognized or suspected, ocular or vision abnormality, which require treatment or surveillance. (Maureen S, et al.:1999). India has the largest population of blind people in the world. That‘s over 12 million people. Most of them live in the poorest parts of the country with little or no access to even basic health care facilities. The important causes of blindness are cataract, followed by glaucoma and age-related macular degeneration. (WHO, 2002).

Cataract is a clouding of the eye‘s lens – the part of the eye responsible for focusing light and producing clear, sharp images. It is the leading cause of blindness in India. Cataracts often develop in both eyes at the same time. The symptoms vary, but include a gradual blurring of vision, halos around lights, glare and double vision. The worst type of cataracts – where the iris appears almost entirely clouded over – can cause a total loss of vision. There is no single cause of cataract.

A number of risk factors seem to have an impact. While some risks can be reduced through a change in lifestyle, others may not. Although cataracts cannot be prevented, they are relatively easy to cure. A cataract operation takes as little as 20 minutes. JPM Rotary Eye Hospital, Cuttack is a pioneer institute in Odisha promoted by Rotary International is dedicated to provide ophthalmic health care facilities to poor not only to the people of Odisha but to nearby states like Chhatisgarh, Jharkhand and Andhra Pradesh. During the year 2014, 222 Eye camps have been conducted, 16126 patients were checked up and 4679 Cataract Patients including pediatric underwent free Cataract surgery. School Eye Check-up Camps, Diabetic Retinopathy Screening Camps, Teacher Training Programme, Low vision Training Programme for Anganwadi & SHG Workers and Skill Development programme for visually impaired children are conducted in different parts of Odisha on regular basis.

2. Aims And Objectives The present study is based on the following objectives I. To investigate into the availabilities and accessibilities, care services in JPM Rotary Eye Hospital.

II. To study the contribution of JPM Rotary Eye Hospital in providing ophthalmic health facilities to the poor.

3. Materials and Methods Systematic random sampling was done to select the required sample size. Patients aged 2 years and above with eye problems coming for treatment to eye hospitals were interviewed. The present study was conducted in the city of Cuttack, Odisha from August 2010 to February 2013.

This article is based on the study being conducted for award of Ph.D. from Utkal University. The interesting case studies were presented to highlight the noble work being carried out by JPM Rotary Eye Hospital

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4. John Pears Rotary Memorial Eye Hospital Rotary is a worldwide organization of more than 1.3 million business, professional, and community leaders. Members of Rotary clubs, known as Rotarians, provide humanitarian service, encourage high ethical standards in all vocations, and help build goodwill and peace in the world.

There are 35,000 Rotary clubs in more than 200 countries and geographical areas. (Rotary News:

June.2015) Clubs are non-political, nonreligious, and open to all cultures, races, and creeds. As signified by the motto ―Service above Self‖, Rotary‘s main objective is service — in the community, in the workplace, and throughout the world. The Rotary motto ―Service above Self‖ conveys the humanitarian spirit of the organization‘s members. Strong fellowship among Rotarians and meaningful community and international service projects characterize Rotary worldwide.

Rotary Club, Cuttack is a part of this great movement. Initially this club was organizing Eye Camps in the remote areas of the then undivided Cuttack district. Members of this Rotary Club as well as other Rotarians used to contribute towards the expenditure of the camp. Later the cost was supplemented by RCSB (Royal Commonwealth Society for the Blind). Initially the club used to organise about 20 eye Screening Camps per year. At a later stage, it was felt that, providing eye care services in such non-comprehensive manner was not sufficient to meet the need and a permanent specialised Eye Hospital should be set up to fight against preventable blindness.

This idea gave birth to JPM (John Pears Memorial) Rotary Eye Hospital & Research Institute. The Hospital was built in collaboration with Sight Savers International (SSI) formerly known as Royal Commonwealth Society for the Blind, U.K., under 3 H programme of Rotary International. They have not only given financial help, but also have imparted technical know-how and have helped in training of the personnel. In fact, they are also supporting this Hospital now.

This Hospital was inaugurated on 14th January 1992 with twenty seven cataract surgeries and in the first year it could operate 907 cataract cases.

The Hospital started with 40 beds and an outpatient section mainly for cataract patients.

Within the period of 21 years, the Hospital has expanded to have 120 beds of different categories with several specialised departments. The Hospital from its inception has examined more than 1,46, 00,000 patients in the OPD. Despite certain problems, it was heartening to see that the hospital continued to get patients as per the predicted load to a higher side and the average attendance increased to 240 patients daily. There were certain variations found during the rainy seasons as the state had to suffer from severe floods and cyclonic storms. However, except of few such incidences the hospital had its patient flow as predicted. The out and in patient strength was maintained appropriately, through active outreach and in reach programmes while providing them qualitative service. Patients were examined in camps conducted in rural areas, and brought to the base Hospital for operation totally free of any cost. This hospital has been running on a standard baseline of providing 70 % of its all kinds of eye care services totally free of cost to the community while charging a very reasonable fee to the paying patients. This has been possible due to the skills manifested in management of funds, materials as well as human resources.

To meet the need of the community and reach out to poor patients who were unable to afford quality eye care services, it provides minor treatment on their door steps. Covering an average radius of around 150 kilometres daily, it has efficiently managed to provide quality eye care services by their medical team. Everyday this hospital examines hundreds of patients at each camp spot and based on the screening, those who were fit for operation of cataract were brought to the Hospital for treatment and operation and thereafter, transported back to their homes. Food was

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provided freely to these patients. Required follow up of the cases were also done at the rural camps, six weeks thereafter.

5. Different Progressive activities under taken by the Hospital JPM is the only Eye Hospital in the state of Odisha with a full time Paediatric Ophthalmology unit, Glaucoma Unit, Retina unit. In many parts of the State quality Cataract Services are also not available and even if available not enough to tackle the problem of the State.

Due to very poor referral systems & linkages in place, health care and eye care do not find a heightened level of performance. Awareness among general ophthalmologist / Paediatrician / Gynaecologists is also lacking. Trained personnel to manage Glaucoma / Retina Services are also very few and lack of such ophthalmic personnel makes the scenario even more grievous. JPM rotary eye hospital provides the following care services.

1. Cataract services

2. Paediatric services:

3. Glaucoma services

4. Retina services

5. Cornea services

6. Low Vision services

7. Blind School Activities

8. Integrated Education

9. Training & etc.

6. Successful Case Studies Of Jpm Rotary Eye Hospital I. The Case Of Rukmini Kalhar

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Kalarpara is a small village in the Nowrangpur district which happens to be one of the remote, underdeveloped, tribal, and poverty stricken districts of Orissa. The village is surrounded by forests and mountains. There are no communication and electricity facilities to this village. One primary health centre operates here without any Doctor during most of the year. Due to its location and lack of facilities government employees and even doctors do not want to come here and reside.

In this village, Phoolwati and Bajrang kalhar stay along with their sundhi community in the local structural hierarchy which enjoys higher status than the tribals. All of them are landless and daily labourers. They earn around forty rupees daily which is absolutely insufficient to meet the

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expenses of day‘s bread. Even, they have to remain hungry days together as they do not get work.

Although, each family live in nuclear pattern, they stay unitedly in all occasions. They cannot provide better education, food, and medical treatment to their children and their family members. In case of any sufferings they have to wait for help either from government or from any other source.

Phoolwati and Bajrangi have one son Khileswar of fourteen years and one daughter Rukmini of two and half year‘s age. The son who is elder did not get minor education due to obvious reasons. To their misfortune, the younger child ‗Rukmini‘ was born spastic and was unable to walk. She had also a congenital physical deformity of a small tumor in her left eye called terratoma.

Initially ‗Rukmini's‘ parents couldn‘t understand the case of ailment and didn‘t give any importance to it as the overgrowth in the eye was small. But afterwards they became concerned about their daughter's future and first took her to the government hospital at Nowrangpur. Due to lack of medical facility for opthalmic surgery, they had to return hopeless. After some days they went to Raipur, the state headquarters‘ of newly formed Chhatisgarh and faced the same situation there. At Raipur the doctors informed about the high expenditure required for the operation. They were really upset and afraid of. Gradually they left the hope of her treatment. The small tumor in the eye grew as she grew up. At about the age of two years, the bigger retrobular mass caused loss of vision and pain in the eye. ‘Rukmini‘ was found to be a restless and a crying child. Her parents marked that her legs and hands were becoming thinner day by day and she was unable to move like a normal child.

The case of ‗Rukmini‘ came into the notice of the public, especially the Collector, chief district medical officer (CDMO), and the news media like OTV during a district eye camp at Nowrangpur. As it was a complicated ophthalmic case, she was referred to the JPM Rotary Eye Hospital and Research Centre, Cuttack for further check-up and treatment. Collector gave Rs

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