Light for the World: Scaling up social enterprising of ophthalmic units in the DRC

Poor sight is not only a health issue, it excludes people from key life-changing opportunities such as education and productive employment, often leading to poverty and marginalisation. 253 million people are visually impaired around the world (i.e. blind or suffering from moderate or severe visual impairment), of which 36 million are blind.

While more than 75% of these cases can be prevented or cured through surgery or the right pair of spectacles, millions of people in need still cannot access these treatments, due to needlessly high costs, lack and far located medical providers and lack of information.

The Democratic Republic of Congo, where visual impairment prevalence is estimated at 4,7% - among the worst rates in Sub-Saharan Africa -, is affected by a blatant lack of quality eye-care. There is a severe shortage of trained medical staff, with only one ophthalmologist per one million inhabitants, among which 75% are located in the capital, Kinshasa, and only 205 sanitary infrastructures offering eye-care in the country. As a result, the DRC ranks 100th of 102 countries worldwide as to its cataract surgical rate.

People who have their sight restored get back into society by (re)gaining their autonomy and contributing to the wealth of their communities. Research by PwC and the Fred Hollows Foundation has estimated a potential benefit of eliminating avoidable blindness in the developing world of at least $517.1 billion, outweighing the additional required investment of $218.2 billion (i.e. $2.20 of additional investment on top of what is already spent on eye care per capita per year for 10 years).

With over 20 years’ experience in eye care in Tanzania, Rwanda and the DRC, Light for the World Belgium has a strong track record in curing preventable blindness and visual impairments. In 2018 in the DRC, Light for the World Belgium, together with the local partners, provided more than 100.000 consultations and performed nearly 6.000 surgeries (of which more than 60% are cataract procedures) through its 4 eye care clinics and its mobile clinics in three provinces of South DRC.

In the context of the DRC National Plan for Eye-Care and Vision, Light for the World Belgium has been mandated by the Ministry of Health to provide eye-care services in the 9 Southern provinces of the country.

Since September 2018, KOIS has been supporting Light for the World Belgium in the consequent significant scale-up of its eye care activities in the region. Following the operational and financial performance analysis and benchmarking of Light for the World Belgium’s existing centres in the DRC, KOIS has made recommendations as to the integration of strengthening elements towards improving the operational efficiency and the financial self-sustainability of existing and future centres. In parallel and based on this analysis, KOIS is exploring potential blended finance models to finance Light for the World Belgium’s scale-up plan in South DRC.

"The optimization of Light for the World Belgium’s operational footprint in the DRC will enable the NGO to improve the self-sustainability and overall impact of its existing and future centres. In the current context of drive for efficiency, this is a necessary step to help Light for the World raise significant donor funding and/or return-seeking capital to finance its scale-up strategy in South DRC."

Juliette Averseng, Associate, KOIS Brussels

Impact story: Two young Lubumbashi brothers

Célestin and Jacques, two young brothers living in Lubumbashi, are completely blind.

This double case of blindness is a burden for the mother, Lorriane. Because of their visual impairment, her two children do not go to school and she has to take care of them constantly, which prevents her from working.

One day, at a mobile clinic near their home, a nurse diagnosed the two boys with cataracts and explained to the family that a simple operation could cure them of the disease and restore their eyesight.

Lorriane then learned of the existence of the Ste-Yvonne ophthalmology clinic in Lubumbashi, supported by Light for the World since 2009. She immediately takes her two children there. On the spot, the local ophthalmologist performed an operation on Célestin and Jacques.

However, the operation is not enough. The children had to go back regularly to the clinic for visual therapy sessions. These are very important as they allowed them to stimulate and develop their vision. They trained each eye separately and used glasses to see at a distance.

Thanks to these sessions, Jacques was able to regain good eyesight. But this was not the case for Célestin, whose vision was declining again. In fact, sometimes the capsule that supports the artificial lens placed during the operation becomes opaque, a phenomenon called secondary cataract.

Fortunately, the boy was then treated within seconds with a Yag laser. The procedure allows the ophthalmologist to clean the opacification by making a small opening in the capsule. This time, mission accomplished: Célestin immediately regained good visual acuity!

His mother expressed her gratitude to the Ste-Yvonne team:

"I am very happy with the hospital; they are good doctors and therapists. As soon as the problems in the eyes of my sons are completely solved, I will take care of registering them at school. They have never been to school before, but that will change!"

A cataract operation performed on children like Célestin and Jacques costs only 150 euros. Together, we offer children like Jacques and Célestin a glimpse of a better future!

Sources: International Agency for the Prevention of Blindness (IAPB) Vision Atlas, Vision Loss Expert Group estimates, 2015; Investing in Vision, The Fred Hollows Foundation, PwC, 2013

Note: Light for the World Belgium is headquartered in Brussels is associate member from Light for the World international, headquartered in Austria

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