News

This year, IEF was one of 12 organizations to receive the Novartis eXcellence in Ophthalmology Vision Award (XOVA). Reviewers select programs that align with XOVA’s mission to have a significant impact on unmet needs.

The IEF project supports a Blindness Free Village Initiative, with our partner hospital Udhampur Rotary Eye and ENT Hospital (REH), in northern India.

Proposal - Udhampur Rotary Eye and ENT Hospital
XOVA Novartis Pharma AG, 2019

Background 

Founded in 2000, the Udhampur Rotary Eye and ENT Hospital (REH) in Udhampur, Jammu and Kashmir State, northern India, is a 25-bed multi-specialty secondary hospital serving 500,000 highly underserved populations that live in the surrounding mountainous communities. The REH served 30,000 patients and performed 1,900 surgeries in 2019 and plans to increase the number of examinations and surgeries by an additional 33% by 2022. As part of a longer-term initiative to establish Blindness Free Villages, REH surveyed 15,385 households and identified 2,255 persons with cataracts and performed surgery on 737 (33%). To increase surgery REH requires medical consumables, renovations and a surgical microscope to establish a second operating theatre. A second OR will increase the capacity to perform surgery from 45 to 60 per day. 829

Objectives 

Goal - Eliminate cataract blindness in 16,000 households. Objective 1) Purchase cataract medical consumables to ensure poor patients receive surgery. Objective 2) Renovate a second OR, Objective 3) Purchase and install a surgical microscope. Milestone 1) operating room is operational and, Milestone 2) 1,500 patients receive cataract surgery (eliminating bilateral cataract). 378

Execution steps

The REH will plan and implement the following activity and tasks over 12 months. 1) Develop an implementation and work plan that details all major activity, roles and responsibilities, budget, targets and indicators for monitoring the project. The REH core team, supported by the International Eye Foundation, will complete this objective in the first two months. 2) Purchase the cataract medical consumables and inventory in the supply room. REH will procure the supplies using REH's routine procurement plan. 3) Renovate space at the REH for the operating room. The REH will renovate the first floor to accommodate two ORs and administrative offices. This opens up new space on the ground floor for patient services and increased patient flow through. REH will hire a qualified architect and a builder to renovate the space to meet State certification requirements. The architect's plans will require two months and the construction of up to six months to allow completion. 4) Research and purchase a surgical microscope, preferably with an observer scope and AV video for teaching residents and clinical staff. The REH will purchase the microscope within three months. The OR will be opened for service when renovations are complete, the microscope installed, and the operating room is inspected and certified. The REH will evaluate the schedules for operating to coordinate surgery between both ORs to increase the number of surgery days and hours. The REH hospital has a strong dedicated clinical and management team in place that includes four ophthalmologists and 39 staff. They are not able to increase their consultation and surgical output because of the lack of space. By moving the OR to the first floor will free up additional surgical space to accommodate the ORs as well as provide more space in the ground floor for the expansion of outpatient services. This lack of space directly impacts delivery of services to those in need as well as reduces income generation to support the cost to serve poor patients. The Jammu and Kashmir State is a politically volatile and geographically remote impacting on hiring and retaining qualified staff. IEF has worked with REH since 2015 to develop their institutional capacity and training their clinical and management staff. 2287

Measure and evaluate 

The REH will measure and evaluate the project based on the detailed work plan and the monitoring and evaluation plan. The REH will write reports on the completion of each activity accompanied by photographs to verify completion. The reports include standard indicators on the number of consultations; surgery; number of free consultations and surgery; refraction and eyeglasses; number of staff; cost of surgery; surgery visual outcome and complication rates; and revenue and expenditure. 488

Ensure impact 

The REH is financially sustainable from user fees from consultations, surgery and optical services, and other donations. In 2019, revenue exceeded expenditure by 104% while providing free consultations to 12% and free surgery to 21% of patients served. The REH has partnerships with the Rotary Club and the International Eye Foundation and is part of an IEF multi eye hospital Management, Leadership and Sustainability initiative established in four underserved states in the northern region. 492