Did you know that three-quarters of the 40 million sightless people in the world don’t have to be blind? According to ORBIS International, a global nonprofit organization, most of the world’s blind population owes its lack of sight to a lack of access to care.

ORBIS’ mission is to eliminate avoidable blindness by "strengthening the capacity of local eye health partners in their efforts to prevent and treat blindness." Through a process that ORBIS calls capacity building, local partners gain "self-sufficiency in eye health care and residents enjoy quality eye health services that are affordable, accessible and sustainable."

As part of ORBIS’s broad-based capacity building program, the organization works with carefully selected local partners on projects typically lasting at least three years. ORBIS has about 100 of these active partners, which include hospitals, health centers, universities and training centers, local non-governmental organizations (NGOs), eye banks and government health departments.

Currently, ORBIS’ long-term capacity building projects are taking place in
Bangladesh, China, Ethiopia, India, Vietnam, Peru and Jamaica; the
group relies on an active pool of roughly 500 volunteer faculty members
to provide clinical and technical expertise at local hospitals.  In
addition, ORBIS’ Flying Eye Hospital — a ophthalmic surgical and
training center located onboard a DC-10 aircraft–uses volunteer pilots
from FedEx and United Airlines to transport the Flying Eye Hospital
from one destination to the next.

Consider the case study of Ethiopia to get a sense of what ORBIS does on the ground.
Ethiopia is burdened with one of the world’s highest levels of
avoidable blindness. An estimated 1.6% of the population is blind, with
approximately 12% of this blindness caused by trachoma — a highly
infectious eye disease that is entirely preventable.

ORBIS explains that “trachoma is spread through contact with an
infected person’s hands or clothing, or by flies that have come in
contact with the discharge from an infected eye or nose. When left
untreated, repeated infections lead to trichiasis, an agonizing
condition in which the eyelid turns inward, causing the eyelashes to
painfully ‘rake’ across the surface of the eye, scarring the cornea and
eventually leading to blindness.”

How to fight trachoma? ORBIS’ “strategy includes a national effort to
build latrines, educate community members on trachoma prevention, and
train rural eye care workers to distribute antibiotics and perform
sight-preserving eyelid surgeries. These interventions cost very little
but contribute immeasurably to an individual’s quality of life.”

The action plan above isn’t as simple to implement as it may sound, but
it is straight-forward and relatively cheap. It’s also very necessary:
as Maggie noted
back in October, “developing nations spend $500 million to educate
health care workers who leave to work in North America, Western Europe
and South Asia,” a trend that leaves countries like Ethiopia with a
shortage of medical experts. As one JAMA article put it, “unchecked
flows of health workers leave regions with the greatest health care
needs with the fewest workers…37% of the world’s health care workers
live in the Americas, predominantly in the United States and Canada,
yet these countries carry only 10% of the global disease burden. In
contrast, Africa is home to only 3% of the world’s healthcare workers,
yet it has 24% of the global burden of disease.”

The sort of work that ORBIS does—community-based education and
prevention—is extraordinarily important because it is operating in a
context of much disease and few medical workers. The work of ORBIS also casts an exceptionally
unflattering spotlight on some of the other health care issues in the
developing world that we’ve discussed here on Health Beat. Recall that:

• In November, Maggie pointed
  out how Big Pharma bribes doctors in developing countries in order to
  encouraging the selling and prescribing of their products: “In
  Kashmiri, a physician confides, ‘representatives of pharmaceutical
  companies offer cash, refrigerators, color televisions, laptops, PCs,
  mobile phones, ovens, phone bills, [and even to pay school] tuition
  [for your] children.’
     
  “In India, a doctor from Mumbai reports:  ‘On sale of 1,000 samples of
  the drug, you get a Motorola handset. On sale of 5,000 samples you get
  an air cooler. On sale of 10,000 samples get a motor bike.’”
     
   
• In March, Maggie wrote
  about how pharmaceutical manufacturers are “up in arms” because
  countries like Thailand are importing “less expensive generic versions
  of drugs for which these companies hold a patent monopoly”—including
  anti-AIDS and cardiovascular drugs.
     
   
• Just last week, I penned
  a post on medical tourism and pointed out that the practice of
  traveling to countries like India, Thailand, or Malaysia in order to
  receive medical care ends up creating a two-tiered health care system
  which leaves poorer citizens out in the cold. In India, for example,
  the WHO worries that “medical tourism could worsen the internal brain
  drain and lure professionals from the public sector and rural areas to
  take jobs in urban centres” and notes that medical tourism “does not
  augur well for the health care of patients who depend largely on the
  public sector for their services.”

Bribery, monopoly, and the creation of a two-tiered health care
system—these are the scourges of global healthcare. Organizations like
ORBIS help show us another way to approach health care improvement in developing
countries. Be sure to check them out.