How we help

Working with blindness
Sightsavers works to both cure people who have reversible eye conditions and prevent people from becoming needlessly blind.  One of the key ways of doing this is by training local eye care experts and volunteers.

Curing blindness
Cataract is the world’s leading cause of blindness, with around 17 million people blind as a result. Although cataract is found all over the world, getting treatment for it is much more difficult in developing countries, and it affects children as well as adults. Many people are needlessly blind from cataract because they don’t know that it can be cured.

Curing cataract
Although cataract cannot be prevented, it is relatively easy to cure. In fact cataract surgery has been described by the World Bank as “one of the most cost-effective surgical interventions”. Sightsavers and our local partners work in communities to identify people with cataract, as well as performing surgery and providing follow-up care.

Treating child cataract
Our partners make sure community health workers are trained to recognise the symptoms of cataract in children, and to know when to refer on for surgery, as well as to support paediatric teams to run specialist eye clinics. Although child cataract surgery is more complex than adult surgery it’s still a quick, relatively cheap procedure. After children have had surgery follow up care is provided.

Training eye care staff
One of the main problems in providing surgery for cataract is the shortage of eye surgeons. As well as training eye surgeons, we provide specialist training for eye nurses enabling them to perform straightforward cataract cases leaving the surgeons free to deal with the more complex ones.

Reaching remote communities
In order to reach people with eye problems such as cataract who live in rural areas, health teams go out to remote villages and hold eye camps. Leaflets are distributed prior to the camps and announcements are made on local radio to encourage people to attend. During the camp each person will undergo a visual ability test. If they are found to have cataract they are taken to the hospital to have surgery.

Preventing blindness
Millions of people are still going needlessly blind in the developing world from preventable diseases such as river blindness and trachoma, and in children, Vitamin A deficiency. Poverty, lack of services and resources, as well as a dire shortage of medical staff across sub-Saharan Africa are the main reasons why people continue to go blind from preventable causes.

Preventing river blindnessOur partners train community volunteers to oversee and distribute the drug Mectizan® which must be taken over 20 years in order to prevent river blindness. Mectizan® is donated by the pharmaceutical company Merck & Co. which has promised to continue to provide the drug free of charge for as long as it is needed.

Tackling trachoma
Communities are taught the importance of hygiene and face washing to prevent the spread of trachoma. Ointment is provided to treat people who already have the infection, and finally if it’s progressed to the later state of trichiasis we perform surgery, which can be done at a local health clinic or even in the home, meaning that people do not have to travel huge distances to seek treatment.

Stopping childhood blindnessIt’s important to ensure that children with eye conditions are identified and treated at the earliest opportunity. As well as distributing Mectizan® to children, we work with governments to facilitate Vitamin A distribution programmes and also promote health education, such as teaching mothers about the importance of keeping children’s faces clean to prevent the spread of trachoma.

Health care in the communityOne of the key ways of preventing blindness is by integrating eye care into existing primary health care provision, which focuses on bringing health care as close as possible to where people live and work. We provide training in eye health to community health workers so they can identify and treat people
with common eye conditions during home visits and refer them on for treatment if necessary – these measures can prevent more complex eye problems occurring.

with common eye conditions during home visits and refer them on for treatment if necessary – these measures can prevent more complex eye problems occurring.

Training eye care workers
One of the most challenging aspects of eye care is the severe shortage of trained staff. Ophthalmologists tend to be based in the larger cities, while isolated rural communities have extremely limited access to eye health. The shortage of trained ophthalmologists, especially in Africa, has meant that alternative approaches must be sought in providing eye care to communities.

Training staff
Since the 1980s, Sightsavers has been tackling the shortage of eye care personal by working with local partners to train staff at all levels. Every year we train over 50,000 people to become community volunteers, specialist teachers, nurses and cataract surgeons.

Building skills
We focus on building up the skills of mid-level eye care workers, such as eye nurses, so they can conduct minor operations as well as provide pre-operative and post-operative care to patients. Not only does this allow the eye surgeons to concentrate on more complex cases, but also helps motivate the nurses, and provide a platform to help them move onto the next stage of their career.

Community volunteersIn West Africa, our local partners train community volunteers to distribute the drug Mectizan® that will prevent river blindness. Volunteers are taught how to determine the correct dosage of the drug, as well as how to keep a record of the distribution. Our partners also train village workers to spread simple eye care messages among their community.

Skill sharing
We try to integrate eye care into existing health and education systems. Our partners give health workers basic training in eye health enabling them to identify and treat common eye conditions, or refer people on for further treatment. We also support training for teachers to enable them to identify children in their class with eye problems.

Community development
It''s our sincere belief that the best way to provide long term eye care in the developing world is to help build up sustainable infrastructures in the communities in which we work.  We do this by pursuing three key practices: advocacy, partnership and sustainability.

Advocacy
Working together with our partners we are able to influence governments around the world more effectively to combat avoidable blindness and encourage social inclusion. At an international level, Sightsavers is a major player in the Vision 2020 coalition which includes the World Health Organization and the major eye care non-governmental organisations.
Our partnerships with the Global Campaign for Education and International Council for Education of People with Visual Impairment help us to promote and advocate for the social inclusion of visually impaired people through tackling the large percentages of children who are blind not in school.
The strategic importance of these partnerships will increase as Sightsavers plays a part in helping to achieve the Millennium Development Goals. Alleviating poverty due to blindness and campaigning for the education of children who are blind as part of the goal of universal primary education will both contribute to this global action plan agreed by governments at a UN Summit in 2000.

Partnership
We work through local partner organisations to directly implement projects. These partners range from government ministries of health and education to community-based non-governmental organisations. We learn from our partners and share training, best practice and technical support with them. At the heart of any partnership is a solid relationship based on good open communication.
In order to learn more about how partners perceive Sightsavers, we commissioned an independent consultant to visit 40 of our key partners and find out their views on the relationship we have. The learning from this review, which was completed in early 2005, will inform our future growth and the way we identify and work with partners.

Sustainability
We want the effects of our work to be long-lasting. In order to achieve this projects are locally managed by our partners to ensure they are appropriate for the many different cultural settings in which Sightsavers works and that local legal and administrative systems are complied with. Our long term intention is that partners will eventually develop their own capacity to fully manage projects and develop sustainable services - enabling Sightsavers to direct its support to new programmes in different geographic areas.

Education
Sightsavers supports the principle of inclusive education. This is where children who have a disability such as being blind or visually impaired are included in the mainstream education system

Learning and blindness
Fewer than ten per cent of children who are blind or have low vision receive any kind of formal schooling. This fuels a cycle of illiteracy and poverty, leaving people who are blind as one of the most vulnerable and excluded groups in the world.

An inclusive approach to education
Sightsavers supports the principle of inclusive education. This is where children who are blind and visually impaired are included in the mainstream education system.

Making inclusion work
Sightsavers works with children, teachers and parents, as well as governments, to make inclusion work. This can involve:
ensuring teachers are trained to deal with every child''s needs
providing children with special needs teachers
helping to prepare children for school life
supporting children to use special educational resources and learn Braille
supporting parents of children who are blind or visually impaired
campaigning for changes in the curriculum
We are also a member of the Global Campaign for Education which advocates for the right of every child everywhere to go to school.

Working with teachers
Sightsavers works with local partners to ensure that children who are blind or visually impaired are included in mainstream schools. Yet in order for inclusive education to fully succeed, teachers need to be given the training and support they need to teach every child.

The issues
Many teachers in poorer countries cope with little training, poor pay and conditions, and enormous class sizes, so it isn''t surprising that they sometimes find it difficult to attend to every child''s needs. It is for these reasons that many teachers feel unable to accept children with disabilities into their classes, or unsure of how to work with them.
Teachers'' attitudes and skills are the key to including disabled children in education. Social prejudices assume that children with disabilities are unable to participate in education. If teachers can be supported to challenge these assumptions, disabled children can quickly and easily be included in school.

Specialist teachers
Teachers specially trained to work with visually impaired and blind children can aid the inclusion process in the classroom. We support the training of these teachers, often known as itinerant teachers, who visit a number of schools in their local area teaching visually impaired children skills such as Braille, as well as supporting classroom teachers in the classroom.

The job of a specialist teacher
Finding children not in school. Special needs teachers seek out children with sight problems who are not in school. Parents may not realise that school is a possibility for their child, so these teachers will explain the issues to them. If the parents consent the child will be found a place in school.
Helping at home. Teachers visit the children and parents at home to help prepare them for school. This could include helping the child use a white cane, or starting to teach them Braille. They will also answer any questions that the parent or child has about school.
Preparing for the classroom. Sometimes blind or visually impaired children are not ready to go straight into the classroom. In this case they can learn in a special resource room, where there is lots of special equipment to help them learn. When they feel confident they will join the other children in a mainstream classroom.
Helping in the classroom by giving one-to-one help to children in the classroom, through using Braille machines for example, specialist teachers help children who are visually impaired to become included in the classroom.

Global Campaign for Education
The Global Campaign for Education promotes education as a basic human right, and mobilizes public pressure on governments and the international community to fulfill their promises to provide free, compulsory public basic education for all people; in particular for children, women and all disadvantaged, deprived sections of society.

We believe education is:A universal human right
The key to poverty alleviation and sustainable human development
A core responsibility of the state
Achievable if governments mobilize the political will and available resources.

Together we are calling for:
Governments, to involve citizens'' groups, teachers and communities in developing concrete plans of action for delivering and sustaining free, good quality public education for all
Governments, to abolish fees and charges for public primary education, and to increase their own spending on adult, early childhood, primary and basic education, with priority investments in schools and teachers serving the most disadvantaged groups
On the World Bank and rich Northern countries, to increase aid and debt relief for basic education, and fund a Global Initiative to back national plans with speedy, coordinated and predictable delivery of the additional resources needed
On civil society organizations, to hold their own governments and international institutions accountable for upholding the right to education, and delivering on the Education for All goals.

Equal opportunities

Rehabilitation
Teaching basic daily living skills is one of the key ways of enabling people who are irreversibly blind to live with some kind of independence. This could include making their way around their town or village with a white cane, preparing food, dressing themselves or taking care of their own personal hygiene. Enabling people to do these kinds of simple activities means that they will require less assistance from their family and, hopefully, it will help to increase their confidence.

Vocational training
Being blind shouldn''t mean that people are prevented from providing for themselves and their families. With some vocational training, there are a variety of jobs that they can do, from farming to setting up small businesses, from shopkeeping to craft production.

Trainer training
One of the key areas of our work is in training people to act as rehabilitation workers in their communities. They can then help to provide support to people in the area who are irreversibly blind, as well as to provide advice to the sighted members of the community.

Advocacy
Sightsavers is strengthening the leadership, fundraising and technical skills of local organisations who are working to secure the rights of people who are blind. We also help them to lobby local and regional government to make sure these rights are respected not just in theory, but also in practice.