As we crossed the border from Andhra Pradesh into Orissa I began to notice the subtle changes in environment. All of a sudden dense forestry engulfed us and the splendour and colour of Adivasi dress became apparent. The Adivasi’s are India’s indigenous people and in Rayagada, the area we were visiting, the Khond tribe are the most predominant of these people. The most distinguishable thing I noticed about the women was their nose piercings in which a gold hoop in each nostril was on display plus a gold septum ring with a beautifully ornate bright pink stone in the middle. I was instantly fascinated and wanted to learn all I could about their way of life and the pre-conditions of their existence.
This particular visit I happened to be monitoring an inclusive eye health project and therefore was interested in the health seeking behaviour of the area’s inhabitants. Partner staff were quick to explain that awareness around avoidable blindness and prevention of curable eye conditions as such was quite low. In addition to this, community members tended to inhabit a deep seated fear about operational procedures such as those associated with cataract surgery. This became even more apparent as I saw an elderly tribal woman literally run away from Partner community workers when they identified that she required surgery.
In order to attempt to quell these instances consistently occurring into the future, the Partner invests in activities beyond just those which are hospital based; with particular emphasis on community awareness raising, screening and counselling to promote the uptake of services. For this reason community outreach work has become paramount towards achieving goals of eliminating avoidable blindness in the surrounding areas of the Partner’s treatment institute. So with all of this in mind, now enter the ‘Vision Guardians’ and Community Mobilisers of this region..
In such a rural environment in which low educational outcomes are synonymous with everyday life, community members rely on Partner staff to provide them with necessary information relating to their eye health. It is the therefore the responsibility of those aptly named as the ‘Vision Guardians’ to identify members of communities who require treatment, counsel them to take up what is available which in most instances is free services and treatments, and accompany them to the hospital for these procedures.
As you can imagine the role of these Vision Guardians is hugely important in quelling taboo and stigma around the uptake of services and supporting patients along their journey including following up with home visits crucial in the post operative care cycle.
I was of course very much impressed with the model of operation in which the Partner was yielding. However, what astounded me even more was how the project had imbedded inclusion standards and practices not only into its hospital operations but also within the mandate of how it sees out its vision and mission.
It was during a community eye screening camp that I began to understand just how deeply entrenched the message of inclusion is within the Partners work. The camp itself was held on the premises of the Gram Panchayat (local level government) in which the Partner had negotiated for eye screening to go hand in hand with assistance of persons with disabilities to obtain certificates allowing them access to disability pensions and schemes. In taking this one step further, the local Partner was assisting the lodging of the paperwork for disability certification through an online portal which most people in the area would not be able to access without their assistance.
In speaking to some members of the gathering, I met with those who told me that treatment for low vision or eye health conditions was just the first point of call in their journey within the project. After they had received treatment and been rehabilitated for their eye health conditions, the Partner had assisted in referring them to vocational training institutes and facilitated the application of small scale loans with local banks for business operations according to their skills. Others told me of how the Partner had identified them with multiple disabilities in addition to eye health conditions and thus been the link to referring them to other specialised services in the area, to address compounding impairments.
I remember standing there in the heat surrounded by village people and thinking that this project could actually claim with showcased evidence what others are unsuccessfully trying to achieve. This being inclusive, accessible services in which holistic development assistance is resulting in a better quality of life for all those involved.
*Images © CBM Australia, taken by Sabene Gomes