Creating a Future Vision for Community in Delhi Slums

Next to a cement shop in the slums of Delhi sits an unprepossessing, narrow doorway leading up a slender staircase to a bustle of activity in a building the size of a three-bedroom apartment. Color is exceptionally vibrant, radiating off the posters on the walls and the brightly colored garb of more than 100 local residents seeking or waiting for treatment. In the flurry of activity, the crowd navigates their way around a boy propped in the center reading letters off an eye chart on the wall. This refuge for eye care is part of Sightsavers’ Vision Delhi program – an initiative to strengthen eye care services in the Delhi slums.

Approximately 20 percent of Delhi’s residents live in slums, largely comprised of daily wage earners and migrants living in poor and unhygienic environments with unmet health needs. In line with the strategies of the Government of India’s National Program for Control of Blindness, five fully equipped centers were established in slum centers identified in east, south and west Delhi. With the support of Baxter and the Baxter International Foundation, more than 45,790 patients were reached in one year, providing greater access to care for those that need it most.

The program, originally launched by the joint secretary to the government of India and carried out with the Rajendra Prasad Center for Ophthalmic Sciences, is part of Sightsavers’ broader contribution to Vision 2020: The Right to Sight – a global initiative for elimination of avoidable blindness by the year 2020 created by the World Health Organization. The vision centers provided 2,045 hospital referrals for more complex eye conditions, exceeding their target by 50 percent to reduce the incidence of blindness through identification and treatment.

Optometrists and field attendants were dispatched into the community weekly to screen people and encourage them to come forward for treatment. A basic eye test was given, and if further assistance was required, they would strongly encourage the patient to visit one of the vision centers.

Mike Straney, director of Major Giving for Sightsavers, described his visit to the vision centers as “overwhelming.” However, he noted the queue of people waiting to have their eyes tested was a clear sign of just how essential this program was to the community.

“One gentleman in his sixties who had lost his sight to cataracts and had a disabled son knew his family depended on him for their livelihood,” Mike said. “He was so impressed with the facility that, after his sight-restoring surgery, he brought his wife in to have her own cataracts treated. His display of trust for the service is what showed me the incredible impact we’re having on families’ lives.”

The program trained 37 teachers from schools in the community to identify refractive error – the most common cause of visual impairment in India and the second most common cause of blindness. As a result of integrating school eye screening activities, 24,188 children were reached through 34 screenings and 1,696 pairs of glasses were dispensed to children by the Municipal Corporation of Delhi.

Our program has enabled eye health screening and treatment for Delhi residents, with a specific focus on the women and children that make up over half of the slum population and provided the necessary training for improved eye care among community workers.

Julia Strong, trust manager at Sightsavers

“Eye health service in Delhi slums is limited, and for those with refractive error, road side vendors dispensing cheap quality spectacles provided the only affordable service,” Julia Strong, trust manager at Sightsavers, said. “Our program has enabled eye health screening and treatment for Delhi residents, with a specific focus on the women and children that make up over half of the slum population and provided the necessary training for improved eye care among community workers.”

As part of the program, several eye health education sessions took place, advocating for the integration of eye health as an integral component in the general health sessions conducted at Gender Resource Centers, which focuses on women’s empowerment and health education, among other key areas. Sightsavers’ also reported the government departments in Delhi are now giving increased importance to eye health thanks to the program’s success.

Forty-year-old Delhi resident Veeru Pratap visited a vision center when he realized everything he had worked for was in jeopardy when his eyesight began failing. He had recently lost his job as a result of his sight problems and he and his family quickly descended into poverty. The center’s support and funding allowed him to undergo cataract surgery, which led to clear sight and even eliminated the need for glasses. Veeru was then able to secure a new job and once again provide for his family.

“I never expected my eyesight to be restored so easily in a small span of time at a high-tech hospital without any cost for my family,” Veeru said.

By the support of Baxter and the Baxter International Foundation to constructing better access to eye care for slum residents, the organization intends to increase the number of vision centers given the success of the current model to reach even more beneficiaries with primary eye care services. Sightsavers also plans to continue using the program outcomes, including a study on health seeking behavior change among slum communities, to influence the replication and scale-up of the program in other Indian cities with similar needs.