Update on the activities of Jonga Trust for the period 2009 to 2010

COMMUNITY BASED EYE WORKER SERVICE

Of the first intake of community based eye worker screeners taken on in 2008 by Jonga Trust, all have found either formal employment or been career pathed. With a 38% of unemployment in South Africa this program has proved itself as a foundation phase for those who have passed grade 12, but have no chance of employment or a stable future. It provides an invaluable eye care service for underprivileged communities and health services are now provided within their own communities by young people from the community, who understand the culture and speak their language. An important factor as South Africa has 11 official languages.

The need for eye health services is enormous. The current strike of people being screened and then referred further for formal refraction is 98%. In the Western Cape Province, 78% of clients referred for cataract surgery to the high volume cataract units come from the Jonga Trust community based eye care worker screening service.

In 2010 the physical number of community based eye screen workers was increased from 18 to 24. Included is Jonga Trusts first disabled community based worker who had both hands maimed in a mining accident and then became unemployed. He proved to be invaluable during the recent research study project for the Rapid Assessment of Avoidable Blindness (RAAB study – to be published in 2011).

STATISTCS FOR THE COMMUNITY BASED EYE SCREEN WORKERS 2009 AND 2010

RAPID ASSESSMENT OF AVOIDABLE BLINDNESS STUDY

Jonga Trust was requested by the Department of Health and the University of Cape Town, Department of Ophthalmology, to assist with the data collection and surveying for the Rapid Assessment of Avoidable Blindness (RAAB) study which was completed in November 2010. The gathered data is presently being analysed by the principle researchers, epidemiologist and statistician for publication in 2011.

The study aims were:

  • To establish the percentage of avoidable blindness in the Cape Metropole with population of 4.8 million, of which 3.8 million are indigent.
  • A grid spaced random sample of 3,000 subjects were surveyed and tested across privileged and underprivileged communities in the Cape Metropole
  • To establish what percentage of undiagnosed diabetics could be in the population through random blood glucose testing.
  • To establish if an ophthalmologist using a direct ophthalmoscope sees what is seen on an image taken with a retinal screening camera.
  • The community based eye workers were allocated to assist the ophthalmologists in their communities by doing vision testing which they do on a day to day basis and blood glucose monitoring in which they were trained by a Jonga Trust Trainer.
  • This study was required as there is no South African data available for future planning of eye care services.

EYE CARE AWARENESS WEEK REPORT 2009

Eye Care Awareness Week 2009 was held from 24 October 2009 till 10 October 2009. This was made possible with various instances of Jonga Trust partnering with state-, private- and non-profit organizations like the Department of Health, Lions International Service Organisation, Alcon Laboratories, Transitions Optical, Pick ‘n Pay, Ster Kinekor (Prime Media) and the South African Broadcasting Corporation (SABC).
The Eye Care Services program involved learners from various schools in the Cape Metropole being pre-screened by School Health Nurses (trained by Jonga Trust) and elderly people from the communities being pre-screened by the Jonga Trust community based eye workers for any eye health pathology or refractive errors.
All the learners and elderly who required visual correction were then refracted by a number of Optometrists who voluntarily gave of their time. All received their spectacles within a week of each event held, graciously sponsored by various organizations.
Those who required any further treatment were referred to the next level of care.

EYE CARE AWARENESS 2010 REPORT

Eye Care Awareness Week 2010 was held from 11-16 October 2010. This was made possible with Jonga Trust partnering with the Department of Health, Lions International Service Organisation, Transitions Optical, Liquid Lingo communications, Alcon Laboratories, Pick ‘n Pay, Ster Kinekor and the South African Broadcasting Corporation (SABC).
The Eye Care Awareness Week consisted of a series of Eye care and Eye health awareness campaigns with newspapers, radio and television and also eye care services, mainly in the form of providing eye tests and prescription glasses to indigent people at no cost to them.
Numerous newspaper articles were printed, promoting eye health during the week and radio interviews were done discussing eye health and the role of Jonga Trust. An interview with one of the Jonga Trustees, Charl Laäs, discussing eye health was also aired on national television during a breakfast show.
Prior to Eye Care Awareness Week, learners from various schools in the Cape Metropole were pre-screened by School Health nurses and schools in Malmesbury and surrounds (outside the Cape Metropole) were screened by Jonga Trust’s Community Based Eye Care Workers. Once this was done, optometrists went to the schools to refract the learners flagged and the spectacles were then made up.
During Eye Care Awareness week various ‘Eye Care Camp Days’ were held. During three Eye Care Camp days, held on the 12, 13 and 15th of October 2010 the learners tested prior to Eye Care Awareness week received and had their spectacles fitted. They were then entertained by an educational show by both the bird- or snake-man promoting animal conservation and Jonga Trust promoting eye health.

They were them served a wholesome lunch donated by Pick ‘n Pay and then had a treasure hunt to end the day’s activities.
Another program was held in conjunction with Ster Kinekor Mission Vision in Malmesbury on the 14th October 2010. During the day the learners were bussed to a central location in Malmesbury were Ster Kinekor had set up a mobile movie theatre. The learners were then given their spectacles, a box of popcorn and juice, a Ster Kinekor t-shirt, pen, pencil bag and bracelet all compliments of Ster Kinekor (Prime Media). Once everyone was settled with their new spectacles they were treated to a complimentary movie, Toy Story 3, which for most of the children was a first experience.
A wellness day was also held at the Mfuleni Community Centre on the 16th October 2010. Members of the Mfuleni community had their eyes screened by Jonga Trust’s Community Based Eye Care Workers. Those having refractive errors needing refraction and those with eye pathology were then referred to their Community Health Centre for further treatment and next level of care.

Jonga Trust Community based worker screening at the Mfuleni community outreach day October 2010
Jonga Trust community based worker testing near vision in a presbyopic client

JONGA TRUST PRESBYOPIC VISION TESTING KIT

It proved difficult for the community based eye workers to do near vision testing in high volume, so the professional staff at Jonga Trust developed a near vision testing kit with various near vision power spectacles which aids clients to quickly and easily determine their correct reader for their specific focusing distance.

The near vision reading chart proved to be a challenge due to all the official languages in South Africa. The languages of choice in the Western Cape Province are generally English, Afrikaans and Xhosa. To further improve the near vision testing process, Jonga Trust had the Jagger Near vision Test translated from English into Afrikaans and Xhosa. All tree Jagger Near Vision Charts in English, Afrikaans and Xhosa is included in the Jonga Trust Presbyopic Vision testing Kit.

Presbyopic Community Based Eye Worker testing kit

RETINAL CAMERA SCREENING PROJECT

This Retinal Camera Service has not been increased significantly to cover the 52,000 diabetics due to restricted financial resources and lack of further resources from Department of Health. The financial situation will hopefully be improved in the near future with possible funding through Lions International. Jonga Trust with the assistance of Lions sight committee of Distirct 410A have submitted a proposal to Lions International in Oakbrook, USA for funding which is available for Diabetes intervention in the prevention of complications related to Diabetes.

This service has provided useful eye health service and data for future planning for the prevention of avoidable blindness in Diabetics at a National and Provincial Government level.

STATISTICAL GRAPH DEPICTING DIABETIC RETINAL CAMERA SCREENING SERVICE
YEARS 2007 TO 2010

Abbreviations: Oph = Ophthalmology. Ref = Referred

INSULIN DEPENDANT CHILDREN’S DIABETIC CAMP

During March 2010, Jonga Trust was requested to do a Diabetic retinal screening and education program for Diabetic children during a Diabetic Camp. The first camp of its kind.

Data gathered from the camp were as follows:

  • 37 Juvenile diabetics screened with the retinal camera
  • All the children were under the age of 13 years
  • 13 of the children had early diabetic retinopathy
  • 1 child had advanced (serious) proliferate retinopathy which was immediately referred for Diabetic retinopathy laser treatment.
A young Diabetic having a diabetic retinal camera screening done
Insulin Dependent children being educated by Jonga Trustee, Di Powell, around the importance of having their retinal scan done annually

COMMUNITY SERVICE MEDICAL OFFICER TRAINING

The training of Doctors in Primary eye conditions and care is very limited in their undergraduate years. Jonga Trust has voluntarily undertaken to train this cadre of worker in community and primary eye care. To date a total of 54 doctors have received training in primary paediatric and diabetic retinopathy ocular conditions. See the educational lectures developed by Jonga Trust for Health Professional training purposes included in the Jonga DVD entitled “Primary Eye Care” and “Guidelines for trauma management

SCHOOL REFRACTION SERVICE INITIATIVES

The literacy and numeracy levels are extremely low in disadvantaged urban and rural public schools. Once of the concerns identified by the Jonga Trustees was that no formalised eye health screening projects are in place in South Africa.
A pilot program was launched with Western Cape school health services in the Cape Matropole where relevant school nurses were trained by Jonga Trust to screen for eye health in learners. Where identified a mobile refraction team consisting of a qualified paediatric Optometrist and Ophthalmic dispenser are sent to the school to refract the children during school hours on the school premises. Being on location minimises the impact on the child’s time away from the class room and the parents time away from work.
Due to the success of the program Jonga Trust wanted to expand the program to schools in the Cape Metro pole and outlying rural areas not covered by the school health services. These are severely disadvantaged and underfunded public schools. Jonga had to source other financial resources in the form of partnerships with the Ikanya school projects, L Abrahamson Trust, Ster Kinekor and Durbanville Rotary club
In partnership with these organizations, Jonga Trust can now screen, refract and supply spectacles to the learners of some of these non-privileged schools. To further enhance the project and understand the impact of these services to education as a whole, Jonga Trust started a research project to establish the impact on the academic achievement of the learners and the school before and after the eye care services was rendered for a period of two years.
Some of the interesting, yet alarming, facts were children in Grade 4 to 6 with prescriptions ranging from -6.00D to as high as -16.00D without spectacles and one of the children in Gr 4 was referred to Ophthalmology for cataract extractions!

Jonga Trust Community based worker doing a visual acuity test
Jonga Trust Optometrist refracting a learner at Mitchel Heights Primary

TEACHER TRAINING

In the South African school system there is a severe shortage of resources. One of them is lack of basic health screening and particular eye health screening in the school system. The Trustees at Jonga Trust realised the importance of training teaches, who are in contact with the learners every day, to identify children who might have potential sight problems
Jonga Trust then undertook to develop a training package for teachers in the schools. The training package consists of a comprehensive PowerPoint lecture, accompanying workbook highlights sheet. Please see enclosed the Back to School Workbook and Highlights Sheet. Also find the slide presentation on the Jonga DVD entitled “Back to School”
During the past 6 months of 2010, 57 teachers have been trained by Jonga Trust in the Back to School program.

JONGA’S AIMS OBJECTIVES AND GOALS FOR 2018

  • High Volume Refraction Clinic in Kahyaleitsha
  • Development of rural community based eye worker project for remote areas.
  • Development of mobile school screening and refraction service for rural areas farm schools

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