Botswana is an upper middle-income country that boasts one of the highest ratios of eye care professionals and services per person in Africa. Yet 2.4% of Botswana’s population of 2 million is visually impaired as a result of correctable or preventable conditions. With healthcare principally accessible through private providers in populous, metropolitan areas, the country’s rural margins suffer from a needless lack of diagnosis and treatment for simple eye maladies.
International aid has been instrumental in addressing public health crises in sub-Saharan Africa, but its focus on containing infectious diseases has neglected the emergency of remediable blindness and visual impairment. 80% of the 36 million people around the world unable to see live in the global periphery, an enormous majority of whom could be helped with glasses, eye drops, or simple routine surgeries.
Visual impairment and blindness in Botswana are increasing at an accelerating rate. A Rapid Assessment of Avoidable Blindness study recently found that Botswana with visual impairment increased from 36,000 to 50,000 and those with blindness grew from 10,000 to 15,000 between 2004 and 2014.
Peek Vision in Botswana
Peek Vision began as a research project housed at the London School of Hygiene and Tropical Medicine before transitioning to an independent social enterprise in 2015. The organization was founded by an eye surgeon whose childhood was marked by the discovery that the learning and behavior problems his teachers diagnosed were in fact the result of his need for glasses. With this first-hand knowledge of the difference early eye care intervention can make, Peek Vision seeks to ensure that children without access to healthcare infrastructure receive the care they need to see well.
In a 2016 pilot project in Goodhope, a sub-district at Botswana’s southern border, Peek Vision partnered with the government to provide mobile eye examination technology to local schools. Peek, an acronym for “Portable Eye Examination Kit,” addresses Botswana’s need for eyesight screening outside major cities with a smartphone adaptor and mobile application that allow trained vision screeners to conduct eye tests outside a formal clinic. The devices and screening procedures are all scientifically vetted; the tools have been subject to formal clinical trials.
The pilot program drew on personnel resources of the World Health Organization’s Expanded Program on Immunization. Peek Vision trained immunization staff to use the Peek Retina device and platform to test all school-age children in Goodhope over the age of six.
The Peek Vision Foundation is a registered charity in the United Kingdom. It receives funding from grants, donors, and governments.
Over the course of two weeks in the fall of 2016, Peek Vision screened more than 12,000 public school pupils at 49 schools. Ophthalmological professionals later traveled to schools where students’ required follow-up care, providing over 800 pairs of glasses to those who needed them.
The success of the pilot means that the partnership with the government is expanding into a national program. The program, in collaboration between the Ministry of Health and Wellness and the Ministry of Basic Education, aims to use local trainees and mobile examination technology to screen every school-age child in Botswana by 2022.
Aside from scaling its Botswana program to the national level, Peek Vision has expanded its sites of service to three additional countries: Zimbabwe, Kenya, and Pakistan.
The program draws on research that suggests that early intervention in diagnosing treatable eye disorders can not only improve educational outcomes, but also positively affect long-term psychological and economic wellbeing.
The Peek Retina trainings assume smartphone literacy that many healthcare workers lack. Since the trainings began in the research stages in 2011, more and more healthcare workers have acquired familiarity with smartphone usage as well as obtained smartphones of their own. While older healthcare workers tend to still lack experience with the devices, teams of vision screeners have been successfully navigating this obstacle by dividing the labor of exams between technological exams and the logistics of patient flows.
To learn more about the Peek Vision please visit their website or see the case study.