{"id":1257,"date":"2018-05-09T13:09:45","date_gmt":"2018-05-09T13:09:45","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=1257"},"modified":"2018-05-09T13:12:20","modified_gmt":"2018-05-09T13:12:20","slug":"making-a-difference-in-low-resource-settings","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2018\/05\/09\/making-a-difference-in-low-resource-settings\/","title":{"rendered":"Making a Difference in Low-Resource Settings"},"content":{"rendered":"

By Nathan Douthit<\/p>\n

In February, 1999, the World Health Organization partnered with more than 20 non-governmental organizations involved in eye care to launch VISION2020: The Right to Sight. The goal of this initiative is to eliminate the main preventable and treatable causes of blindness by the year 2020. The threefold strategy involves disease control, human resource development, and infrastructure and appropriate technology development. Despite major improvements, there is still work to be done.[1]<\/sup><\/a><\/p>\n

In \u201cManagement of a rhegmatogenous retinal detachment in a low-resource setting: treatment options when there is no vitreoretinal surgeon,\u201d Emsley et all highlight the difficulty in management of opthalmological problems in low resource settings, where no subspecialists are present. The patient presented with a treatable retinal detachment and retinal tear, but, \u201cUnfortunately, no access to any vitreoretinal trained personnel or vitrectomy equipment currently exists in Sierra Leone\u2026. [T]he nearest facility in Ghana is 2018 km away and beyond the financial means of the patient.\u201d Despite presenting with vision acuity of 20\/30 bilaterally, \u201cAt review 8 months later, the visual acuity had dropped to 6\/36 and the retina had completely detached.<\/p>\n

In the discussion, the authors present the incidence of rhegmatogenous retinal detachment in sub-Saharan Africa and Sierra Leone. Despite the growing prevalence of this disease and the \u201clate presentation with advanced disease and secondary complications\u201d in the developing world, only 15 subspecialty trained vitreoretinal surgeons practice in the region of Senegal to Kenya and Ethiopia to Tanzania. The lack of equipment and continued training for opthalmologic specialties is a well documented problem.[2]<\/sup><\/a> The need to develop a system for screening, referring and transporting patients to well-equipped tertiary care centers is also well-described.[3]<\/sup><\/a><\/p>\n

Despite steps in these directions, however, there are still countless patients suffering with no access to the necessary specialties\u2014in this case, a vitreoretinal surgeon. Rather than forgoing any care, healthcare professionals with appropriate training can optimize the treatment with the resources they have available to them. Emsley et al excellently describe several interventions in there article that would have helped this patient without the need for a vitreoretinal surgeon. They focus on pneumatic retinopexy, \u201c[T]he ideal treatment option for the case described above in this setting.\u201d<\/p>\n

BMJ Case Reports invites authors to submit global health case reports that describe feasible interventions that could alleviate disease in low-resource settings. These cases could focus on:<\/p>\n