Leadership Transfer into Nepali Programme Director

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Eastern Regional Eye Care Programme Sagarmatha Choudhary Eye

2012 The Eastern Regional Eye Care Programme (EREC-P) comprises of

Hospital (BEH) in Biratnagar, 8 Satellite Clinics/Eye Care Centres

EREC-P is a high volume treatment programme, which provides high

population in eastern Nepal and northern India.

1 Eastern Regional Eye Care Programme Sagarmatha Choudhary Eye Hospital, Lahan Biratnagar Eye Hospital, Biratnagar ANNUAL REPORT 2012 The Eastern Regional Eye Care Programme (EREC-P) comprises of Sagarmatha Choudhary Eye Hospital (SCEH) in Lahan, Biratnagar Eye Hospital (BEH) in Biratnagar, 8 Satellite Clinics/Eye Care Centres in the Terai and hilly region. EREC-P is a high volume treatment programme, which provides high quality comprehensive eye services at a cost affordable to a huge population in eastern Nepal and northern India. HIGHLIGHTS: Leadership Transfer into Nepali Programme Director 95,843 Surgeries at EREC-P Eye Hospitals incl. 2,101 Paediatric Surgeries

OUTPATIENTS: SCEH, Lahan: 154,423 Biratnagar Eye Hospital: 197,845 8 Satellite Clinics/PECCs: 80,935 303 Cat. Screening Camps Patients: 54,312 6 Surg.

Camps : 321 TOTAL : 95,843 Cataract: 78,068 Sutureless ECCE/IOL (SICS): 55,923 Sutured ECCE/IOL: 1,600 On children: 1,192 Phaco ECCE/IOL: 18,833 Other lens removal procedures: 520 Glaucoma: 3,185

2 OUTPATIENTS: SCEH, Lahan: 154,423 Biratnagar Eye Hospital: 197,845 8 Satellite Clinics/PECCs: 80, Cat. Screening Camps Patients: 54,312 6 Surg. Camps Outpatients: 2,304 TOTAL: 489,819 SURGERY: SCEH, Lahan: 50,482 Biratnagar Eye Hospital: 43,384 Satellite Hosp. Malangwa: 1,656 6 Cat.Surg.Camps : 321 TOTAL : 95,843 Cataract: 78,068 Sutureless ECCE/IOL (SICS): 55,923 Sutured ECCE/IOL: 1,600 On children: 1,192 Phaco ECCE/IOL: 18,833 Other lens removal procedures: 520 Glaucoma: 3,185 Trabeculectomy: 1,068 Combined Cat&Trabeculectomy: 1,340 Trans scleral cyclo photocoagulation:267 Nd. YAG iridotomy: 439 Surgical PI: 71 Corneo-Scleral Surgical Procedures: 3,188 Keratoplasty: 35 Amniotic Membrane Graft (AMG): 55 Corneo Scleral Repair: 349 Other Corneal Procedures: 273 Pterygium: 2,476 Vitreo-Retinal Surgery: 1,357 Pars plana Vitrectomy: 1,296 Scleral Buckling: 61 Oculoplasty Procedures: 3,655 Dacryocystorhinostomy: 1,530 Dacyrocystectomy: 1,032 Entropion: 371 Ectropion: 44 Evisceration: 442 Enucleation: 3 Eye Lid Repair: 62 Other oculoplasty procedures: 171 Laser procedures: 3,782 Retinal Laser: 1,859 Nd. YAG capsulotomy: 1,923 Others: 2,608 TOTAL: 95,843 Page 2 of 9

Leadership Transfer into Nepali Programme Director: Dr Hennig worked as founder Programme Director

After retiring on April 2012, leadership of EREC-P was handed over to Nepali Programme Director Dr.

Lila Raj Puri was given responsibility of Acting Medical Superintendent of SCEH from 1st January

jointly by Dr. A. Hennig & Ms. Kristina Hennig for construction of OT & Academic building of Lahan.

SPECIAL SERVICES at EREC-P: Paediatric Department Examination: 36,045 children Surgery: 2,101 (1,192

3 Leadership Transfer into Nepali Programme Director: Dr Hennig worked as founder Programme Director of EREC-P for over 30 years. After retiring on April 2012, leadership of EREC-P was handed over to Nepali Programme Director Dr. Sanjay Kumar Singh from May 2012 onwards. Similarly Dr. Lila Raj Puri was given responsibility of Acting Medical Superintendent of SCEH from 1st January Foundation Stone Laying of Operation Theatre & Academic building: A foundation stone was laid jointly by Dr. A. Hennig & Ms. Kristina Hennig for construction of OT & Academic building of Lahan. The new OT & Academic building construction is in progress which will be ready by July SPECIAL SERVICES at EREC-P: Paediatric Department Examination: 36,045 children Surgery: 2,101 (1,192 on cataract) In the Cornea Departments of both hospitals 3,390 corneal ulcer patients were seen and treated. Several awareness programmes for Eye Donation were organised in co-operation with local organisations to increase understanding and acceptance of eye donation in the society. In last one year 20 corneas were harvested and 1,269 people filled up eye donation willingness forms. Before surgery After surgery Page 3 of 9

Dr. Hari Sharma received VR surgical training from BEH and has restarted VR surgery at SCEH.

In the Vitreo- Retinal (VR) Departments of both hospitals 1,357 VR surgeries have been performed.

In Oculoplasty Department of both eye hospitals, 3,655 oculoplasty surgeries have been performed.

In the Low Vision Department 949 patients with low vision were assessed, including 366 children. Special low vision devices were offered to those who required them for improving their vision.

4 Dr. Hari Sharma received VR surgical training from BEH and has restarted VR surgery at SCEH. ROP screening has been started at BEH in co-operation with neonatal units of different general hospitals at Biratnagar. In the Vitreo- Retinal (VR) Departments of both hospitals 1,357 VR surgeries have been performed. In the Glaucoma Department of both eye hospitals, 5,809 patients were examined and 3,130 computerised visual field examinations were performed. In Oculoplasty Department of both eye hospitals, 3,655 oculoplasty surgeries have been performed. In EREC-P s Ocular Prosthesis Units 216 patients received artificial eyes, 80 of them being custom made by specially trained staff, like for this 18 year-old girl. In the Low Vision Department 949 patients with low vision were assessed, including 366 children. Special low vision devices were offered to those who required them for improving their vision. Subsidy to poor patients About 59% of all cataract patients paid NPR 1,000 (USD 12) for their surgery. Poor patients presenting at SCEH and BEH or in Screening/Surgical Camps received free or subsidized treatment or even food and transportation support, amounting to a total of NPR 3,873, (USD 44,020). OUTREACH ACTIVITIES: Besides continuing 7 Satellite Clinics/Eye Care Centres (Malangwa, Rajbiraj, Siraha, Gaighat, Diktel, Bhojpur, Terhathum), a new Eye Care Centre was established at Rangeli. 303 Cataract Screening Camps were conducted in Inauguration of ECC Rangeli, collaboration with local organisations in Sagarmatha and 22 Feb Koshi Zone. Out of the 54,312 patients examined, 8,413 were transported to SCEH, Lahan or BEH, Biratnagar for free or subsidised cataract surgery. In 6 Cataract Surgical Camps in the hilly districts of Sagarmatha and Koshi Zone 2,304 patients were examined and 321 eye surgeries performed, out of which 244 were cataract. In 164 School Screenings 19,213 children were examined. 279 children had refractive error and were referred to SCEH or BEH. In addition to school screening programme, 1,468 children were examined in 7 Paediatric Eye Camps. Page 4 of 9

5 In 6 Diabetic Retinopathy Camps 1,374 Patients were examined. BEH has started Combined Eye and Ear Screening Camps. A total of 45 combined camps were conducted and 2,259 ear patients were examined and treated. Out of which 129 were referred for further treatment and 16 underwent surgery. DISABILITY & INCLUSIVE DEVELOPMENT ACTIVITIES: D & ID concept was introduced at EREC-P hospitals. Workshops were organized for orienting the EREC-P team about disability and inclusive development with specific reference to the mandate of Eye care facilities by CBM SARO. D & ID orientation programme for camp organizer, local government officials and disabled people s organizations (DPOs) were conducted by both hospitals. Meetings with the key stake holders working in the field of disability were conducted for establishing networking in both hospitals. HUMAN RESOURCE DEVELOPMENT & TRAINING: Besides continuous medical education for the hospitals ophthalmologists the following special teaching and training programmes were conducted. Anterior Segment Fellowship: 5 Ophthalmologists completed their two-year Anterior Segment Fellowship at SCEH and BEH, which also includes training in sutureless cataract surgery (Fishhook Technique) and phacoemulsification. At present, 7 ophthalmologists are undergoing fellowship. Vitreo-Retinal Fellowship: 3 ophthalmologists are undergoing two-year Vitreo-Retinal Fellowship at BEH. Co-operation with BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS), Kathmandu and BP Koirala Institute of Health Sciences (BPKIHS), Dharan was continued with a comprehensive clinical and surgical training for 4 Post-graduate MD Residents from BPKLCOS, Kathmandu (2 months) 3 Post-graduate MD Residents Residents from BPKIHS, Dharan (1.5 month). 5 Optometry Students from BPKLCOS underwent one-month training at SCEH or BEH. EREC-P is sponsoring four candidates for post-graduate MD Residency in Ophthalmology at BPKLCOS and NAMS at Kathmandu. Page 5 of 9

MISCELLANEOUS: Staff at all EREC-P Centres: 413 member staffs includes 24 ophthalmologists, 15 administrative staff, 16 ophthalmic assistants (OA), 2 anaesthetic assistants, 18 health assistants, 2

Josef Schneider, Austrian Project Manager and CBM Co-Worker who was in charge of new Biratnagar Eye Hospital building construction, completed his tenure successfully in March 2012.

6 MISCELLANEOUS: Staff at all EREC-P Centres: 413 member staffs includes 24 ophthalmologists, 15 administrative staff, 16 ophthalmic assistants (OA), 2 anaesthetic assistants, 18 health assistants, 2 optometrists, 3 staff nurse, 62 eye health workers and trainees. Mr. Josef Schneider, Austrian Project Manager and CBM Co-Worker who was in charge of new Biratnagar Eye Hospital building construction, completed his tenure successfully in March Cataract Package Tours : 10,113 cataract patients, collected by 37 agents in North-India, were brought to SCEH, Lahan and BEH, Biratnagar for surgery. 7th Eastern Regional Ophthalmological Conference: To Improve Coordination in Prevention of Blindness Work and to provide continuous ophthalmic knowledge in Nepal s Eastern Region, SCEH organized 7th Eastern Regional Ophthalmological Conference from 31st March to 1st April 2012 in Lahan. There were 70 participants from different eye hospitals of Nepal who presented 26 scientific papers during the conference. New comprehensive Hospital Management Information System Software was developed and implemented in both hospitals which includes medical records keeping, inventory, fixed assets and financial management. Co-operation between SCEH and IMPACT Nepal in Lahan: SCEH has been providing support and part of its premises for Lahan Ear Hospital under the management of IMPACT Nepal for the benefit of patients with hearing impairment and ear diseases. Emergency Relief for Fire Victims: SCEH distributed emergency relief package like clothes, food and others to the fire victims of Shibnagar and Aurahi of Siraha district with financial support from CBM. Page 6 of 9

Felicitation and Farewell Ceremony of Dr. Hennig & Kristina Hennig: A felicitation and farewell ceremony was organized by civil society of Siraha for Dr.

Visitors & Visiting Faculty & Guest Lecturers: Many visitors came to observe the work at EREC-P hospitals. Prof.

delivered lectures on various topics of glaucoma in March.

Various Trainings / Workshops and Conferences at EREC-P: Various orientations, short and long-term ophthalmic training programme were continued for Eye

Female Community Health Volunteers and School Teachers.

7 Felicitation and Farewell Ceremony of Dr. Hennig & Kristina Hennig: A felicitation and farewell ceremony was organized by civil society of Siraha for Dr. A. Hennig and Ms. Kristina Hennig for their excellent leadership, dedication and commitment for over 30 years in SCEH, Lahan. Visitors & Visiting Faculty & Guest Lecturers: Many visitors came to observe the work at EREC-P hospitals. Prof. Christian Mardin, University Erlangen- Nuremberg, Germany provided clinical training to ophthalmologists, residents and ophthalmic assistants and delivered lectures on various topics of glaucoma in March. Prof Arin Chatterjee from India provided Continuous Medical Education to ophthalmologists and ophthalmic assistants in June/July. Various Trainings / Workshops and Conferences at EREC-P: Various orientations, short and long-term ophthalmic training programme were continued for Eye Health workers, Health Assistants, Auxiliary Health Workers and Auxiliary Nurse Midwives, Staff Nurses & Health Assistant Students, Drug Retailers, Female Community Health Volunteers and School Teachers. Various types of training were provided to the hospital staff for capacity building like House Keeping, 7 Habits for the Highly Effective People, Effective Communication, Clinical Low Vision Training, Refresher Training for Eye Centers Incharge and Optician training for Optical staffs in both hospitals. Awareness Rallies: World Sight Day (11 th October 2012) International Day of Persons with Disabilities (3 rd December 2012) Page 7 of 9

8 Various Trainings / Meetings / Workshops and Conferences in Nepal: Mr. Surat Lal Mahato & Md. Rafique: Advance Training of Trainers at TITI, Kathmandu: Mr. Animesh Acharya & Mr. Suresh Singh: Training on Management Skills at TITI, Kathmandu: Dr. Lila Raj Puri presented a paper on Two years Anterior Segment fellowship at EREC-P: A comprehensive approach at International symposium of Ophthalmology, Kathmandu on Dr. Lalit Surin participated in Pediatric Conference at Lumbini Eye Institute, Nepal: Nepal Ophthalmic Society Annual Conference 2012 on o Dr. Sanjay Kumar Singh presented a paper on Pediatric cataract management (EREC-P approach) o Dr. Lila Raj Puri presented a paper on Approach to management of Glaucoma at High volume center: The Lahan Experience Dr. Hari Sharma underwent VR surgical Training at BEH, Biratnagar: The Retina & Glaucoma Conference in Kathmandu: o Dr. Pratap Karki presented a paper on Retina Services in EREC-P. o Dr. Hari Sharma presented a video on The management of dropped nucleus. o Dr. Lalit Agrawal & Mr. Ramanand Biswakarma also participated in the conference. In addition, several staff joined various workshops and awareness programmes organized by CBM, NNJS, BPKLCOS in Kathmandu. Courses / Workshops / Conferences & Presentations outside Nepal: Dr. Pratap Karki & Mr. Abhishek Roshan attended a course on Management Priorities in eye care delivery, Lions Aravind Institute of Community Ophthalmology/India: Dr. Pratap Karki attended Evidence Conference at LVPEI, India: Mr. Sunil Kumar Chaudhary participated in a Pediatric Optometry and Strabismus Course at Shroff Charity Eye Hospital, India: Dr. Rajan Labh went for Observership on Oculoplasty at Aravind Eye Hospital, Madurai, India: Mr. Raj Kumar Yadav completed a short term course in Community Eye Care Outreach Management at Sadguru Netra Chikitsalaya, India: MD. Rafique attended a course on Community Outreach Training at Lions Aravind Institute of Community Ophthalmology/India: Dr. Pratap Karki did a ROP Training at LVPEI/India: Mr. Bindeshwar Mahato participated in 9th IAPB, Hyderabad, India: Dr. Sanjay Kumar Singh participated on Health Systems for Universal Coverage in eye care at LAICO, India on Mr. Sudhir Thakur participated in CBR world congress at Agra, India: Publications: Sharma H, Puri L R Melanocytoma of the optic disc a case report Nepalese journal of ophthalmology,volume 4 N0 1, Issue 7, January 2012, Puri L R, Sharma H, Aryal S Weill- Marchesani Syndrome - a rare case report Nepalese journal of ophthalmology,volume 4 N0 1, Issue 7, January 2012, Page 8 of 9

9 FINANCIAL SUPPORT: In addition to CBM as major donor the following organizations are also sponsoring the Eastern Regional Eye Care Programme: The European Commission (EC) is supporting the Eastern Regional Eye Care Programme for 4 years ( ) for Improving the Quality of Life of Vulnerable Target Groups in the Eastern Region of Nepal by Improving Eye Care and Sight Restoration. The programme was extended till April Standard Chartered Bank (SCB) is supporting the Eastern Regional Eye Care Programme for 4 years (July 2009-June 2013) through its Seeing is Believing (SiB) Programme in order to strengthen the eye care service delivery in eastern Nepal and significantly reduce the prevalence of blindness in Eastern Nepal, thus improving the quality of life and economic situation of reversibly blind persons and those at risk of blindness. ORBIS International is supporting Sagarmatha Choudhary Eye Hospital, Lahan through its agreement with Nepal Netra Jyoti Sangh for a hospital based National Program for Control of Childhood Blindness in Nepal for 5 ½ years (mid-july December 2015). Acknowledgements: The Programme Director gratefully acknowledges the support rendered by CBM and their donors, the European Commission, Standard Chartered Bank, ORBIS, German Donor initiatives and the local community. Special thanks go to Ministry of Health, Social Welfare Council and Nepal Netra Jyoti Sangh for their continuous support. He would also like to thank his colleagues and all staff members who as an enthusiastic team made the eye services of the Eastern Regional Eye Care Programme once again such a success. Dr Sanjay Kumar Singh Programme Director Eastern Regional Eye Care Programme Mail address : G.P.O.Box 15108, Kathmandu, Nepal sanjay.singh@erec-p.org, info@erec-p.org, Website : sceh@erec-p.org Page 9 of 9

HIGHLIGHTS: 116,787 surgeries / 683,728 patients examined

HIGHLIGHTS: 116,787 surgeries / 683,728 patients examined Eastern Regional Eye Care Programme (EREC-P) is a non-profit, high volume treatment programme providing high quality comprehensive eye services at affordable cost to a huge population in the eastern Nepal