She’s also proof of the unique role women can have in impacting the health of communities across Africa.

“I was working as a community health nurse before I was invited to be trained as a primary eye care worker,” Mabel says, referring to her work with the care team at the government-run Kormantse Clinic. “There’s a high prevalence of eye conditions among the fisher folk in my community. The nature of their work makes them more likely to suffer from eye diseases. That’s why I joined the fight against avoidable blindness in the municipality.”

Today, thanks to the training she received through Operation Eyesight, Mabel provides education and eye health screening to others across the Municipality of Mfantseman. “I still carry out my duties as a community health nurse, but eye care is now well integrated in the things I do,” she says.

Vision impairment disproportionately affects women and girls across the globe, yet they are less likely to be prioritized for eye care. Lack of income and transportation are common barriers, as are traditional female responsibilities like child care and collecting water. That’s why it’s so important to have women like Mabel trained to screen for eye conditions. She can reach women and girls at home, provide referrals, and offer the information and reassurances that some may need to seek treatment.

As a single working mom, Mabel needs to balance her work with caring for her young daughter. She says she enjoys the flexibility that comes with working with Operation Eyesight.

“Operation Eyesight supports me with transportation and meals when I go to the field,” she says. “I save part of my wages to pay for my child’s school fees.”

Mabel says she’s passionate about helping others, especially those experiencing poverty.

She recalls a patient whose story has stuck with her. Yaw, a 69-year-old man who lives in Kormantse, had been experiencing blurred vision for three years. Mabel says she visited his home as part of a routine door-to-door screening and quickly discovered that he had cataracts. She referred him to the base hospital for surgery, which he promptly visited the next day. He underwent sight-restoring surgery and today he can see clearly.

Other times, Mabel may face more reluctant patients, so part of her job is to encourage those who have had little interaction with the healthcare system to get treatment, and to assure them that it’s both safe and worthwhile. She adds that spending time with people in her community is what makes her work so rewarding.

“The job gives me the opportunity to interact with many people,” Mabel says. “My family sees this job as an opportunity to change the perception about eye health through education.”

International Women’s Day 2023

March 8, 2023 is International Women’s Day – it’s an opportunity to spread the message of gender equality and highlight the importance of creating a society free of gender bias. It’s also a chance to celebrate the unique role women like Mabel play in communities globally.

Most of the community health workers trained by Operation Eyesight partner hospitals are women. When women are employed as community health workers, they have an opportunity to become trusted leaders in their communities and act as catalysts for positive health outcomes. This employment improves their ability to become active participants in their family’s socioeconomic stability.

Not only is empowering women and reducing gender inequalities the right thing to do, it’s also the smart thing to do. Evidence shows that empowering women is one of the strongest catalysts for driving sustainable development across all sectors. It enhances economic growth, improves education and increases positive health outcomes. You can learn more about our gender strategies by signing up for our eNewsletter.

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Udhampur Block is a rural area perched high in the foothills of the Himalayas in India’s Jammu and Kashmir region. Due to the rugged terrain and roads that are often affected by flooding, it can be difficult for the people who live there to access services like eye health care. For women and girls, the barriers are even greater, as the men and boys in their families are often prioritized for health treatment.

What’s more, our research in the area revealed health myths affecting women, including those that suggest that a woman wearing eyeglasses is in poor health overall, that poor eye health is a result of sinful behaviour in a past life and that only elderly people should wear eyeglasses.

The idea behind this project is to outfit a four-wheel-drive vehicle as a fully functioning optometry clinic. An all-female heath care team will run the mobile clinic and deliver services to everyone in the project area.

We are training eight local women as Community Health Workers to do door-to-door eye screenings and to provide referrals to the Rotary Eye and ENT Hospital. They will also deliver educational sessions to women’s groups, with the goal of debunking the female eye health myths that exist in the communities.

People in the area will also be asked for their input on what kind of eye health education they would like to receive using a type of participatory research called PhotoVoice. This research will place cameras into the hands of locals, who will be asked to take pictures of things that highlight the themes of the research: activities, beliefs and circumstances of eye health.

Ninety per cent of blindness worldwide is preventable or treatable, but people in underserved areas like Udhampur Block often fall through the cracks. This project will help people get access to the eye health care they need while also addressing some of the gender inequalities related to poor vision.

This innovative project aims to:
✔ Address the barriers faced by women and girls by targeting feminine eye health myths that perpetuate inequality;
✔ Incorporate input from local women on the content of our eye health education sessions and the delivery of eye health services on an ongoing basis;
✔ Activate a Mobile Vision Centre to provide eye health services to people’s doorsteps, so that all residents, including women and girls, can avoid travel-related barriers;
✔ Make role models of local women and girls by publicly engaging them in good eye health practices; and
✔ Generate buy-in from men and boys about the importance of women’s and girls’ eye health.

We are grateful to partner with NorQuest College on this initiative, which was awarded the Fund for Innovation and Transformation by the Inter-Council Network and Global Affairs Canada. To learn more, sign up for our newsletter to receive project updates: operationeyesight.com/signup

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Globally, women experience a disproportionate burden of disease and death due to inequities in access to basic health care, nutrition and education.[2]  Women’s leadership in global health is essential to address these inequities, because women know first-hand the unique barriers women and girls face when accessing health resources. Therefore, they need to be involved in decision-making processes in addressing these gaps in health provision.

Shortly after COVID-19 was declared a pandemic, United Nations Secretary General António Guterres urged governments to put women and girls at the centre of their efforts.[3]

“That starts with women as leaders, with equal representation and decision-making power…Gender equality and women’s rights are essential to getting through this pandemic together, to recovering faster, and to building a better future for everyone.” – António Guterres

Women as health leaders

In Kenya, our Country Manager Alice Mwangi provides overall strategic direction and leadership for our Kenyan programs. Alice is a public health specialist with a wealth of experience in developing, managing and implementing programs. In her role, she develops valuable partnerships with hospitals, the Ministries of Health and Education and other non-profit organizations. These relationships are essential for implementing our flagship Hospital-Based Community Eye Health model.

Women have been bearing the brunt of COVID-19 around the world.[4] Alice knows first-hand that it is important to empower women to become catalysts of change to address health issues and create a lasting impact. Under her leadership, our COVID-19 response in Kenya focused on training female community health volunteers to provide critical health information to their communities. In total, these community health volunteers provided health education on COVID-19 to 602,366 individuals.

Women in eye health

Globally, 55 percent of people experiencing vision loss are women or girls.[5] This is partially because women tend to live longer than men and are therefore at a higher risk of age-related eye health issues such as macular degeneration. In many of the countries where we work however, women face more barriers than men when accessing eye health services.

We’re working with communities to empower them to take ownership of their eye health needs, starting with female community health workers. Women like Pinky, an Operation Eyesight-trained community health worker from Berasia, India, are champions of eye health in their communities. Pinky, who is a single mother, visits households in nearby villages to screen people for eye conditions and refer them for follow-up care if needed. In this role, she is not only able to help people in her community, but she’s also able to independently support herself and her daughter without assistance from male family members. 

Because of this, Pinky has become an inspiration to many young girls in her village. They look up to her for her tireless work ethic and independence. She says she finds her work so rewarding that she hopes that her daughter will one day also choose to work in the eye health sector. Pinky and many other female community health leaders like her are helping move the dial on eye health inequity.  

In celebration of #IWD2021, we #ChooseToChallenge inequities in eye health and support female leadership in global health.

[1] https://www.lshtm.ac.uk/research/research-action/women-leaders-global-health
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167801/
[3] https://www.unwomen.org/en/news/stories/2020/4/statement-sg-put-women-and-girls-at-the-centre-of-efforts-to-recover-from-covid19
[4] https://news.un.org/en/story/2020/09/1071502
[5] https://www.iapb.org/learn/vision-atlas/inequality-in-vision-loss/gender/

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The theme of International Women’s Day 2020 is an equal world is an enabled world. We know that a gender equal world benefits everyone, not just women. We imagine a world where women and girls no longer needlessly suffer from vision impairment because they are not prioritized for treatment. We envision a world where women and girls have equal access to essential care and are empowered to take ownership over their eye health needs. In 2015, the United Nations set out 17 Sustainable Development Goals (SDGs) as a blueprint for a better world. Access to quality health care for all is paramount to SDG #3 – Good Health and Well-Being. To achieve both the SDGs and the World Health Organization’s VISION 2020 goals, we must eliminate all forms of inequity in access to eye care for women and girls.

Eye screening being performed by a community health worker

In spirit of IWD 2020, we are sharing the successes and challenges eye health organizations have had in their gender equity programming. This gives us an idea of where we’re presently at with integrating gender strategies into global eye health, while also highlighting the gaps that still need to be addressed going forward.

Two of the biggest challenges to gender equity programming that we face in eye health are addressing cultural barriers, and getting the full buy-in and support from local partner organizations. The Fred Hollows Foundation addressed these challenges by partnering with the Ministry of Women’s Affairs in Cambodia to conduct gender equity and eye health training within communities. They also partnered with the Ministry of Health to further embed gender equity within health programs. SDG #17 – Partnerships for the Goals, advocates for inclusive partnerships between governments, the private sector and civil society. By partnering with local, regional and national levels of government, we can address gender barriers to eye health and ensure the long-term sustainability of our efforts.

To achieve gender equity in eye health, we need the full participation of women and girls and men and boys. Operation Eyesight promotes this by training community health workers who conduct door-to-door surveys in their communities. They identify all people in need of eye care services and refer them to vision centres to ensure that they receive appropriate treatment. They also counsel the patient’s family members to ensure nobody is left behind. A champion of Operation Eyesight is Jaya Raju. Jaya is a widow who lost her husband in a fatal accident and was disowned by her in-laws. She suffered from severe depression following the accident, which was compounded by her fear regarding how she could support her child and aging parents. While looking for work, Jaya learned of an opportunity to work as a community health worker for Operation Eyesight and decided to apply. Although Jaya had very little experience, her determination and commitment landed her the job. Now, Jaya travels for two hours a day visiting households, talking to people and listening to their problems and concerns. She is now the breadwinner of her family. Her parents call her “Shanni Jaya” (Smart Jaya). They say, “she has now found the purpose of her life.” Jaya is an inspiration to other women in her community. Her willingness to learn and step outside of her comfort zone has allowed her to realize her full potential and achieve her dream of helping people by eliminating avoidable blindness from her community. 

The International Agency for Prevention of Blindness (IAPB) Gender Equity Working Group brings together eye health organizations working to eliminate avoidable blindness and eliminate all forms of inequity for women and girls. Collectively, we are addressing SDG #1 – No Poverty, SDG #3 – Good Health & Well-Being, SDG #5 – Gender Equality, SDG # 6 – Clean Water & Sanitation, and SDG # 17 – Partnerships for the Goals.  

Thank you to Fred Hollows Foundation, Seva, Mission for Vision and Operation Eyesight for their contributions to this article.

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