Community Eye Health MSc dissertations

Following decades of civil war, approximately two million internally displaced persons (IDPs) are living in and around Khartoum, the capital city of Sudan; 400,000 have settled in the four official camps, and the rest live in 30 ‘squatter areas’ scattered around the city. These communities are poor, vulnerable, and at greater risk of avoidable or preventable blinding eye disease. Our study aimed to evaluate the distribution, availability, and accessibility of eye care services in the camps for displaced persons. This descriptive situation analysis of human resources and infrastructure is a necessary first step towards providing adequate and sustainable services. All four official IDP camps surrounding Khartoum were included in our situational analysis. Quantitative data on human resources and infrastructure was collected, using a checklist, from the ministry of health and from the available services in the visited camps. Qualitative data aimed to explore the behaviour of IDPs in seeking eye care; they included focus-group discussions with mothers of school-aged children, semistructured interviews with functionally blind IDPs, and semi-structured interviews with health care staff working in the camps. Virtually no eye care services were found in the camps. The only permanent service found in all the visited camps was a single eye clinic in a camp housing around 150,000 people, which was integrated within a primary health care unit. When assessing the IDPs’ barriers to accessing medical eye care, we found that the main ones were: poverty, the absence of services, the lack of an accompanying individual, the fear of surgery, and customs and beliefs. Given the absence of services and appropriate health care cadres, as well as the inability of IDPs to afford even subsidised basic eye drops, existing health care staff felt inadequate because they could provide very little help. In conclusion, future service planning in the area should be directed towards affordable eye care services for the IDPs. Health service planners also need to look into the reasons behind the absence of service provision: lack of commitment, funding, or personnel. Suppurative keratitis at Groote Schuur Hospital, South Africa: epidemiology, clinical features, and microbiology