Eye care in rural communities: reaching the unreached in Sunderbans

Good health is dependent on having services which are accessible and affordable. The Sunderbans in West Bengal, India, is a conglomeration of 106 islands, 52 of which are inhabited, and the remaining of which are home to India’s famous tigers and the world’s biggest mangroves. Small boats are the main mode of transport. Sunderbans has the most deprived and marginalised population in India, with more than 40% of households living below the poverty line and 13% officially declared as the poorest of the poor.1 The health infrastructure is dismal and nearly 70% of health services in the Sunderbans is provided by the government (in the public health system). There is a huge shortfall in the number of primary health centres and in the number of people working in the public health system. The general morbidity rate is higher in Sunderbans than in the rest of West Bengal: about half of the children under 5 years are chronically malnourished and women are very vulnerable. The Sunderbans are prone to natural disasters, which further accentuates poor health conditions. People in the Sunderbans are significantly disadvantaged in terms of eye health: whereas the prevalence of blindness amongst people aged 50 and above in West Bengal is 1.19% (and in India 1.0%), the prevalence of blindness in Sunderbans is 2.1%. To address these challenges, Sightsavers is implementing the Sunderbans Eye Health Service Strengthening Project supported by Seeing is Believing. The five-year project, which started in September 2013, has recognised that multiple efforts and approaches are needed to address the inequity in eye health experienced by the people of Sunderbans. They have therefore employed various strategies to provide services and access to these remote communities: both by strengthening the existing channels of eye care provision and by creating new ones to provide eye health services in this rural part of West Bengal.