Yaruqui-Ecuador: An ongoing district VISION 2020 programme.

The programme Prior to 1995, access to eye care was poor. In April 1995 the Community Ocular Health and Valley Programme was started in the town of Yaruqui, with support from the Christian Blind Mission International (CBMI). The unit consisted of three rooms, with basic ophthalmic equipment. It was staffed by an ophthalmologist, an ophthalmic nurse and an administrator. From the outset, the emphasis was on cataract, although the unit catered for all eye diseases. The number of patients attending the unit gradually increased, as did the number of operations. However, a lot of work was required to inform the community about the need for eye care and to let them know about the services that were available. In 2001, with support from the German Agency for Project Development (BMZ), German Lions Club, and CBMI, a larger clinic and dedicated operating room were built, and diagnostic equipment was increased. This led to an increase in demand for the service by the community. Approximately 100 patients now visit the unit every day. Patients present with cataract and diabetic retinopathy, and a pilot programme is in place for refractive errors and glaucoma. The unit has four ophthalmologists, two nurses and six ophthalmic assistants. One ophthalmologist works full-time in the unit, one part-time and the other two doctors work one day per week. It is difficult for ophthalmologists from the city to travel 40 km to work in the project and this has been a limiting factor to the growth of the programme. Currently, a good number of operations, technology, social motivation and an economic incentive encourage the ophthalmologist to work in this poor area.