Ensuring Vision for tomorrows Future

Zambia 2011 Annual Report

LIONS AID NORWAY _ ZAMBIA

Table of content.

1. Message from the Country Director

2011 Annual Report

2. Background. 3. Human Resource Development. 4. Infrastructure. 5. Service delivery. 6. A dream almost lost: Nawas Story. 7. Service Delivery continued. 8. Advocacy. 9 Advocacy continued. 10 Organisation. 11. Data and statistics summary. 12. Financial report. 13. Appendices.

School children perform a play during World Sight Day

LIONS AID NORWAY _ ZAMBIA

Message from the Director.

Welcome to our 2011 Annual Report. The end of
2011 marks 15 months of Lions Aid Norways existence in Zambia and particularly in Western Province. This year has been quite an exciting journey for us. I am particularly proud that after a lot of planning and unwavering support from Ministry of Health and other partners, the construction of the Multi Million Kwacha Eye Department at Lewanika General Hospital (LGH) has commenced. The facility will be the first comprehensive eye department in Western Province and it will serve over 1 million people. 2011 has also seen us usher in an advisory board comprising of experienced and seasoned professionals in the field of eye care issues. I am confident that this team will guide LAN in its delivery of programs for many years to come.

2011 Annual Report

In this report, you will have an insight into our work in supporting the development
of Human resource for Eye Care, our support to Ministry of Health in its delivery of Eye Care services and our work in supporting advocacy initiatives aimed at raising awareness on issues of Eye Care. We have also attempted to bring to you stories of people of Western Province whose lives have been changed by our support to eye care in that Province. Mr. Subulwas story which you will find on page 6 of this report is one that clearly defines the purpose of our work in this field.

Looking ahead

to 2012, we look forward to some exciting opportunities as well as

some challenges which we have carried forward from the year past. One of the opportunities include our partnership with Vision Aid Oversees in the field of optometry. This will enable our outreach teams and the Eye Department at LGH offer full optometry services from refractions to making of lenses. One of the challenges continue to remain the limited financial resources. This has led us to cut down on some of the activities initially planned in 2011.

In conclusion,

may I take this opportunity to thank our partner Ministry of Health both

at National and Provincial for the tremendous support that they have given to this project. Our gratitude also goes to the Lions for being there every step of the way, my fellow Lions back home in Norway who have continued to support Lions Aid Norway and our funding partner the Norwegian Government through its development agency NORAD. Lastly but not the least, I would like to thank my staff who whose contribution and dedication has brought us where we are today. Thank you and enjoy your reading.

Jan Erik Larsen

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Background.

i. Introduction
2011 Annual Report
The aim of LAN is to reduce avoidable blindness through the provision and support of Afford-able, Accessible and Available Eye Care services in Zambia. LAN is working in close collaboration with the Ministry of Health and other partners to build, strengthen and support existing Eye Health systems and services in Western Province in a sustainable and cost effective manner. LANs support is within the context and framework of the National Eye Health Strategic Plan.

ii Our Vision
To provide people of Western Province with equity of access to cost effective quality eye care as close to the family as possible within the global initiative for elimination of avoidable blindness The V2020: The Right to Sight.

iii Our Aims

1. To support the development of Eye care infrastructure. 2. To support the development of Human Resource for eye care. 3. To promote and provide appropriate technology and Infrastructure necessary for delivering eye care services. 4. To create awareness on eye care conditions and related issues.

iv Our 2011 Objectives

1. Start construction of an Eye Department at Lewanika General Hospital. 2. Identify 8 cadres to be trained as Ophthalmic Clinical Officers (4) Ophthalmic Nurses (2) and Optometrists (2) 3. Train 80 Primary Eye Care (PEC) workers in 4 districts. 4. Support 2 surgical outreach activities in 2 districts.. 5. Support of Surgical activities for Trachoma elimination in Kaoma District. 6. Develop 16 radio awareness programs on Eye Care issues. 7. Sensitize 4000 people on eye care issues.

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Human Resource Develeopment.

1. Training of Ophthalmic Clinical Officers and Nurses. (2011 Objective: 8 to be trained by the end of 2013) 2 candidates from Lewanika General Hospital (LGH) are currently training as Ophthalmic Clinical Officers in the Gambia. Two more candidates from LGH and 1 candidate from Lukulu District are scheduled to commence training in the same discipline at Chainama College of Health Sciences in January 2012. The five candidates so far represent a 62.5% progress towards meeting the objective. The remaining 3 candidates will be supported for training in 2013. 2 Primary Eye Care Training (2011 Objective: 40 health workers, 40 community health workers trained in PEC by end of 2011)

2011 Annual Report

Wamulume and Precious currently in the Gambia are expected to complete the training in July 2012

In 2011, LAN has supported 4 Primary Eye Care trainings in 4 districts namely Mongu, Senanga, Lukulu and Sesheke. The objective of the training is to establish and strengthen district Eye Care and referral system by equipping health workers with the basic skills in disease identification, diagnosis and treatment. A combined total of 39 health workers and 40 community health workers have been trained from all the 3 districts. The target is to train 10 health workers and 10 community health workers per district per year until all the health centres have staff trained in Primary Eye Care. The number of people trained represents a 97.8% progress against the planned objective. 3 Training of Health workers in TT Identification. (2011 Objective: 10 health workers trained in TT identification) A total of 10 health workers were trained in the identification TT in Kaoma District. The objective of the training was to equip health workers with the skills required Lukulu DMO addresses a team of health workers during a PEC training workshop to identify and book for surgery patients that require Trichiasis surgery. Following the training in TT identification, 6 health workers were selected for training in conducting Lid rotation surgery. The training of surgeons is ongoing as all candidates are yet to meet WHO requirements for them to be certified as surgeons.

Dr. Kasongole orients a team of health workers during the training.

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Infrastructure.
2011 Annual Report

Front view: A computer model of the Eye Department currently being constructed at Lewanika General

Support Sector 2: Development of Infrastructure for eye care in Western Province.

(2011 Objective: start construction of Eye Department at Lewanika General Hospital) In June 2011 LAN signed a contract with a firm which was responsible for preparing all the drawings, bill of quantities and tender document. The firm is also responsible for monitoring the whole project during the construction period as well as 6 months after completion of the building. In September 2011 LAN awarded the contract for the construction of the Eye Department to the successful bidder and works have since commenced. Completion of the project is expected in July 2012 and will be at a cost of K6 billion.

LAN Country Director and woodlands investments Director at a signing ceremony for the award of the contract to construct the Eye Department

Arial view: A computer model of the Eye Department currently being constructed at Lewanika General Page 4

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Service Delivery.
2011 Annual Report Support Sector 3: Delivery of eye care services in Western Province.
3.1 Surgical Outreach camps (2011 Objective: Conduct 2 eye camps in two districts) In October 2011 LAN supported 1 eye camp organised by the Ministry of Health in Senanga District. A total of 90 cataract surgeries were conducted and over 2000 people were screened with about 300 prescribed and given medicine. LAN could not support another eye camp in another district due to lack of funds resulting from over expenditure in other activities. This represents a 50% progress towards the set target of 2 outreaches.

Cataract surgeries being conducted in Senanga District

3.2 Kaoma Lid Rotation Surgeries (2011 Objective: Treat 80 TT cases in Kaoma District) A total of 3 surgical camps in Lid Rotation have been conducted in a Kaoma. The support includes funding of community sensitization and community screening activities leading up to the surgical camp. A total of 70 cases have been treated. This represents 87.5% progress towards meeting the target. However, the exercise proved to be more costly and less effective than planned due to constraints in identification and mobilisation of patients. Most cataract patients are old and the condition hampers their ability to sustain themselves economically. Successful cataract operation enables them to fend for

Lid rotation surgeries being conducted in Kaoma District

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NAWAS STORY
Mr. Nawa Sibulwa
is a 41 year old middle aged man who has a passion for Art and Football. Mr. Nawa who stays with his wife, two children and two nieces leaves in Mulambwa compound of Mongu District in Western Province. He recalls that in August 2009, at the time when he and his wife had started to build their dream home, his vision started to detoriate. For the next two years, his condition continued to worsen until June 2011 when he was diagnosed blind.

Dr. David Kasongole,

the Provincial Ophthalmolo-

gist who diagnosed Mr. Nawa described his case as a rare form of cataract for a man his age. He said that he was bilaterally blind (blind in both eyes) with light perception only.

common in diabetic patients and people leaving with HIV. However, Mr. Nawa was not affected by any of these diseases.

Due to Cataract, Nawa could not paint any more and thus he lost his income

Usually, Dr. Kasongole explained, such kind of cataract is

During the period

that his sight became poorer

and poorer, Nawas family dream of building his own house came to a halt. He could no longer do any of his art work hence he lost his income. He describes the period as having been a difficult time for he was not able to pay rent and school fees for his children. Mr. Nawa described those times as having been the most scary moments of his time.

After being

diagnosed with mature cataract at

Lewanika General Hospital, Mr. Nawa underwent surgery made possible by the support from Lions Aid Norway Eye Care program. Mr. Nawa explained how unbelievable it was for him to be able to see again. His second operation was also successful and Dr. Kasongole is impressed that his patients visual acuity is so good that he doesnt need spectacle correction.

Nawa shows off some of his works

Mr. Nawa says

that he cant still believe that he

is able to see. He expressed his gratitude to Lions Aid Norway and Ministry of Health staff explaining that he had even been given a quotation of $ 300 just for consultation at a private hospital in Lusaka. There is no way

i could have managed to pay for the operation at a private hospital, Mr. Nawa explains, at that time, I could not even afford transport to go to Lusaka.

Dr. Kasongole

encouraged people with similar prob-

lems to visit Lewanika General Hospital adding that the service was free with the support of Lions Aid Norway. Nawa with one of his children and nieces of in conclusion. Mr. Nawa is now actively back at his work and the dream building a family house which had seemed dead is now alive.

Am happy that we have now even managed to build a foundation for our house , Mr. Nawa happily exclaimed

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Service Delivery.
2011 Annual Report
3.2 Equipment and Consumables (2011 Objective: Equip Lewanika General Hospital eye department with essential equipment and tools) Equipment: Based on the situation analysis conducted during the first planning meeting, LAN purchased and donated equipment worth 326 million Kwacha (NOK 413,000). Among the equipment includes an Operating Microscope, Slit Lamp and various instruments for Lewanika General Hospital. (Please see appendix for a detailed list of equipment). Part of the equipment donated to Lewanika General Hospital In 2012 LAN will focus on equipping the eye department whose completion is expected in July of the same year. It is estimated that equipping the eye department will cost $800,000 Consumables: Also based on the needs assessment carried out at Lewanika General Hospital, LAN has provided the eye clinic with various eye care drugs worth over 20 million Kwacha. LAN has also supported LGH with 50 cataract kits.
Former Western Province Permanent Secretary during the handover of equipment to Lewanika General Hospital

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Advocacy.
2011 Annual Report
Support Sector 4. Raising awareness on eye care issues through Advocacy and Information Sharing 4.1 Radio programs (2011 Objective: Develop 16 Radio programs on Eye Care) LAN has been working in partnership with a Local Community Radio Station called Radio Liseli to develop Radio Programs aimed at creating awareness about Eye care issues. A total of 14 programs have been aired as at the end of 2011. This represents 87.5% progress against objective. The programs are currently reaching an estimated 400,000 people in four districts namely Mongu, Senanga, Lukulu and Kaoma. The radio programs have played a key role during community mobilisations and sensitizations for outreach camps and other public events such as World Sight Day.

The radio programs reach an estimated 400 people

4.2 Development of IEC Materials (2011 Objective: Develop IEC materials for raising awareness on eye care issues). LAN has developed various IEC materials for use during sensitization meetings and trainings. The materials which were developed with technical input from the Provincial Ophthalmologist and other experts include the following;

What is Trachoma: A teaching aid for the community and health workers in the identification of Trachoma.

Promoting Community Eye Health: A teaching aid for schools and communities in basic eye care.

World Sight Day Information Pack: A one page brochure highlighting the significance of WSD and the role of LAN in the province.

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Advocacy.
2011 Annual Report
4.3. Commemoration of World Sight Day. (2011 Objective: 3000 people sensitized on eye care issues) In October 2011 LAN supported the first ever commemoration of World Sight Day in Western Province. The event which was commemorated in Mongu was attended by over 2000 people. The event was characterised by various eye care, advocacy and sensitization activities during dances, poems and plays were used to Four schools participated in the match past World Sight Traditionalsensitize people on eye care Week. Activities included; Community eye screening services. Eye health information sessions. Eye health drama, plays and poems.
800 pupils benefited from eye health education sessions

A total of over 600 community members received free eye screen800 pupils ing benefited from the eye health information sessions and a total of about 600 community members received free eye screening. An estimated 400,000 people were reached through the Radio programs surpassing the targeted number of 3000.
Speaking during the commemoration of world Sight Day, LAN country director revealed that K6 billion had been set aside for construction of an eye department at Lewanika General Hospital. He also emphasised the need for MOH leadership in the Province to integrate the eye care program in their programs

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2011 Annual Report

Activity

When it was conducted Details

February 2011 The meeting was attended by 6 District Medical Offices and their Eye Care focal point persons. Key staff from the Provincial Office and Lewanika General Hospital were in attendance. The aim of the meeting was to develop the three year strategic plan for the Western Province Eye Care Plan. A second Trachoma planning meeting was held in Kaoma. This was a follow up planning meeting to complete the Trachoma District plan. The first planning meeting was facilitated by former Sightsavers Country Director Mr. Joseph Munsanje. The meeting was attended by all Trachoma task force members. The aim of the meeting was to complete the three year Trachoma Elimination plan for that District. LAN Country Director accompanied by the Program Officer and the Provincial Ophthalmologist conducted a familiarisation tour of Senanga, Shangombo and Lukulu Districts. The purpose of the visit was to assess the scope of eye care services and find out what is available in the districts as regards to eye care. The general impression of the visit is that all the Districts lack basic and fundamental requirements needed to support and implement Eye Care services. For example, all the districts have little or no supply of Eye Care drugs. Equipment and essential instruments required for providing the service are lacking. LAN represented by the Program Officer attended Southern Africa International Agency for the Prevention of Blindness conference. In July 2011 LAN participated in the development of the national action plan for the elimination of Trachoma. The meeting which was sponsored by ITI was hosted by the Ministry of Health. LAN through the Mongu Program Office conducted District Monitoring and review visits to selected districts. The aim of the visits was to assess and document the impact of LAN supported programs.

Provincial Meeting

Planning

Kaoma Trachoma Planning

February 2011

LIONS AID NORWAY _ ZAMBIA

District orientation visits

June 2011

IAPB Conference

July 2011

Planning and Coordination.

Trachoma Action Planning workshop.

August 2011

Page 10 September 2011

District visits

Monitoring

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Data and statistics summary

2011 Annual Report

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Financial Report.
2011 Annual Report

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Appendices.
2011 Annual Report

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+260 211 840 234 +260 211 840 233

admin@lan.co.zm

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