Monthly Archives: September 2015
This week in New York, the Sustainable Development Goals will be finalised. This is a historic moment for CBM and other civil society organisations as world leaders come together to agree on 17 goals and 169 targets that aim to transform the world we live in over the next 15 years.
The SDGs replace the Millennium Development Goals (MDGs) which were agreed in 2000 and come to an end this year.
The SDGs mark a huge shift from the MDGs in a number of ways. The MDGs were largely designed by a small number of individuals from high income countries. Discussions on the SDGs have included governments from low, middle and high income countries, civil society and more than 8 million people from 194 countries have had a say through online and face to face surveys. The MDGs only applied to low and middle income countries, while the SDGs are universal and apply to everyone.
In most cases the MDGs were about getting half way, for example halving the number of people living in extreme poverty. The SDGs are much more ambitious, they are about ending extreme poverty – finishing the job.
The other major difference is that disability wasn’t mentioned in the MDGs, which has led to people with disabilities being excluded from their progress. The number of children going to primary school for example has increased dramatically, but children with disabilities are much less likely to attend than their non-disabled peers. In Nepal for example, 85% of children who are out of school have a disability.
For several years CBM and our partners have been advocating for the SDGs to address this exclusion and to be inclusive of people with disabilities.
So we are therefore really pleased that SDGs promise to ‘Leave no one behind’ and to reach the furthest behind first. Disability is referenced 11 times in the new document. This includes making sure that all children can get an education, that people with disabilities have equal access to decent jobs and that they can participate on an equal basis with others in society. Many of the targets are also universal – which means that they have to be met for everyone, including people with disabilities.
Sometimes the discussions that happen between world leaders in New York can seem a million miles away from our everyday lives or the work we do. But reality is that the SDGs have the potential to have a huge impact on people’s lives around the world. They will determine what governments at both a national and local level prioritise, and where they spend their money.
We need to see the SDGs as a huge opportunity to change people’s lives for the better. They can get people and governments talking seriously about reducing inequalities and promoting social justice. They are a chance to make governments realise the importance of including people with disabilities in their policies and planning. They are also an important advocacy tool for people living with disabilities – who can take the document to their governments and argue for their inclusion.
When the goals are agreed at the end of this week a new challenge will begin; translating their ambition into action. CBM and our partners will continue working to make sure this ambition is realised. If we can grab the opportunities that the SDGs give us then we should all, including people with disabilities, be living in a much better world by 2030.
By Andrea Brandt von Lindau, CBM UK’s Trachoma and Eye Health Programme Officer.
Trachoma is the world’s leading cause of preventable blindness. 6 million people have lost their sight to Trachoma. If it is not effectively treated, the eye infection causes constant pain and will eventually lead to blindness. CBM is working with partners in the wider context of the Queen Elizabeth Diamond Jubilee Trust’s Trachoma Initiative which supports efforts to eliminate Trachoma in eleven Commonwealth countries.
CBM is active in Uganda, Kenya and Malawi, where we conduct TT (Trachoma Trichiasis) surgery. This is one of the four elements of the SAFE Strategy (Surgery, Antibiotics, Facial Cleanliness, Environmental Improvements) which has been endorsed by the World Health Organisation as an effective and comprehensive way to eliminate Trachoma. TT Surgery addresses the advanced, blinding stages of the disease, saving people from further visual loss and from going completely blind.
TT surgery is often conducted at outreach camps in districts which have a high Trachoma prevalence. This allows us to reach remote, and often very poor, populations – people who would not otherwise have the money to travel to a hospital or even to their local health clinic or to pay for treatment or medication. CBM has been running Trachoma outreach camps in Uganda since October last year. I recently had the opportunity to visit a CBM Trachoma outreach camp in Uganda.
The camp lasted for one week and clearly involved a great deal of planning and preparation. Staff from CBM’s local partner organisation, the Benedictine Eye Hospital, based in Tororo, spent each day in a different local health centre in the target sub-district, where they set up an operating theatre for the day. TT surgeons from the local district, who were trained by our programme, operated all of the Trachoma patients who attended the camp each day. Patients returned the following day to have their bandages removed and to be given eye drops with instructions of how to look after their eyes. Surgery patients were also given antibiotics to prevent reoccurrence of the infection.
One major logistical challenge during these outreach camps is patient mobilisation, not only in terms of finding patients and encouraging them to seek help, but also transporting them to the outreach site and back home. CBM uses radio adverts and the ‘town crier’, a car with loudspeakers which drives around the villages and makes public announcements to make people aware of an upcoming Trachoma camp. In addition, CBM has started using so-called ‘case finders’, a method which has proved extremely successful. In Uganda, case finders are usually members of existing Village Health Teams, who are trained to inform people about different health issues and possibilities for treatment and/or prevention.
CBM’s Trachoma programme has trained a number of case finders to make an initial Trachoma diagnosis and counsel people to encourage them to seek treatment. The latter can be extremely challenging because people are often suspicious or fearful of undergoing surgery. However, now that the Trachoma outreach programme has been running successfully for some time, people hear more and more success stories from former patients. As a result, more new patients are now coming forward for surgery. All patients will also receive counselling at the camp itself where they are being told about what the surgery entails and where they can ask questions. Some people will still refuse surgery at the camp, but this is usually a small minority. CBM also provides transport for patients who live too far from the health centre to walk there and who can’t afford transport, which again increases patient numbers.
The outreach camps also see a large number of patients who do not have Trachoma but all kinds of other eye problems. Some issues, e.g. allergies, can be treated with eye drops; however, many other patients require further treatment such as Cataract surgery. This has created a significant need to complement the trachoma camps with Cataract surgery camps. Currently, Cataract patients’ details are recorded so they can be notified the next time a Cataract camp is held. In future, Trachoma and Cataract camps could be organised concurrently, meaning that Cataract patients would no longer have to wait for treatment. In any case, the treatment of other eye diseases is of course extremely important, not only to help as many people as possible, but also to maintain people’s trust in the programme and ensure that patients keep attending. The saddest thing to see is when patients attend the camp who have already suffered irreversible sight loss through diseases like Glaucoma and who have to be told that they cannot be helped. These patients are also referred to the counsellor who will explain the difference between their problem and those of other patients who can be helped.
Something else that struck me is how many people had other disabilities, in addition to Trachoma. This could be other eye issues like Cataract or physical disabilities. One elderly man whose bandages were removed following his Trachoma surgery told us he still couldn’t see anything, due to Cataract. He will now be added to the list of patients who will be alerted the next time CBM will hold a Cataract outreach camp in the area which could be several months later. Benyamen, an Ophthalmic Assistant who screened patients at the camp, talked about meeting a number of elderly women from some remote villages at a recent Cataract camp, who, in addition to having Cataracts, were unable to walk, and had never accessed health services before.
At the Trachoma camp, we met Joyce who is unable to walk and therefore very reliant on her daughter in her every-day life. Her daughter had found out about the camp from a local case finder and the camp vehicle picked Joyce up from her home. It is good to know that she has now received the surgery which will save her from going blind, as this would have made her mobility issues even worse; however, as a disability organisation, I feel that CBM should be providing support for her physical disability too, and was glad to hear that our project team is currently sourcing a wheelchair for Joyce.
CBM will continue to conduct TT surgery in Uganda. This work is complemented by the distribution of antibiotics which prevent the infection and other organisations working to improve water and hygiene standards. The ultimate aim is to eliminate Trachoma in Uganda.
Watch Joyce’s story here:
The ability to read and write is hugely powerful. Women who can read have fewer children later in life, and the children they do have are much more likely to survive. Being literate helps people to find jobs, access information and make decisions about their lives.
Today, on International Literacy Day (8th September), we think about the 781 million adults who cannot read, write or count, and about what needs to be done to make sure that they have the opportunities to gain these valuable skills.
While the data is poor, we know that people with disabilities often have lower levels of literacy than people without disabilities. This is hardly surprising when you consider that in developing countries, as many as 9 out of 10 children with disabilities do not go to school.
In the last 15 years there has been a huge global effort to get more children enrolled in primary school. This has led to a drop in the number of children out of school from 100 million in 2000 to 57 million today. While this progress is huge, many children with disabilities have been left behind. In many low and middle income countries, having a disability more than doubles the chance of a child not going to school. In Nepal for example, 85% of children out of school have a disability.
If they do attend school, children living with disabilities are often more likely to drop out and leave school early. They are also less likely to be able to learn – because schools are not correctly equipped, teachers are not trained or because they are discriminated against. Often getting children in to school and making sure they have the opportunity to learn vital skills such as reading and writing involves small changes; in teaching methods, in physical accessibility or even just in attitude.
Illiteracy among adults with disabilities is even more prevalent than among children, because those who are adults today were less likely to attend school that today’s children. To address this, adult literacy programmes need to be inclusive of people with disabilities. More broadly, we need to make sure that information is provided in alternative formats so that those who are unable to read can still access it.
Goal 4 in the new Sustainable Development Goals recognises the importance of inclusive education and promotes learning for all, including lifelong learning. This is a huge step forward and an important opportunity to ensure that people with disabilities have the same chance to become literate as their non-disabled peers. CBM is advocating that in the indicators that measure the new goals school enrolment is broken down by disability. Because only when we have good data about how many children with disabilities are not in school will we really be able to reach them all. We are also advocating for an indicator on the number of trained teachers to teach children with special educational needs; because getting children into school is not enough.
We often talk about the cycle of poverty and disability, the fact that disability causes poverty, and poverty causes disability. Literacy is one way of breaking this cycle – because when people learn to read and write they are more able to participate in society and have the power to change their own lives.