The Observatory

Seeing the bigger picture: Disability Inclusion in eye health programs

In a tiny rural community high in the mountains of Timor-Leste I sit on a rickety old wooden bench among a group of elderly Timorese. They wait patiently and excitedly, creating a buzz of chatter and curiosity. The mobile eye clinic has arrived and the team are setting up. The mountain is so high that we are sitting above the clouds, but what lies hidden from view is a tiny village without electricity; without running water; without a health clinic and with only one classroom. The landscape is so steep and unforgiving that as each older person arrives, many with poor eyesight, they are being helped by someone, often a young child.  For most people, this is the first time they have ever had their eyesight tested. 

Global statistics estimate that in developing countries like Timor-Leste, up to 80 per cent of eye conditions are treatable, which means that up to 20 per cent are untreatable.  While preventing and treating avoidable blindness has a great impact on people’s lives, there is a bigger picture: one that includes people with disability. Watching Zolekha’s story on End the Cycle got me thinking of the role of eye health projects in the bigger scheme of things: What can eye services do for the other 20% of people whose eye condition can’t be treated? Or how does a person with a disability, such as a woman with a physical impairment, access an eye clinic in a remote village in Timor-Leste? 

This is where the bigger picture comes in: People with disability, including people with vision impairment, are often excluded from accessing health services, such as eye clinics. Barriers to access range from physical such as poorly designed buildings to attitudinal, such as stigma and discrimination. So it is not just about the other 20 per cent, it is about including all people with all disabilities. For the 20 per cent of people with permanent vision loss, it also about how they can access wider opportunities like education, low vision services and livelihoods.

The experience of exclusion is part of the cycle of poverty and disability. Check out this short video to learn about the cycle. In my own words, I describe the cycle of disability and poverty like this: people with disability are more likely to live in poverty as they are often excluded from opportunities like education and employment, have poorer access to quality health care and cannot access rehabilitation services. While on the other hand, people living in poverty are more likely to acquire a disability due to lack of quality healthcare, water and sanitation or unsafe work practices. Disability inclusion is about ensuring that all people can overcome the barriers and gain access to health services as well as ensuring people with permanent vision loss access wider opportunities. Disability inclusion in eye health is about seeing our work in alleviating avoidable blindness within a bigger picture. Simple strategies to ensure people with disability are included in healthcare programs can have a huge impact in helping to break the cycle of poverty.

Vision2020 Australia are doing fantastic work in disability inclusion, and are playing an important role in the bigger picture. Vision 2020 Australia has been the driver behind a huge collaborative effort across 14 international agencies, including CBM Australia, to create a manual for Disability Inclusion in Eye Health Programs.  It is through efforts like these that we can help to break the cycle of poverty and disability.  Thanks to the efforts of V2020 Australia, field teams who reach tiny village in remote parts of developing countries, like my old colleagues in Timor-Leste, are better equipped to think about the 20% and to include people with all types of disabilities in their programs.

If you want to learn more or to join the fight to end the cycle of disability and poverty, visit End the Cycle campaign: