*Spotlight: Cataract (39) Ending cataract blindness
You nailed it. In way too many countries in Africa and S.E. Asia there are 1-2 ophthalmologists per million people. Thus, they suffer the world’s lowest CSRe [*]. Twenty million bilaterally blind plus 80 million visually impaired by cataract.
Africa and SE Asia are drowning in cataract blindness and visual impairment. This didn’t come about quickly. It took a very long time.
The solution is the massive training Manual Small Incision Cataract Surgery (MSICS). A single MSICS operator has the potential to treat 30,000 eyes in a career. Further, MSICS is uniquely suited for economically challenged areas found throughout developing world. It is high quality, with no reliance on uninterrupted electricity or sophisticated and expensive electronics. Phaco, which is 100 times more expensive than MSICS, is used throughout the developed world. Where funds are hard to get MSICS is the winner by far.
So how does the world train 30,000 to perform high quality MSICS? It requires a huge pivot away from traditional training methods which are time-based (seat time, fixed course lengths, and attendance) to competency based (outcome-based skill and mastery.
Combined with high fidelity simulation with realistic haptic surgical feedback, objective performance data, all under the supervision of of a trained instructor, large-scale standardized curriculum can produce high quality, high volume MSICS operators in calendar time never imagined previously.
If you have doubts, look at commercial aviation. it’s training today is competency based. It has resulted in safety records that can only be imagined by others.
Let’s commit ourselves to ending cataract blind. We have the cure. Sight restoring MSICS treatment takes as little as 5 minutes, BUT it requires well trained hands and competent highly skilled operators who consistently demonstrate competency.
Jim Ueltschi
HelpMeSee
Food For Thought
HIFA profile: James T Ueltschi is Chairman of HelpMeSee, United States. jim AT helpmesee.org
[*Note from HIFA moderator (NPW): CRSe = effective Cataract Surgical Coverage]