Eyes on the future
The Government should address low vision problems in children.
It is widely believed that there are over 120 million people worldwide with Low Vision (LV), a condition that cannot be corrected, cured or treated by conventional medicine or surgery. Over 90 per cent of these people with LV live in developing countries.
According to the National Association for the Blind (NAB), this figure could be as high as 45 million children and adults in India. Approximately 50 per cent of all childhood blindness is preventable or treatable, unfortunately less than 15 per cent of those with a visual impairment have access to vision enhancement or rehabilitation services that could help change their lives! Despite the magnitude of the problem, LV is still sadly no where near the top of the agenda, for governments either at the state or national level.
More than a decade on, the government has done little more than list LV as one of the seven disabilities in The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995. Most of those with LV, despite having usable vision continue to be packed off to schools for the blind or neglected in the general school system simply because they don’t have access to or cannot afford vision enhancement or rehabilitation that could help them to integrate into regular schools.
A survey done among ophthalmologists in 2005, listed some of the barriers to effective treatment of LV in India.
It was found that an overwhelming majority of ophthalmologists lacked training and knowledge of LV, while others lacked awareness, a sizeable percentage cited non-availability of LV devices for effective treatment. On the other hand, it is important to remember that ophthalmologist can only provide medical intervention; while social and economic rehabilitation needs to be planned for and addressed by the government.
It is extremely important that LV during childhood should be addressed seriously because it has a tremendous impact on the child’s development, education, future work opportunities and quality of life. The disability has serious social and economic implications for the family and the negative effects experienced by the child will influence the child’s life and beyond.
Since nearly 50 per cent of LV and visual impairment is preventable, it is important to focus on the causes of LV, one of which is Vitamin A deficiency, which results in corneal scarring and thus visual impairment. Vitamin A deficiency gains special significance due to the high levels of malnutrition in the country. Economically backward states are known to have higher rates of LV due to malnutrition; other causes of LV include diseases that the mother may have during pregnancy eg Rubella and genetic causes.
However, NGOs can do only very little and it should largely be the responsibility of the government to take steps adequate to the scale of the problem and size of the country.
The need of the hour is to implement the Sarva Shiksha Abhayan (SSA) so as to benefit children with LV. Launched in 2001-02, the SSA seeks to provide inclusive education for all with a zero rejection policy and strives for 100 per cent retention of all children in school. However, it has been largely found that children with LV are passive attendees in class, having not been provided text books with large print, magnifiers or assistive devices like spectacles; they are thus unable to reap the fruit of a formal education.
The Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995, needs to go beyond paper and be implemented to bring concrete social and economic rehabilitation in the lives of those with LV.
The government must provide for the medical rehabilitation of those with LV, for if left untreated, LV can degenerate into a progressive loss of vision and only adds to the already large figure of totally visually impaired individuals in the country, thus further putting pressure on already scare welfare.
(The writer is a member of DisAbilityFirst, an advocacy group working on issues of disability)
(The above article appeared on the 23rd of May 2008 in the Bangalore Edition of the Deccan Herald, http://www.deccanherald.com/Content/May232008/editpage2008052269454.asp)