Cambodia is a country of spectacular landscapes and a busy, vibrant culture. Its twenty provinces, when combined are slightly larger in size than the Australian island state of Tasmania. Unfortunately, it only has 24 optometrists serving its population of 14 million.
There is an existing network of 19 Eye Units based in its provinces. These units are staffed by ophthalmologists, Basic Eye Doctors, Basic Eye Nurses and ophthalmic nurses. Many of these units receive additional support from international non-governmental organizations (INGO) but there are limited health care facilities in Cambodia.
Currently, ICEE is collaborating with other NGO’s and the National Program for Eye Health of Cambodia to develop the National Refraction Training Centre to train local eye care personnel to address vision impairment due to refractive error. Part of this process is building local capacity – training eye care staff to, not only provide eye care services but, act as educators themselves – limiting the need for the continued presence of organisations like ICEE.
According to World Health Organisation (WHO), Asia-Pacific has the greatest need in terms of vision impairment and blindness. Since 2003, Gerd Schlenther, International Centre for Eyecare Education (ICEE) Programs Manager for Australia and the Asia-Pacific, has watched the region as it begins to address the problem.
According to Gerd, “Our training models are all about developing sustainable systems that are culturally appropriate and will last beyond ICEE involvement in that country.”
The region, that also includes countries such as Timor Leste, Vanuatu and Papua New Guinea, ICEE optometrists and educators have been involved in providing and developing eye care for a number of years. Through collaboration with local communities and ministries of health, ICEE has begun to establish eye care services.
In 2004, ICEE conducted a situational analysis of the refractive error services in Cambodia with the Christian Blind Mission International and Disability Action Council of Cambodia. Together with the Cambodian Optometrists Association (COA) and the National Program for Eye Health, ICEE developed the current, Ministry of Health approved, three month refraction training curriculum and conducted a ‘Train the Trainers’ program for the refraction trainers at the COA.
Gerd explained that the means of addressing the refractive error problem is, “Training eye care personnel and ensuring affordable spectacle supply – that’s what ICEE is all about”.
The approach sounds simple enough, but achieving the goal of providing access to basic eye care to all people is a complex task that involves substantial resources deployed through a range of programs and activities, requiring the support of governments and communities and managed by a lot of dedicated, competent people.
There is an existing network of 19 Eye Units based in Cambodia. These units are staffed by ophthalmologists, Basic Eye Doctors, Basic Eye Nurses and ophthalmic nurses. Many of these units receive additional support from international non-governmental organisations (INGO) but ultimately, there are limited eye care facilities in the country.
Currently, ICEE is collaborating with non-government organisations (NGO) and the National Programme for Eye Health of Cambodia to develop a National Refraction Training Centre. The centre will train local eye care personnel to address vision impairment due to refractive error. Part of this process is building local capacity – training staff to provide eye care services and act as educators themselves.
The development of national refraction training has begun. ICEE curriculum has been translated into Khmer and in early 2008 a Refresher Training Course in refraction for nurses was conducted by ICEE staff members Dr May Ho, Project Manager Asia Pacific and Neilsen De Souza, Education Development Officer. Dr Ho also taught a two week Train the Trainer Course in July 2008.
A three month Refraction Training Course, conducted by ICEE educated trainers under the supervision and guidance of May Ho and Neilsen De Souza, is now underway and is scheduled to conclude in November 2008.
The National Training Centre, at the Department of Ophthalmology in Preah Ang Duong Hospital in Phnom Pehn, once established will deliver the following training in refraction:
1. Refresher Training Courses: Refresher Training Courses are offered in refraction and run for 3 weeks. Courses are provided to 14 existing refractionists in the first and second year of the project, with 7 trainees enrolled each year.
2. Training of Trainers Course: The Training of Trainers Courses run for 2 weeks each year and offer training in refraction to 6 practicing refractionists who have completed the Refresher Training Course. The course will be held in the first and second year of the project, with 3 trainees enrolled each year.
3. Refraction Nurse Training Course: The Refraction Nurse Training Course will be offered at the National Training Centre to graduates of the Training the Trainers Course. At least 20 Eye or Basic Eye Nurses will take part. This course will be delivered each year of the 5-year Project. Four trainees will be enrolled for duration of 3 months each year.
It is expected that 20 fully qualified refraction nurses will be available to the public health sector in Cambodia at the end of the 5-year project.
The key objectives of the Project are:
1. To establish a national refraction training centre in Cambodia.
2. To train and deploy local national refraction trainers in Cambodia.
3. To develop and deliver a refraction nurse training course in Cambodia.
4. To support continuing refraction education of refractionists in Cambodia.
5. To improve the delivery of refraction services in eye care facilities in Cambodia.
