December 19, 2011 2:58 pm

Sightsavers sees clear path to local handover

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Habila Shehu Muazu moves through the ranks of patients with the assured manner of a senior medical professional.

Occasionally he stops at one of the benches, glances at a case file and makes a rudimentary assessment. On the wall are some eye charts that use symbols instead of letters to test the vision of those unable to read.

The medical director of the eyecare centre at the Gambo Sawaba general hospital in Zaria, northern Nigeria, prides himself on running one of the region’s busiest facilities.

Services range from basic eye tests and the manufacture of spectacles to operations – “about 30 to 40 a week, done on two days” – to restore or preserve sight.

This is a marked difference from two decades ago when Kaduna state – where the ancient trading city of Zaria, famous for the ornate, tiled palace of its emir, is located – did not have one ophthalmologist. Now Dr Muazu has two on his staff; across the state of 6m there are nine.

In Kaduna at the turn of the century there were about 600 operations a year for cataracts, the leading cause of blindness in Nigeria. There are now some 3,000.

One of the main reasons for the improvement has been the training of eyecare professionals – “capacity building” in the jargon.

Dr Muazu started out as a general practitioner before being trained on a programme funded by Sightsavers, the international development organisation the Financial Times is supporting in its seasonal appeal.

Training is one of the organisation’s core operations – from west Africa to south Asia, from surgeons working in well-equipped hospitals to community nurses staffing remote health centres.

In Kaduna such support has paved the way for the next big step for Sightsavers: pulling back. After 20 years it says it has trained enough people and lobbied enough officials to ensure that the right systems are in place for the local government to take over. From next month it intends to move on to neighbouring areas where the need is greater.

As such, the Kaduna programme offers a textbook example of how organisations such as Sightsavers build up the necessary local capacity and services to address a particular problem and then hand them over.

For Dr Muazu this is a positive step. “Without [Sightsavers] things would be very different. But now we have come of age . . . it’s going to be our programme,” he says.

Not everyone is as sanguine. At the National Eye Centre in the city of Kaduna some of the students are anxious about Sightsavers’ decision. “Are we mature enough to wean?” asks Asabe Dogo.

She and her fellow students recount stories of the ignorance and poverty common in their communities and their fears that, without the active involvement of organisations such as Sightsavers, the state government will neglect eyecare.

Some officials also temper their enthusiasm for the move with privately expressed concerns about whether they will be able to cope.

Yet Sunday Isiyaku, Sightsavers’ Nigeria director, is convinced it is the right decision.

“What we have managed to do is make sure that eyecare is part of the state’s strategic health plan,” he says.

He acknowledges that there are risks. Asked for his experience of working with politicians, he sighs before responding: “Promises, promises, promises – without fulfilling them.”

Sightsavers lobbied hard to ensure that eyecare receives dedicated budget lines. But such commitments can wilt in the face of overwhelming demands from elsewhere.

A memorandum of understanding aims to forestall such an outcome, and also allows for Sightsavers to remain in an advisory role.

Still, Mr Isiyaku says, there have been raised eyebrows from colleagues from other development organisations questioning whether Sightsavers is making the right move.

“But if you don’t, you never learn,” he says. “We need to take this step.”

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