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| photo by Art Simon |
To maximize the impact of its five-point program on eye disease in Armenia the AECP works closely with all sectors in the country and throughout the world - government, business, nonprofit. These include national and regional authorities, ophthalmologic and medical institutions, international and local organizations and companies, individuals, the Diaspora, international agencies for development and private corporations.
The AECP has developed and is currently managing four large-scale and comprehensive and integrated programs to provide eye care and combat eye disease in Armenia - reaching as many ages and population groups as possible. The AECP works closely with international organizations and each of these programs is designed and implemented in compliance with international standards. Additionally, the AECP works very closely with the Armenian Ministry of Health to establish national eye care goals and to develop targeted programs to achieve those goals. Their involvement in the AECP’s programs has always been significant and encouraging.
1. “Bringing Sight to Armenian Eyes” - 2003 to date
In 2002, the AECP transitioned from a one-person organization to a major nonprofit organization and established offices in the U.S. and in Armenia. At the same time the AECP raised funds to purchase a state-of-the-art Mobile Eye Hospital (MEH), which travelled by boat from the U.S. to Armenia and has been the hallmark of the AECP for the past ten years. The AECP formed a Charitable Foundation in Armenia and in 2003 launched its major initiative - “Bringing Sight to Armenian Eyes” - to strengthen Armenia’s eye care delivery system and to reduce preventable blindness in Armenia.
From 2004 through 2011 the AECP partnered with the United States Agency of International Development (USAID) and with their funding expanded “Bringing Sight to Armenian Eyes.” Together the AECP and USAID implemented the Project’s expansive five-point program and made significant progress in reducing preventable blindness.
The Mobile Eye Hospital, along with medical screening groups, travels throughout Armenia and makes regular visits to all of the marzes (regions) of Armenia. It takes two years to make one complete rotation of the country visiting each marz. The AECP field missions provide Armenians with a full complement of eye care services including general eye examinations (screening), surgery and laser treatment on the MEH, prescription and provision of eyeglasses and referrals to specialists. All medical services are provided by the AECP at no cost to the patients who are low income and at or below poverty levels. The sixth medical mission begins November 2013.
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| photo by Art Simon |
From June 2003 to September 2013 the AECP initiative “Bringing Sight to Armenian Eyes” achieved the following results:
- 333,446 people (136,860 children) screened by AECP medical groups in their villages or in adjacent settlements
- 36,651 people received thorough examination on the MEH
- 17,030 patients operated on and treated on the MEH
- 59,588 eyeglasses were provided
- 1,684 health care providers — 61 regional ophthalmologists and 37 ophthalmic nurses — trained in eye diseases
- 514,156 public education handouts distributed
- 450 public education classes for 11,800 children and 900 parents and health activists delivered.
The AECP research program has been able to collect and analyze large amounts of data during the past ten years, which has provided the scientific underpinnings for the development and implementation of eye care programs. Of particular importance is the prevalence of eye diseases and visual impairment among the Armenian population. According to the AECP data approximately 13 percent of Armenia’s adult population (16 years and older) has at least one eye disease that can cause blindness. Among those age 50 and older the percentage is almost three times as high or 37 percent with cataract as the leading cause at 27 percent. Further, nearly five percent of Armenia’s adult population have visual impairment - blind or have low vision - and 51 percent of those cases are a result of cataract.
The leading cause of blindness in the world is cataract as it is in Armenia. The overwhelming majority of surgeries performed on the MEH are cataract cases. Most are performed with an advanced method of phaco emulsification (96 percent) and the IOL installation rate is 98.5 percent. The rate of success for cataract surgeries on the MEH is close to 85 percent with physicians following the standards set by the World Health Organization.
2. “Center of Excellence for the prevention of Childhood Blindness”
2012 – 2015
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| photo by Art Simon |
Developing countries like Armenia are now seeing this disease that the U.S. first encountered in the early 1950s when an epidemic of ROP left an estimated 7,000 children blind in one year alone. ROP emerged in Armenia in the mid 2000s with practicing neonatologists and ophthalmologists encountering more and more cases. According to some estimates about 500 - 600 children are born annually who belong to the risk group, which is defined as birth weight of less than 1500g or with a gestational age of 30 weeks or less and infants with a birth weight between 1500g and 2000g or gestational age of more than 30 weeks with an unstable clinical course. According to international data, more than 50 percent of newborns having a birth-weight of less than 1250 grams have some degree of ROP. The probability of ROP is inversely proportional to birth-weight; the lower the birth-weight of the child, the higher the probability that he or she will develop ROP.
In 2010, in cooperation with the Ministry of Health, USAID, Children’s Hospital of Los Angeles and other partners the AECP introduced an ROP initiative including screening, early detection and laser treatment. ROP has a very rapid course and infants can go blind in a matter of weeks if not days. If not detected in time treatment will most certainly be less effective if not impossible.
The AECP has equipped ROP screeners with state-of-the-art equipment and has provided continuous professional support including mentors. The program started in all neonatal intensive care units in Yerevan. Through September 2013, 2,052 premature infants have been screened and 70 infants have received laser and anti-VEGF treatment. ROP screening is now provided in Gyumri and will be established in Lori and Kapan shortly.
In 2012, in partnership with USAID, established the Center of Excellence of the Prevention for Childhood Blindness (CEPCB) in Armenia. This enabled the AECP, along with USAID, the Armenian Ministry of Health, Children’s Hospital of Los Angeles and a number of other partners, to expand its ROP program to include a surgical tier. Children who require further treatment may now receive it in Armenia rather than in anther country, which can be prohibitively expensive and time consuming.
The mission of the CEPCB is to establish and develop a specialized ophthalmological capacity to help children from Armenia and abroad to combat childhood blindness and to facilitate the exchange of knowledge among medical professionals in the region. Specialized eye care is made accessible to all children in Armenia and throughout the region to eliminate childhood blindness caused by ROP and other diseases.
The continuing involvement of U.S. physicians — among the finest retina and ROP specialists in the world — along with highly trained AECP Armenian surgeons and modern equipment will elevate the treatment of ROP in Armenia to a level that will qualify it as a regional center. The project is committed to ensuring excellence in treatment and in service. The lack of trained professionals and equipment, as well as the increase in ROP cases in other countries — a majority of which do not have nationwide or systematized programs — make the services of the Center of Excellence very much in demand. The program also works to improve the quality of care for newborns. To accomplish this objective the AECP and Children’s Hospital of Los Angeles have introduced an online training program for neonatologist and neonatal nurses.
With the addition of the surgical tier the full complement of treatment options for ROP is available in Armenia making it possible to provide treatment for all cases of ROP and related eye diseases thereby preventing a lifetime of blindness. The CEPCB has initiated training for Armenian surgeons in the U.S., has secured surgical equipment and is working toward the establishment and implementation of tools for professional cooperation.
3. Online Training Platform for Primary Health Care Providers and Ophthalmologists: 2013 – 2014
Two training tools have been developed and implemented with the joint effort of the AECP and the Orange foundation. These training tools will open up education and training opportunities in eye care for primary health care providers and ophthalmologists, students, clinical residents, medical students and others. The online training tools have three components: (1) a digitalized textbook which provides extensive information on eye care issues; (2) video presentations — digests with case studies and delayed answers — to facilitate the learning process; and (3) online self-tests with randomized multiple choice questions — used to check the acquired knowledge. These training tools will be available in three languages — Armenian, English and Russian.
4. “Revitalization of the eyecare system in the regions of Armenia”. It is a five year project which is planned to start in 2014 with the establishment of a regional eye clinic in Tavush.
The Regional Eye Clinics will be located in the premises of medical centers operated by the Armenian Government. The locations of five regional eye clinics will be selected based on their potential capacity to provide services for a larger number of people; the absence of an eye clinic or a clinic of poor quality; the potential of securing a specialist including an ophthalmologist surgeon for the region. Those Regional Eye Clinics will make high quality eye care services accessible, affordable and affable for a large majority of the population in the regions.
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