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In the 1970’s, the late Dr. Moses the first Malawian ophthalmologist in his country, was given an IEF grant to help expand the national eye care service in that small southern African nation. From 1972-1976, Dr. Larry Schwab, now an IEF Board member, and Dr. Van Joffrion were posted with their families to Ethiopia to train ophthalmologists and build the national eye care service. Throughout the 1970’s, IEF facilitated an exchange program with the US Navy which exposed US Navy ophthalmology residents to the challenges of providing eye care in Africa and the Middle East, and provided fellowships for Ethiopian and Egyptian ophthalmologists to come to the US for training. Ophthalmologist and nurse training programs as well as vitamin A deficiency control programs were conducted in Afghanistan, Pakistan, India, Bangladesh and Indonesia.

The United States Agency for International Development (USAID) supported IEF’s Kenya Rural Blindness Prevention Project from 1976-1984 which became a model for East Africa. Three US ophthalmologists were posted to Kenya with their families to work with the project. Dr. Randolph Whitfield, Dr. Larry Schwab, and Dr. Paul Steinkuller served as Ministry of Health (MOH) Provincial Eye Surgeons in Kenya’s Central and Rift Valley Provinces. Victoria Sheffield was posted at the Director of Training, and Dennis Ross-Degnan followed by Dr. F. M. Mburu were posted as the project’s epidemiologists. Notably, nine major blindness prevalence surveys were conducted over the eight years, training of ophthalmologists and Ophthalmic Clinical Officers was expanded, and countless general physicians, nurses, and village health workers were trained in primary eye care.


In the 1980’s, IEF posted ophthalmologists to Caribbean island nations where eye care was only provided by doctors who flew in for a day or two once a month. In 1980, IEF established Malawi’s Ophthalmic Medical Assistants Training Program in collaboration with the Ministry of Health; and posted US ophthalmologists for 3-4 years at the Queen Elizabeth Central Hospital in Blantyre over a 15-year period until 1995 until a Malawian ophthalmologist could be trained and assigned there. In1985, the World Health Organization (WHO) awarded IEF “official relations” status, the first international eye care NGO to be recognized in the way, and began aligning programs with WHO priorities. In 1987, IEF launched the Ethiopia Ophthalmic Manpower Development Program in collaboration with the Ministry of Health and set up the first Ophthalmic Assistants Training Program at the Menelik Hospital in Addis Ababa, the capital of Ethiopia. At the same time, USAID awarded child survival grants to IEF in Africa and Latin America that focused on nutrition education and reducing blindness from vitamin A deficiency. The availability of Mectizan® by Merck & Company allowed IEF to pioneer the first community-based ivermectin (Mectizan®) distribution programs in Guatemala, and in collaboration with Africare in Nigeria in 1990, followed by Cameroon and Malawi in 1992 to fight onchocerciasis, commonly known as “river blindness”.


In the 1990’s, we saw a changed world after the Berlin Wall fell and one of the first USAID grants for Eastern Europe was awarded to IEF to implement public health eye care programs in Bulgaria and Albania. While ophthalmologists were well educated in Central and Eastern Europe, they lacked modern technology under the old system. Programs focused on building an outreach program to underserved populations; providing training and technology, especially for vitreo-retinal surgery, and Retinopathy of Prematurity (ROP) to save the sight of premature infants. Recognizing the need for public health strategies, IEF in collaboration with Professor Sheila West and Dr. Richard Gieser at the Dana Center for Preventive Ophthalmology (now the Bloomberg School of Public Health) at Johns Hopkins University conducted the first random sample epidemiological blindness prevalence survey in Bulgaria called “The Sofia Eye Study” with Prof. Petja Vassileva, IEF’s Country Director and her team. Data was published and used by WHO to extrapolate blindness rates throughout the former Communist region.

Late 1990's

In the late 1990’s, IEF determined that eye hospitals in developing countries were still underperforming, and lacked management capacity and revenue sources. At the urging of David Green, MPH, the leading social entrepreneur in eye care, IEF established its SightReach® Management program reorienting its mission to sustainability programming for eye care institutions. This included developing a model utilized in India that can be adapted by eye units in other regions of the world. Focusing on reducing blindness from unoperated cataract which is responsible for half the world’s blindness and addressing uncorrected refractive error, IEF’s technical assistance and investments improve efficiency, productivity and revenue generating services. IEF is now a global leader in sustainability programming for eye care.

Recognizing the need for modern ophthalmic instruments, equipment and supplies in the developing world, traditionally a small market for manufacturers, IEF established the SightReach Surgical® (SRS) program in 1999, the first non-profit platform to address affordability and lack of access to new ophthalmic equipment, instruments, and supplies by eye care providers and NGOs in developing countries. SRS makes available a wide range of ophthalmic products from manufacturers worldwide to eye care providers and international INGOs reducing the cost of technology and providing valuable procurement and advisory services – www.sightreachsurgical.com

IEF pioneered community-based Mectizan® distribution to fight onchocerciasis (river blindness) in Nigeria in collaboration with Africare, and Guatemala in 1990; and in Cameroon and Malawi in 1992. IEF continues to support onchocerciasis control programs in Adamaoua and South Regions of Cameroon and by 2017, over one million people received their sight-saving dose of Mectizan bringing a cumulative total of over 10 million treatments over the past two decades. The program began small treating approximately 6,000 people in the early years. Villages were added each year until now, over one million people are treated annually. In 2014 with support from Helen Keller International, IEF distributes anti-parasitic medicines to combat other worm infections. Dedicated local staff coordinate these treatment campaigns, each year training thousands of Community Directed Distributors. Gratitude goes to Merck and Company for its donation of the drug Mectizan and the collaborative support from the African Programme for Onchocerciasis Control through 2016, the Lions SightFirst Program, Helen Keller International, and the Cameroon National Onchocerciasis Control Programme.

In Guatemala, IEF’s onchocerciasis control program was established in Yepocapa near the Mexican border in 1990. After three years, it was subsumed into the larger Onchocerciasis Control Program for the Americas (OEPA). In 2016, Guatemala was declared the fourth country in the world to eliminate river blindness. IEF is proud to have been instrumental in the early effort to control and eliminate river blindness from onchocerciasis and proud to see the disease eliminated in Guatemala in our lifetime.

According to the World Health Organization, there are 1.26 million (2010 data, C. Gilbert) blind children in the world today. Of these, 75% live in developing countries. Another 19 million are severely visually impaired of which 12 million need eyeglasses. From 2013-2018, IEF is serving as the Technical Advisory Group to the USAID Child Blindness Program which has provided critical funding for child eye care programs around the world. Having pioneered the grants program from 1995-2000 (Seeing 2000) with a large grant from USAID, IEF is privileged to now influence the direction of this innovative program to bring eye care to vulnerable children in the developing world.




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