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Helping bring eye health into focus Zambia 2012 Annual Report Lions Aid Norway
Helping bring eye health into focus
Zambia 2012 Annual Report
Lions Aid Norway
1. Lions Aid Norway Focusing on Eye Health
Table of Contents.
2012 Annual Report
1. Message from the Country Director.......................................2
2. Background........................................................................3
3. Human Resource Development............................................4 - 5
4. Maboshe’s Story.................................................................6
5. Focus on Kaoma MDA........................................................7
6. Focus on Infrastructure......................................................8
7. Data and Statistics Summary...............................................9
8. Service Delivery.................................................................10
8. Discussion of Results by Dr. David Kasongole ....................11
9. Planning and Coordination.................................................12
9. Other Projects.................................................................13
10 Financial Report...............................................................14
From the Country Director Welcome Message
I would like to welcome you to our 2012 annual report.
This past year has had its own share of successes and
challenges. In this report, you will find updates from all
our three sectors of engagement i.e Human Resource
development, infrastructure, and service delivery.
A Tribute to Ministry of Health: Lions Aid Norway is
particularly encouraged with the commitment that Min-
istry of Health through the National Eye Health office
has shown in bringing eye health on the National
Agenda. The Ministry has made a number of significant
efforts in ensuring that Eye Health is given the attention
it needs at all levels. The launch of the Master of Medi-
cine (MMED) program for training of Ophthalmologists
at the University Teaching Hospital (UTH), the purchase
of Eye Health Equipment for District Hospitals, the com-
pletion of the National mapping exercise for Trachoma
and the initiative to engage parliamentarians in the fight
against Trachoma all goes to show that MOH has priori-
tised Eye Health. We are also happy that MOH has
given us a green light to start supporting Eye Health in
Central Province.
Advocacy and Service delivery: In Western Prov-
ince, one of the key objectives in 2012 has been to ad-
vocate for the integration of Eye health activities within
the District health plans and budgets. We are happy to
have seen almost all Districts respond to this call. LAN
believes that delivery of Eye Health services can only be
sustained if planning for Eye health is achieved at Dis-
trict level.
Trachoma elimination: LAN has continued to support
Kaoma District in its Trachoma elimination efforts. The
highlight of this support for 2012 has been the success-
ful implementation of the Mass Drug Administration
(MDA) exercise by the District. This exercise was not
only the first ever to happen in Kaoma but for the whole
country at large. The MDA exercise is a huge milestone
in the elimination of blinding Trachoma in that District.
You can read more on this exercise on page 7.
Infrastructure and Equipment: LAN has procured
equipment and furniture for the specialised eye depart-
ment. On rather a sad note, I regret to inform you that
the completion of the specialised Eye Department at
which this equipment is to be used has been delayed
due to various reasons beyond our control. I am how-
ever confident that the unit will be completed before
the end of the first quarter of 2013.
May I also take this opportunity to mention that after
working in Zambia for over 2 years, and working for
LAN for many years, I have decided to retire at the end
of April. I am happy with the partnership and collabora-
tion I have had with various stakeholders within the Eye
Health sector. I would also like to extend my gratitude
to my fellow Lions, friends and my staff who have made
my stay in Zambia very worth while and encouraging
Enjoy your reading.
Jan Erik Larsen
2. Lions Aid Norway Focusing on Eye Health
Who we Are.
2012 Annual Report
Introduction
Lions Aid Norway is a non governmental organisation
working in three countries namely Uganda, Malawi
and Zambia. LAN started its work in Zambia in 2010
after entering into a Memorandum of Understanding
(MOU) with the Ministry of Health. The MOU man-
dates LAN to support Affordable, Accessible and
Available Eye Health services in Zambia. LAN is
working in close collaboration with the Ministry of
Health and other partners to build, strengthen and
support existing Eye Health systems and services in
Western Province in a sustainable and cost effective
manner. LAN’s support is within the context and
framework of the National Eye Health Strategic
Plan.
Our Vision
To provide the people of Western Province with eq-
uity of access to cost effective quality Eye Health as
close to the family as possible within the global initia-
tive for elimination of avoidable blindness – The
V2020: The Right to Sight.
Our Aims
1. To support the development of Eye Health infra-
structure.
2. To support the development of Human Resource
for Eye Health.
3. To promote and provide appropriate technology
and Infrastructure necessary for delivering Eye
Health services.
4. To create awareness on Eye Health conditions and
related issues.
Our 2012 Objectives
1. Complete construction of an Eye Department at
Lewanika General Hospital.
2. Sponsor 4 health workers to be trained as Oph-
thalmic Clinical Officers.
3. Train 60 Primary Eye Health (PEH) workers in 3
districts.
4. Support 2 surgical outreach activities in 2 districts.
3. Lions Aid Norway Focusing on Eye Health
Photo: Taken at Ndapula Community
School in Chongwe.
Human Resource development
2012 Annual Report
Training of Ophthalmic Clinical Officers and Nurses.
(2012 Objective: 8 to be trained by the end of
2013)
Two (2) candidates from Lewanika General Hospital (LGH)
have completed their training in Gambia and are now ac-
tively working in the eye clinic. 1 candidate from LGH, 1
from Mongu District and 2 candidates from Lukulu and
Kaoma Districts will be entering their second year of training
at Chainama College of Health Sciences in 2013. An addi-
tional 4 candidates from Shangombo (1), Lukulu (1) and LGH
(2) are scheduled to commence their training at Chainama in
January 2013. 1 candidate from Kalabo District is currently in
training in Gambia and is expected to complete in July 2013.
2. Primary Eye Care Training (2012 Objective: 30
health workers, 30 community health workers
trained in PEC by end of 2012)
In 2012, LAN planned to support 3 Primary Eye Care train-
ings in 3 districts namely Sesheke, Senanga and Lukulu. The
objective of the training is to establish and strengthen Dis-
trict Eye Health referral system by equipping health workers
with the basic skills in disease identification, diagnosis and
treatment. A combined total of 30 health workers and 30
community health workers have been trained from three
above mentioned districts by end of 2012. This represents a
100% progress against the planned objective for the year.
4. Lions Aid Norway Focusing on Eye Health
Photo: An Ophthalmic Nurse (ON) currently in training
removes a bandage from a patient after surgery
Lewanika Eye clinic, Mongu
Focus on Human Resource
2012 Annual Report
Need for Human Resource Human resource is the most important asset of any health system and their availability and quality are key determinants of efficiency and quality of health services provided. It is crucial to the success and sustainability of all health care provision interventions. Western Province is among the provinces that has had a lack of Hu-man Resource for Eye Health. As at the beginning of 2012, the Province with a population of over 1 million only had 3 active Ophthalmic Clinical personnel and 1 Ophthalmologist trained to provide Eye Health services. At the minimum, the Province needs 20 mid level Ophthalmic personnel in order to ensure that the Lewanika General and all District Hospitals have trained staff providing Eye Health Services. Lions Aid Norway has been working to help bridge this gap by supporting the training of Human Resource for eye health
Helping Make a Difference ( Wamulume and Precious Story) Wamulume and Precious are two of the candidates who have just completed their ophthalmic training program in Gambia with support from Lions Aid Norway. They now work at Lewanika General Hospital, the biggest hospi-tal in the Province. With the increase in the demand for Eye Health Services, Wamulume and Precious explain that since they came back from training, the number of patients seen at the clinic has increased with more than 50 people seen every day. “We are able to perform minor surgery such as excisions, eviscerations and TT surgeries” Wamulume ex-plained. Before the two candidates came back from training, the eye clinic depended on one ophthalmologist for every-thing. Dr. Kasongole said that the two Ophthalmic Nurses (ON) are well trained and are able to provide support both in the clinic and in theatre. He added that he was now able to concentrate on much more completed sur-geries such as cataract as he now has other tasks in the clinic being covered by the two Ophthalmic personnel. Wamulume and Precious are among the 14 Lions Aid Norway supported candidates expected to be stationed across the province by the end of 2015.
5. Lions Aid Norway Focusing on Eye Health
Photo: Wamulume and Precious
reviewing a patient after a minor surgery
earlier.
Maboshe’s Story
2012 Annual Report
Maboshe’s is a 32 year old man of Mongu’s Mbo compound in Western Province Zambia. Maboshe walked in the Eye Clinic at Lewanika General Hospital with what he thought was a feeling of sand in his eye. Maboshe explained to the Ophthalmic Nurses (ON) that it all started with what felt like some sand sensation. “Over time, it started becoming painful and realised that something was growing in his eye” Maboshe explained during his review visit at the eye clinic. Maboshe was screened at the clinic by the recently trained ON’s and his condition was clinically diagnosed to be what is known as Squamous Cell Carcinoma. (SCC) After undergoing screening, a surgical inter-vention was recommended for him. The ON under the supervision of the ophthalmologist carried out an excision surgery to remove the tumor and hence stop the spread of the con-dition to the rest of the eye and adjacent structures. Wamulume Namushi, the ON who carried out the surgery explains that there is a high chance of recurrence and the patient has been put on close monitoring and medi-cation. Wamulume said that Maboshe is lucky that his condition has been diagnosed and treated early as failure to do that would have led to a full spread of the cancer and eventually blind-ness. “Lack of awareness about this and other con-ditions have led to many having to lose an eye because in most cases, people have come in late and we have had to completely remove the eye”. Wamulume added. Lions Aid Norway is working with Ministry of Health to raise community awareness on vari-ous eye conditions so that community mem-bers can seek the service they need at the
6. Lions Aid Norway Focusing on Eye Health
Photo: Moboshe undergoing sur-
gery at Lewanika General Hospital
Mongu.
What is Squamous Cell Carcinoma of
the conjunctiva?
Squamous Cell Carcinoma of the conjunc-tiva is a malignant tumor arising from the
membranous lining of the eyeball and eye-
lids. If untreated, the condition has poten-tial to lead to blindness and may also
spread to the brain.
Dr. David Kasongole.
2012 Annual Report
Focus on Kaoma Mass Drug Administration
What is Mass Drug Administration (MDA) ?
The Mass Drug Administration (MDA) exercise is the implementation of the “A” com-
ponent of the WHO recommended SAFE strategy for the elimination of blinding Tra-
choma. It involves the distribution of Zithromax antibiotic to the whole population in a
District that has a Trachoma prevalence of 10% and above. Kaoma District has
recorded the one of the highest prevalence rate of 32.7% among children aged
from 1-9 years. On 24th September 2012, the District embarked on its first
round of the implementation of the Mass Drug Administration (MDA) exercise for
the elimination of Trachoma with support from Lions Aid Norway.
Scope of the Exercise :
Lions Aid Norway co funded the MDA exercise
by supporting the training of 66 health workers, 199
community volunteers, sensitization of 46,000
community members and the distribution of the
drug in the whole district. The trainings were designed to equip health
workers and the community volunteers with knowledge on administering,
managing, monitoring and reporting for the MDA exercise. The community
was sensitized on Trachoma and the need to take the drug in order to avoid
the spread of the disease.
Results :
Kaoma District reported that 94 % (177,478 people) of the population
received the drug. This was a 14% above the WHO set target of 80%.
7. Lions Aid Norway Focusing on Eye Health
Photo: A child in Kaoma
receives a dose of Zithromax
in Kaoma District
Photo: A Community Health
Worker (CHW) measures the
height of a child at a health
centre in Kaoma
Focus on Infrastructure.
2012 Annual Report
Construction of the Eye Department
which commenced in September 2011
has been progressing with some major
challenges. These challenges resulting
from a number of factors have caused
some delays leading to the extension of
the completion date. It is now expected
that the Eye Department will be com-
pleted before the end of the 1st quarter
of 2013.
Lions Aid Norway has procured all the
equipment and furniture for the unit.
Various dignitaries who have visited the
site have expressed happiness at the
rate that the works have moved despite
the various challenges that have been
encountered. These include the Minister
of Health, Dr. Joseph Kasonde, The
Permanent Secretary, Dr. Peter Mwaba,
The Deputy Minister of Sport and Mem-
ber of Parliament, Mr. Nathaniel
Mubukwano and the former Interna-
tional Director of Lions Aid Norway,
Eline Oftedal.
8. Lions Aid Norway Focusing on Eye Health
Lewanika General Hospital Eye Department under construction as
at January 2013.
Second from right: Minister of Health Dr. Joseph Kasonde tours
Construction site in April 2012
Lewanika General Hospital Statistics
2012 Annual Report
9. Lions Aid Norway Focusing on Eye Health
Morbidity 2011 2012 % increase
Cataract 371 424 13
Allergic Conjunctivitis 553 732 24
Refractive Error 252 277 9
Glaucoma 77 79 3
Viral /Bacterial Conjunctivitis 165 294 44
Ophtalmia Neonatorum 43 13 -70
Corneal Ulcers 71 208 66
Stye 19 23 17
Retinoblastoma 0 2 100
Trachoma 44 100
Orbital Cellulitis 17 3 -82
Enophthamitis 6 13 54
Optic Atrophy 12 7 -42
Optic Neuritis 11 48 77
Uveitis 38 356 89
Pterygium/Pinguecular 197 163 -17
Conjuctiva Squamous Cell Carcinoma 29 37 22
Foreign Body 29 50 42
Chalazion 26 137 81
Trauma 100 64 -36
Corneal Scar 33 28 -15
Squint 8 64 88
Retinopathy 18 151 88
Others 1,515 2113 28
Total number of patients 3,637 5330 32
Service Delivery
2012 Annual Report
10. Lions Aid Norway Focusing on Eye Health
LAN fully supported one (1) surgical
outreach camp in 2012 out of the
planned two (2) in Lukulu District. At
this camp, 38 cataract patients were
operated on. LAN also supported one
(1) surgical outreach camp for lid ro-
tation surgery in Kaoma District at
which 28 eyes were operated on.
LAN also partially supported six (6)
surgical outreach camps through the
Ministry of Health Western Province
mobile outreach services. LAN’s sup-
port included the provision of con-
sumables and equipment while trans-
port and allowances were covered by
Ministry of Health.
182 cataract operation have been per-
formed through Mobile Health out-
reach services alone in 2012.
Performance review Dr. David Kasongole
2012 Annual Report
11. Lions Aid Norway Focusing on Eye Health
2012 has been a very productive year
when it comes to service delivery. In this
year, the number of people who have ac-cessed Eye Health services has increased
by 32% compared to last year. This in-crease indicates that the demand for Eye
Health services in the Province is increas-ing and that many of our people are get-
ting the help they need when it comes to
Eye ailments.
Thanks to our cooperating partners Lions Aid Norway, we have had a boost in hu-
man resource with the coming of the two
Ophthalmic Nurses who recently gradu-ated from Gambia. This has particularly
led to a sharp increase in the number of patients seen from July onwards. Western
Province has recorded the highest number of cataract operations in 2012 than in any
other year. Availability of consumables
and the mobile health services has made it possible for us to reach even the fur-
thest parts of the Province.
Our outlook and prospects for 2013 are
even more ambitious than the last year. Our specialised Eye Department will be
fully operational before the end of the first quarter. We have planned to implement a
robust sensitization program across the
whole province to ensure that people are sensitized on the availability of these ser-
vices. We are expecting our cataract sur-gical output to increase by at least 20%.
We will also be focussing on children by ensuring that we implement school
screening activities so that all children
with visual impairment can get the help they need at our department.
The biggest challenge we anticipate this
year is the limited human resource for Eye
Health across the province. Thanks to LAN, the province will receive 5 Ophthal-
mic personnel by the end of this year. However the need for these specialised is
still high.
Finally looking back to 2010 when we
started with the program, I can confi-
dently say that we have had significant
success in ensuring that the people of this
province get the services they need.
Thanks to my Ministry and Lions Aid Nor-
way for the support they have continued
to render us.
Dr. David Kasongole
Photo: Dr. David Kason-
gole posses for a Photo
during a home visit with
one of the patients who
has had the vision re-
stored after a cataract
operation.
“The number of people
accessing eye health
services has increased by
32%”
Planning and coordination
2012 Annual Report
12. Lions Aid Norway Focusing on Eye Health
Activity When it
was con-
ducted
Details
Provincial Plan-
ning Meeting January 2012
The second LAN supported Provincial planning meeting was held at the end of
January 2012. The meeting was attended by 6 District Medical Offices, District
Eye Health focal point persons and planners. Key staff from the Provincial Office
and Lewanika General Hospital were in attendance. The aim of the meeting was
to review progress thus far and to develop a road map for the future. Lions Aid Norway
Board Meeting. February 2012 The first LAN board meeting was held in February 2012.
Visit by Lions Aid
Norway, Interna-
tional Director
March 2012 Former LAN International Director visited Zambia in March 2012 on a familiarisa-
tion tour of the LAN supported project. Ms Eline Oftedal who was accompanied
by LAN advisor Prof Jan Holtet also paid a courtesy call on the Litunga, King of
Barotseland and also toured the construction site of the Eye department.
Training of Lions
Aid Norway staff
in Community
Eye Health Man-
agement
March 2012 LAN represented by the Accountant / Administrator attended training in Com-
munity Eye Health. The training focused on the management of Eye Health pro-
grams at community level.
Provincial Inte-
grated Meeting
(PIM) April 2012 LAN represented by the Program Officer attended the Provincial Integrated
Meeting (PIM). PIM is an annual meeting attended by all MoH units and part-
ners in the Province to share progress, experiences and challenges in relation to
delivering Health services. LAN was given an opportunity to showcase their work
in supporting Eye Health delivery in the Province. District visits –
Development of
MoU.
May 2012 In May 2012, LAN team led by the Country Director visited all the seven Districts
to discuss and develop agreements with individual districts. The aim of the
agreements is to formalise and create a framework of LAN support to individual
districts. Provincial
Planning
Launch.
June 2012
LAN represented by the Program Officer attended the Provincial Planning launch
meeting. The meeting which is attended by all MoH units and partners is the first
activity in the Provincial Planning cycle. Lions Aid Norway
Board Meeting. July 2012 The second LAN board meeting was held in July 2012
Provincial
Planning
Launch.
N o v e m b e r
2012
LAN represented by the Program Officer attended the Provincial Integrated
Meeting (PIM). PIM is an annual meeting attended by all MoH units and part-
ners in the Province to share progress, experiences and challenges in relation to
delivering Health services. LAN was given an opportunity to showcase their work
in supporting Eye Health delivery in the Province. P a r l ia m e n ta ry
presentation on
Trachoma
D e c e m b e r
2012
LAN represented by the Assistant Director attended a parliamentary session were
Ministry of Health was asked to present on Trachoma. The aim of the meeting
was to create awareness among political leaders on the dangers and impact of
Other Projects
2012 Annual Report
13. Lions Aid Norway Other Projects
In February 2012, Lions Aid Norway part-
nered with Mongu Lions Club to improve the wa-
ter reticulation system at Senanga School for the
hearing Impaired. The project which was funded
by Lions Club Jevnaker of Norway involved the
construction of a borehole and water tank to pro-
vide 24 hour running water to the school.
The project was officially commissioned by the
then Western Province Minister Hon. Nathaniel
Mubukwano. In his speech, Hon. Mubukwano
said that he was aware of the poor water supply
at the school and as such was happy to have
been invited to commission it. The water Project
is expected to benefit 72 hearing impaired pupils
with 24 hour water supply.
Speaking on behalf of the children, Namakau, a
grade seven pupil at the school said that she was
grateful to Lions of Norway for supporting the
project. She said that she and her friends would
no longer have to walk long distances hence
avoiding the risk of being hit by cars or attacks
from crocodiles at the river .
Other future projects include the construction of
a girls dormitory at the School for the deaf in
Senanga, construction of teachers houses at
Ndapula community school in Chongwe, con-
struction of a 1 X 3 classroom block at Namilangi
community school in Kaoma.
The improvement of the water reticulation project at Senanga
School for deaf has benefited 72 speech and hearing impaired
children
Community members gather for a meeting to discuss the
Ndapula community school improvement project at Ndapula
community school in Chongwe.
Community members listen to the Country Director of Lions
Aid Norway and Kaoma District Education board Secretary-
during a meeting to discuss the school improvement project at
Namilangi community school, Kaoma.
Financial Report
2012 Annual Report
14. Lions Aid Norway Financial Report
ZAMBIA ACCOUNTS 2012
ZMK NOK
A. Investments
Buildings 3,957,168,877 4,563,117
Inventory and equipment 1,119,169,868 1,290,556
Sum 5,076,338,745 5,853,673
B. Running expenses
Norwegian personnel 222,165,000 257,185
Local personnel 408,399,712 469,995
Consultants 15,000,000 16,623
Transport 104,504,052 119,956
Operating equipment 17,292,250 19,973
Operating expenses 249,887,162 288,221
Teaching and training 233,744,554 273,510
Publicity 3,000,904 3,728
Support to clinics 56,848,210 64,132
Trachoma 290,526,880 320,802
Sum 1,601,368,724 1,834,125
Sum A+B 6,677,707,469 7,687,798
For more information please contact
Lions Aid Norway Plot 30991 Thabo Mbeki Road
Lusaka, Zambia
+260 211 840 234 +260 211 840 233
Compilation, layout and design by Lions Aid Norway
staff
