Dr. Cova Bascaran and Nurse Marcia Zondervan, a two-member team from the London School of Hygiene and Tropical Medicine, has embarked on a mission to appraise the Diabetic Retinopathy- DR Screening and Treatment Program in Dominica, and provide feedback on performance and efficiency.
The venture, which took place from June 30th to July 1, 2017, was funded partly by the Queen Elizabeth Jubilee Trust Diabetic Retinopathy programme headed by Ophthalmologist Consultant Dr Hazel Shillingford Ricketts.
Dr. Bascaran, who is also a member of the International Centre for Eye Health at the institution, noted that the Diabetic Retinopathy Screening and Treatment Program in Dominica is working well and is comprehensive.
“It covers the whole country; it has a very broad coverage. There are good professionals trained in screening,” she said.
The team held meetings with the Ministry of Health technical and Princess Margaret Hospital (PMH) Administrative staff, the Diabetic Retinopathy programme, the Management Advisory Committee, the Ministry’s IT Department and Screeners, and visited the PMH Eye Clinic and observed the Fundus Photography and Laser Treatment.
It is anticipated, according to Dr. Bascaran that in phase two of the Jubilee Trust Program, there will be training on an international level for persons already engaged in the facilitation of the program.
However, considering this training, Dr. Bascaran stressed the need for more equipment camera; equipment that has made it possible for all persons in Dominica to receive screening tests as needed.
“There will also be a big input on health promotion activity to increase the number of diabetics that are aware of this screening program,” she added
Meanwhile, Dr. Ricketts stated that the program itself has faced many challenges, of major concern is patients not keeping their scheduled appointments, and this poses as drawbacks to the productivity of the ophthalmologist doctors and vision restoration for the patients.
“There are some persons that come in too late, and even if we try, there is no success in restoring their vision. Hence, the lesson we learn is, we do not have to wait when you cannot see to see the eye doctor. Prevention of blindness for diabetes is most successful when you are examines and treated before you lose your vision,” she stated.
She stressed that early detection and treatment in order to prevent blindness is the sure way to go in reversing the impact on the workforce as diabetic blindness affects the working population aged 25-30.
Ricketts stated that there is a need for the medical staff to be more proactive in their operations.
“The nurses and the doctors who interface with the patients, it is their responsibility, first of all, to educate themselves about the disease, and to inform and educate their patients, and also follow up is important. We know that the delinquent patients are the ones that run into problems, so we have to develop a follow up system. We have to be more proactive in reaching out to the non-compliant patients,” she stated
With regard to human resource capacity, Ricketts revealed that work is being done training young doctors in the field of ophthalmology including a young Dominican in training who has just started her third out of five year program in the field.
“Now specific to the diabetic program, we have two Grader screeners, and we are going to start training a third in house member of staff. We also just learnt that we have a Dominican, who was awarded a scholarship from the Queen Elizabeth Jubilee Trust to do public health in eye care,” she remarked.
Ricketts is looking forward to the completion of the new National Hospital as it will provide more space where they will be able to offer more services.
Diabetic Retinopathy, by definition, is a disease of the eye caused by diabetes, and it affects the retina which is the nerve lining inside of the eye where images are formed based on what you are seeing.