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GOALS
Rotary Gift of Sight Goals |
Following is the text of a power point presentation with from 60 to 70 slides. Slide numbers are indicated. Some slides may be omitted before certain audiences, and most are listed at the end of the presentation ]
ROTARY GIFT OF SIGHT PROJECT
A PROPOSED JOINT PROJECT OF THE ROTARY FOUNDATION AND THE INTERNATIONAL FEDERATION OF EYE and TISSUE BANKS
1. INTRODUCTION
Focus: What does the individual district do?
Or: What do you want from Rotary clubs & districts?
Include: What can a single club do?
2. The eye is a most remarkable organ. Light enters the body through the cornea and aqueous humor to the lens, which focuses objects before it travels through the vitreous and is projected as images on the retina. Those images then are transmitted to the brain along the optic nerve and interpreted as sight.
The cornea --- is the button sized outer-most layer of eye tissue that is the "gatekeeper" to vision.
3. The outermost 5-6 layers constitute the epithelium, then the Bowman's membrane, the thick stroma, the Desemet's membrane and thesingle row of cells of the endothelium, make up the remainder of the cornea.
4. And whilst the epithelium and Stroma can be regenerated, the number of endothelial cells is fixed,
5. This very thin layer is very important, eliminating excess moisture from the Stroma whilst allowing nutrients into the cornea, but the endothelium is subject to injury, drying out or disease
3- The cornea's function is to protect the interior eye from injury or infection and provides up to 25% of the eyes' focusing power [which explains why my own sight has improved over time]
4- The causes of corneal blindness are many and varied. Some are related to heredity or personal hygiene, compounded by a lack of proper medical treatment. Other illnesses like trachoma and the parasites which cause river blindness are responsible. And, of course, the outermost part of the eye has the greatest chance of external injury.
[8.] Throughout the world, blindness due to disease or trauma to the cornea is a major debility. The bad news is that the number of people suffering from corneal blindness is staggering.
5- It is estimated that over ten million prople have bilaterally impaired vision due to corneal injury or disease, with 90% of these living in developing countries.
Being struck down as a youth in the prime of life results in total dependence on others, as disease of the cornea inevitably leads to functional blindness, generally by early adulthood.
6- The good news is that the vast majority of these victims can be helped by existing medical procedures. Most -- an estimated 80% -- of all corneal blindness can be reversed. This good news is enhanced by the relative simplicity of the surgical procedure called a keratoplasty to transplant cornea, and a high success rate that can be achieved when superior quality corneas are utilized.
7- There are several major challenges: First, the only known procedure is to use living human corneal tissue. This requires the consent of the immediate family of the deceased. Time is a major factor, as the donor cornea must be excised within hours of death
8- Second, procedures for handling and evaluating corneal tissue require expensive specialized equipment.
9- Corneal assessment includes keeping accurate medical records of donor medical history; blood serology testing; and the determining the physical characteristics of the cornea and particularly the size, shape
10- and a minimum number and quality of endothelial cells must be present for successful transplantation.
In addition, there is a significant shortage of medical technicians, even in areas where there are enough ophthalmologists.
11- And since corneal tissue can only be used after a donor dies, public education is necessary to overcome cultural reluctance to the donation of eyes by grieving families
12- [Donor Card] The United States and other developed nations only in the past generation finally have developed systems to provide sufficient corneas to meet ongoing demand.
13- [Needy Pics] Unfortunately, developing countries are hampered by fewer medical facilities, less ophthalmic training in corneal transplant procedures, and by widespread ignorance of the value of organ donation, so the need still far outweighs supply.
14- [The EYE] Finally, although corneal blindness is the second largest cause of blindness, to date no other organization has undertaken the responsibility for ending this scourge.
15. Corneal blindness is needless blindness -- yet only a small fraction -- less than five percent -- of the corneal tissue needed to meet demand are available to restore sight to otherwise healthy young people despite the fact that the necessary technology exists today to recover, evaluate and deliver high quality cornea for transplantation in a simple surgical procedure! Thus up to a quarter of all blindness is not being addressed in most areas of the world.
16- Last but certainly not least is the high socio-economic cost of corneal blindness the vast majority of those afflicted or injured are young and otherwise vigorous persons. This differentiates cornea blindness from cataract debility, which generally is degenerative and which occurs primarily in the elderly.
Corneal blindness leads to a correspondingly greater loss of earning power over a longer period of time, resulting in the greatest economic deficiency and liability to the community. It only makes good economic sense to attack corneal blindness if only as a means to increase productivity by decreasing economic dependency
17- It is on humanitarian grounds, however, that we introduce the rationale for the role of Rotary.
Rotary's role in the world today is well-established.
Rotary's very object is to seek the advancement of international understanding, good will and peace through our fellowship dedicated to service in projects such as this.
18- Rotary has the means, the resources, the presence and the ability to undertake a project of this magnitude. With 1.2 million members in nearly 200 Countries and geographical areas, Rotary has nearly 30,000 autonomous clubs in some 15,000 local communities. An only Rotary has the unique combination of an unexcelled International and locally credible base and record of service to community,
19- with an established system of Matching Grants to maximize resource utilization, and the experience in large public health initiatives such as Polio Plus to succeed where no other organization could.
20- But Rotary works best when it has technical partners whose goals complement ours. In eye banking, Rotary has been fortunate to find a partner which has a demonstrated record of success. Beginning in 1962, the original Eye Bank of Maryland has a long-established mission of relieve human suffering by reducing corneal blindness.
21- Within a quarter-century, this one eye bank grew into Tissue Banks International, a network of eye banking centres around the United States. Tissue Banks International, or TBI, played an integral role in the elimination of corneal waiting lists in this country, which, surprisingly, has been achieved only within the past fifteen year s.
22- TBI's international arm became the International Federation of Eye and Tissue Banks as they expanded into the international scene in 1989. This federation, known by its acronym "IFETB", now has 42 accredited eye banks in 25 countries around the globe, but, most important was their establishment of an eye bank training centre in Prague in 1992.
23- In 1993, a District 7620 project to establish an eye bank in Turkiye required technical evaluation, and we were introduced to IFETB by PDG Dr John Sever.
24- Our successful association over the past several years, along with the international knowledge, experience, and commitment of IFETB, has led to our proposing even closer cooperation between two organizations with shared ideals and ideas on how to develop and implement cost-effective programmes to reduce and ultimately eliminate corneal blindness.
25- Our largest project to date was a US$100,000 Matching Grant to establish the Rotary-Aravind Eye Bank at the largest eye hospital in the world, located in Madurai in southern India. This project came in some $12,700 under budget, due in large measure to our not adequately planning our educational outreach.
26- Most recently a Rotary Matching Grant [#14641] funded the expansion and move of the Eye Bank Coordination & Research Centre in Mumbai to a new, enlarged, and vastly superior facility at the Haji Buchuali Hospital. This project was funded in the amount of $50,000 and will be completed in the Fall of 2001.
27- We supplied a specular microscope along with technical training to the Ramayamma Eye Bank in the spring of 2001 for use by Dr. Gullapalli Rao, a world famous surgeon who has built a state-of-the-art facility in Hyderabad, India
28- and another specular microscope is on its way to the Ort-Mahler International Eye Bank in Chittagong, Bangladesh as we speak. The most advanced specular microscopes are an absolutely essential tool in determining the quality of a cornea and whether it is suitable for transplantation, particularly in areas where eye donation recovery procedures are difficult.
29- Four Rotary clubs in Taiwan, Hong Kong and Philippines have combined to obtain a specular microscope for the Santa Lucia International Eye Bank in Manila. This project is slated to be approved when funds are available from the Rotary Foundation again in July, 2001.
30- With this record of successful collaboration which has built a mutual respect for each other's abilities and commitment, the IFETB and Rotary are on the threshold of even closer cooperation to serve the needlessly blind.
