Blindheitsverhütung in der "3. Welt"

Planned action

No one values vision more than one who lost it.
No one cherishes sight more than one who lost and regained it.

Vision 2020 Germany is part of the global WHO campaign “VISION 2020 – The Right to Sight”, which explicitly deals with the right to eyesight - thus placing ophthalmologic care in the context of human rights. Vision 2020 aims at overcoming avoidable blindness worldwide, by the year 2020. Vision 2020 Germany seeks to promote this objective at the national and international level. We also want to broaden it by including the area of rehabilitation of the blind and visually impaired in Vision 2020.

Vision 2020 Germany is a consortium of eight German associations and organisations, all active in the areas of “vision” and “blindness”. These are the following:

Berufsverband der Augenärzte
(German Association of Ophthalmologists)
Christoffel-Blindenmission Deutschland
(Christian Blind Mission Germany)
Deutsche Ophthalmologische Gesellschaft
(German Ophthalmologic Society)
Deutscher Blinden- und Sehbehindertenverband (German Federation of the Blind and Partially Sighted)
Deutscher Verein der Blinden und Sehbehinderten in Studium und Beruf (German Association of Blind and Partially Sighted Students and Professionals)
Deutsches Komitee zur Verhütung von Blindheit (German Committee for the Prevention of Blindness)
Hilfswerk der Deutschen Lions (Lions Foundation Germany)
Pro Retina (Pro Retina Germany, Patient Organisation of People with Degenerative Diseases)

Planned action on Vision 2020 Germany’s international projects

We would like to introduce our plans for international projects. In the first phase, crucial points of these activities will be the support of collaboration at both the national and international level, with the aim of building up and expanding local coordination structures in developing countries.

Our activities focus on the following objectives:

Educating the German public regarding the causes of blindness and the correlation between poverty and blindness, and mobilising additional resources in Germany
Involving the Federal Ministry for Economic Cooperation and Development in VISION 2020 Germany
Implementing practical projects:
1. Establishing coordination committees with the following tasks:
2. Expanding existing ophthalmic infrastructures
Empowering those concerned

I. Educating the German public regarding the causes of blindness and the correlation between poverty and blindness, and mobilising additional resources in Germany

Conditions / challenge /aims:
For a significant part of the world population, there is a direct correlation between their economic situation and the risk of losing one’s vision. Blindness is the result of poverty. Moreover, for many people, visual impairment or blindness increases the risk of social exclusion and thus leads to additional impoverishment. For this reason, blind and partially sighted people often find themselves in a vicious circle.

In Germany, little is known about the reasons for loss of sight in developing countries, and how to prevent it. Consequently, most of the population is not aware that about 80% of all loss of sight worldwide could have been avoided and that, in numerous cases, loss of sight would have been curable, with relatively few resources.

Vision 2020 Germany aims to better inform the German public about this correlation, and thus to increase its willingness to respond to appeals for donations, that will - in turn - help us achieve our goals

Action plan 1: Public Relations

- Cooperation with the “Week of Sight”
The “Week of Sight” is a nationwide campaign that takes place regularly, and deals with blindness, visual impairment and affection of the eyes. The members of the network Vision 2020 Germany are also involved with the “Week of Sight”. Due to the high media coverage that this campaign enjoys, it makes sense for Vision 2020 to link in with it.

VISION 2020 is one of the main focuses of the “Week of Sight”. It is thus a good opportunity for presenting and intensifying our actions. The organisers of events during the “Week of Sight” are invited to engage intensively with the global initiative VISION 2020. Ample information material is available for this purpose.

- The level of awareness of VISION 2020 and its goals is increased by active media activity, e.g. a radio-kit and central press event.

Action plan 2: Fundraising

The “Week of Sight” enjoys heightened media coverage. The partners in the campaign make increasing use of this potential to initiate fundraising for projects to prevent blindness, and assist blind people in the developing world.

II. Involving the Federal Ministry for Economic Cooperation and Development in VISION 2020 Germany

Aim
As a member state of the United Nations, Germany has actively committed itself to supporting the Vision 2020 campaign and to promoting the implementation of the WHO resolutions 56.26 (2003) and 59.25 (2006). The partner organisations welcome this commitment and are encouraging the Federal Government to play an active role in the network Vision 2020 Germany. The Federal Ministry for Economic Cooperation and Development has already taken up the issue of the correlation between poverty and blindness in its policy paper “Behinderung und Entwicklung” (1) (disability and development). Furthermore it would be desirable if the Federal Government stood up even more for more effective programmes to prevent the loss of sight, for blind education systems and the rehabilitation of blind people in developing countries.

Specifically, the following points appear to be important:

1. Federal Ministry for Economic Cooperation and Development budget for the prevention of blindness and blindness rehabilitation

Germany has agreed to stock up its financial expenditure for development cooperation, from presently 0.28% of GDP to 0.51% by 2010 and to 0.7% by 2015. Our goal is that at least 1% of the additionally earmarked funds is utilised for programmes for preventing blindness, as well as for projects pertaining to education and the rehabilitation of blind people.

In the face of the scandalous certainty that 80% of all losses of sight could have been avoided, we believe that the Federal Ministry for Economic Cooperation and Development should draw up its own budget to attain the goals set out in Vision 2020.

Furthermore, we call for the training of local specialists, e.g. eye surgeons, ophthalmic and rehabilitation staff, as part of development cooperation. Skilled local workers are indispensable to maintaining ophthalmic care and rehabilitation in conflict areas, since foreign specialists then frequently have to leave these areas.

A commitment in the above mentioned target areas is found in the UN Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities. Here, signatory states commit themselves to international cooperation, with each other and the relevant organisations and civil society, to realise the goals of the convention. These goals include the right to education and rehabilitation.

2. Inclusion of blindness prevention in the Millennium Development Goals (MDGs)

In their development cooperation, most states and organisations orientate themselves to the UN Millennium Declaration (2). Unfortunately, this declaration mentions neither the issue of blindness nor that of disability. However, the Millennium Development Goals (MDGs) and its sub-aims are ideally suited for this topic to be taken up, since blind people are among the most marginalised population groups. The MDGs should be spelled out in more detail and include special programmes for the healing and prevention of blindness, blind training and rehabilitation of the blind.

Blindness prevention should be used as an indicator for poverty reduction. We would like to see the Federal Government involve itself more in promoting the inclusion of blindness prevention and blind training/rehabilitation in the MDGs.

The Millennium Declaration clearly defines a total of eight goals in the social and economic field. Most of them are – directly or indirectly – of importance for blind people (3). The following examples make this clear:

MDG 1 Reduce by half the percentage of the world population suffering from extreme poverty and hunger:

Blind people are disproportionately affected by extreme poverty.
Malnutrition causes child blindness.
Thus every strategy to combat poverty must strongly emphasise the avoidance of blindness.
Blindness prevention means combating poverty, just as combating poverty helps in preventing blindness.

MDG 2 Achieve universal primary education

According to UNESCO data, only approx. 2% of children with a disability receive a school education.
When new primary schools are constructed, the particular needs of blind children have to be borne in mind.
Existing schools should be equipped with the relevant teaching material and technical aids for the blind, to support the training of blind children.

MDG 3 Promote gender equality and empower women

Blind women are frequently doubly disadvantaged: due to their status as women, as well as due to their disability.
Blind girls attend school less regularly than blind boys.
Blind girls and women frequently have access neither to vocational training measures, nor to income creating activities and small loans.

MDG 4 Reduce child mortality

50 % of blind children die before the age of 2.

MDG 5 Improve maternal health

Insufficient medical care during the pregnancy contributes toward blindness caused by the conditions of pregnancy and delivery.

MDG 6 Combat HIV/AIDS, malaria and other diseases

Young people who are blind or disabled in other ways have a higher infection rate than other young people, since they are more frequently exposed to sexual abuse.
We advocate for protective action on their behalf.

MDG 7 Ensure environmental sustainability

Clean water is an important factor in the prevention of blindness.
A third of all illnesses that frequently lead to disabilities are caused by environmental risk factors.
We would like to guarantee the provision of clean water to all people in developing countries.

MDG 8 Develop a global partnership for development

More and more governments and international organisations incorporate people with disabilities in their strategies and development cooperation programmes.
We advocate for blind people to be incorporated into strategies and programmes for development cooperation.

3. Initiation of blindness prevention in the Poverty Reduction Strategy Papers (PRSPs)

We welcome the extended HIPC Initiative (4) and the comprehensive debt cancellation decided at the G8 summit in Gleneagles. The core element of the initiative is the close connection between debt relief and the fight against poverty. By these means, heavily indebted poor countries commit themselves to using 20 percent of the saved debt servicing for projects in the area of basic services.

The PRSPs contain the programmes for reducing poverty taken by the government and involving civil society. (5) Therefore, we would like to motivate the Federal Government to promote the inclusion of targets for the prevention of blindness, training and the rehabilitation of blind people in the PRSPs. It would be appropriate if the Federal Government called for the participation of NGOs working in the area of blindness prevention and the interests of blind people in the consultation process that the respective governments conduct with civil society.

III. Implementing practical projects

Establishing coordination offices with the following tasks:

Supporting partnerships between universities, hospitals and ophthalmic practices in Germany and abroad
Supporting partnerships between blind training centres and self-advocacy organisations
Coordinating education and training in the areas of ophthalmology and rehabilitation
Coordinating assignments for German ophthalmologists

Challenge/goals:

The aim is to establish functioning partnerships between universities in Germany and abroad, as well as between blind training facilities and self-help groups in Germany, with according facilities and overseas groups.

University ophthalmic hospitals in developing countries frequently do not have a sufficient supply of necessary resources and adequately qualified personnel to start up and manage sustainable and successful education and training programmes with their own funds.

At the same time, numerous directors of German ophthalmic hospitals are not fully aware of the positive effects a partnership between themselves and a similar hospital in a developing country can have.

Time spent abroad by German ophthalmologists generally not only leads to an additional qualifications, they frequently also attract many other positive effects, such as increased soft skills and motivation, as well as an improvement in teaching skills.

Moreover, these partnerships contribute significantly towards increasing Germany’s engagement in international blindness prevention.

A couple of ophthalmic hospitals already have long-standing good experiences in exchange with universities in developing countries. The most well known are the partnerships between Munich and Nairobi, and Rostock and Kinshasa. Unfortunately, there is still no coordination centre able to bring together potential partners and harmonise the respective interests of German university hospitals with those of ophthalmic hospitals in developing countries.

A similar situation can be found with blind training facilities, such as schools and vocational training centres. Partnerships in these areas can give important stimuli for education and training programmes. Such cooperation generally contributes toward increasing problem awareness and motivation, as well as the sense of responsibility in the countries overseas. By means of cooperation between organisations and facilities, Germany can make a further contribution toward reaching the goals of Vision 2020.

Action plan
We would like to set up an exchange centre that fulfils following tasks:

Task 1: Supporting and facilitating five new partnerships between German university ophthalmic hospitals and/or other ophthalmic practices, hospitals and facilities in developing countries.

We would like to set up a coordination centre to support and facilitate university partnerships and/or other ophthalmological practices and hospitals at the office of the DOG (German ophthalmological association) in Munich. Its task would be to identify potential ophthalmic hospitals in Germany and to note their wishes and expectations. It is intended to bring the partners together and help to clearly define the roles and responsibilities between these parties. It will also function as a contact point if problems in the partnership need to be discussed.
It will liaise closely with the VISION 2020 Linkage Program UK (marcia.zondervan@lshtm.ac.uk )(6)
Its local contact person/s will be the national committees for the prevention of blindness.

Task 2: Supporting and facilitating partnerships between blind training facilities in Germany and overseas

A coordination centre for partnerships between blind training facilities will be established at the DBSV (The German Federation of the Blind and Partially Sighted. Its task will be to find examples of existing partnerships, record the expectations and wishes of blind training facilities and initiate new partnerships.

Task 3: Coordinating education training of ophthalmic personnel

The German Committee for the Prevention of Blindness is looking for sponsors of possible scholarship programmes in Germany for future ophthalmologists from developing countries
The Christian Blind Mission (CBM), in cooperation with the German Committee for Prevention of Blindness (DKVB), is looking for suitable candidates abroad.
The mediation centre ensures a smooth process and coordinates teaching services of German ophthalmologists, within the framework of university partnerships.

Task 4: Coordinating international assignments for German ophthalmologists

A coordination centre at CBM, in cooperation with the DKVB, will have the task of reconciling the queries of German ophthalmologists with the ophthalmologic needs abroad. CBM is looking for suitable projects in developing countries.

Expansion of existing ophthalmic infrastructures

Challenges/ goals
In numerous developing countries, no blindness prevention plans have been developed yet. Such planning is, however, a prerequisite for a functioning ophthalmic infrastructure and for the coordinated and effective employment of the resources raised. Moreover, only with sensible planning can it be guaranteed that all those concerned gain access to these care facilities.

Action plan 1
The creation of five practical sponsor packages, containing consumer goods and appropriate technologies for a particular Eye Care Unit. The aim is to have a targeted approach for German industry and to enlist the support of industry for financing individual projects.

Action plan 2
Creation of a priority list of technologies that have been adapted for work abroad and that are to be affordable (e.g. Neodymium YAG Laser Capsulotomy, Diode Laser for premature babies, and a vitrectomy device for the retina). This will happen in coordination with international NGOs like CBM and SSI and with the health ministry and NGOs in developing countries. In cooperation with German industry, the top three on the list are to be implemented by 2009.

Action plan 3
We are going to verify to what extent we can support developing countries in the development and realisation of national blindness prevention programmes

IV. Empowering those concerned

Challenges/goals
A group we would also like to integrate into the campaign Vision 2020 are those partially sighted and blind people who can no longer be helped medically.

We cannot simply abandon this group of blind and partially sighted people, who are particularly in developing countries. That becomes immediately clear when we consider the aforementioned reciprocal connection between poverty and loss of sight. Access to rehabilitation, education and vocational training is frequently the only way for this group to escape a life as beggars.

We thus consider it necessary that, besides programmes for the prevention and healing of blindness, additional steps be taken to bring about a sustainable and all-encompassing improvement of the life situation of blind and visually impaired people in developing countries. This can only be achieved if society and the government accept them as equal fellow citizens and active participants in society, and consider their particular needs in the planning and implementation of integration, rehabilitation and education projects.

To this end, we require strong and committed organisations for the blind and partially sighted. They can bring about the necessary change in the attitude of society, and represent the rights and interests of blind and visually impaired persons toward the government.

Together with NGOs, employers, the community and local government, these organisations will function as competent social partners in the formulation, implementation, monitoring and evaluation of the strategies aimed at combating poverty.

The facilitation and support of such basic structures are among the measures of international cooperation to which the signatories committed themselves in Article 32 of the UN Convention.

Self-advocacy organisations play a double role in this connection. On the one hand, together with other actors, they move the government of the target country toward considering the topic of blindness in the strategy toward reducing poverty; on the other hand they also implement numerous programmes strengthening the individual competence of blind and partially sighted people. Moreover, they place them in the position of recognising their rights, and fighting for them, in order to participate actively in designing their living conditions within the community. In this sense, “empowering those concerned” describes a two-pronged approach in a sustainable strategy to combat poverty: the development and strengthening of the self-advocacy organisations and the empowering of individuals in terms of rights and skills.

In numerous developing countries there is, however, a lack of strong competent self-advocacy organisations. The demand for empowering those concerned is, first, aimed at passing on basic skills and resources, in areas such as management of associations, administration, finances and fundraising. There can also be capacity-building in respect of rehabilitation programmes, evaluation methods and other training programmes laying the foundation for the effectiveness and sustainability of blind and visually impaired self-advocacy organisations.

Specific action plans

Action plan 1
The aim of the following action plans is the development of basic structures and the empowering of blind and visually impaired organisations. They are to be implemented in collaboration with the groups representing the interests of blind and partially sighted people in developing countries.

Planning and implementing training workshops for blind and partially sighted managers of organisations for the blind and visually impaired (economic and legal foundations of the organisations, personnel management, negotiation, lobbying, communication)
Developing administrative structures (information administration, independent design and creation of documents, mastery of word processing programmes, skills in data transfer, skills in spreadsheet calculation and in the implementation of databases, telephone training)
Relaying competences in the area of finance (budgeting, bookkeeping)

Action plan 2
Access of blind children to education
The inclusion of the support and facilitation of universal primary school education in development cooperation (MDG2) has led to the following forms of practical assistance which we provide, or areas in which we would like to participate:

Giving strategic support to national educational institutions focusing on inclusion.
Supporting blind children in inclusive education
Establishing schools for the blind or classes for special needs within the regular classes
Providing teaching resources and special aids for schools for the blind, and in inclusive education (7)

It needs to be stressed here that all action to improve the access of blind children to education must be in close cooperation with the competent national education ministries and in the framework of national action plans. After all, responsibility for education lies with governments. The decision on the form of education, whether in special schools or inclusive settings must be taken by the countries themselves.

Action plan 3
Mobility and daily living skills
When eyesight becomes worse, or is lost completely, even the smallest distances become a problem, since blindness and visual impairment greatly limit independent orientation and locomotion. The return to independence in domestic, professional and social areas is enabled by training in orientation and mobility. There, with the help of qualified rehabilitation teachers, blind and partially sighted persons, learn the usage of the long white cane so that they can get their bearings and move around safely. Training in daily living skills teaches blind and partially sighted special techniques in the area of living space design, personal hygiene, clothing, household, handling money, writing their own signatures and spatial orientation.

Mobility and practical everyday skills are the foundation for self-advocacy, the ability to assert one’s own interests and rights, and in this regard, empower the persons concerned. The following action plans are directed to this goal:

Developing and implementing programmes in the areas of mobility and everyday skills training (CBR and IBR programmes ) (8)
Creating and implementing programmes in the area of early intervention.
Supporting and facilitating the training of rehabilitation teachers
Allocating aid for mobility and communication, long canes, Braille typewriters, braille frames and styluses.

Action plan 4
Access to vocational training
Establishing and collaborating with institutions in the area of vocational training and rehabilitation.

Adopted by the members of VISION 2020 Germany on 21.09.07 in Berlin

(1) GTZ on behalf of the BMZ (ed.): Behinderung und Entwicklung. Ein Beitrag zur Stärkung der Belange von Menschen mit Behinderungen in der deutschen Entwicklungszusammenarbeit, November 2006. back

(2) www.un.org/millenniumgoals/ back

(3) DFID (ed.): Disability, poverty and development, February 2002
also.: Behinderung und Entwicklungszusammenarbeit e.V., Deutsches Blindenhilfswerk, Interessenvertretung Selbstbestimmt Leben in Deutschland (ed.): Entwicklung für Alle. Teilhabechancen von Menschen mit Behinderung an der weltweiten Armutsbekämpfung back

(4) HIPC stands for heavily indebted poor countries. back

(5) GTZ on behalf of the BMZ (ed.): Behinderung und Entwicklung. Ein Beitrag zur Stärkung der Belange von Menschen mit Behinderungen in der deutschen Entwicklungszusammenarbeit, November 2006. back

(6) www.iceh.org.uk/linksprogramme.asp back

(7) http://unesdoc.unesco.org/images/0014/001402/140224e.pdf
Difference between inclusion and integration :
Integration is an approach from special education aiming to integrate disabled children into regular schools but not to change the system. Inclusion involves restructuring the existing school system; its aim is to change existing curricula along with teaching and learning strategies. back

(8) CBR = community-based rehabilitation;
IBR = institution-based rehabilitation back

This page was last modified on April 15, 2008

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