Poverty, Visual Impairments and Gift of Sight

Written by : Esther

Written by : Zaty

Poverty in Sabah.

Malaysia is a country blessed with a distinct population residing in the 11 states in Peninsular Malaysia, three federal territories and the Borneo states, Sabah and Sarawak (that are separated from the Peninsular by the South China Sea). Sabah is known as a state comprised of various linguistically distinctive groups. The indigenous people of Sabah, also known as Sabahans, are located mostly in rural and remote settlements where they self-sufficiently live off the land and natural resources. Despite the fact that Sabah is rich in oil, it is recorded that Sabah has the highest poverty rate in Malaysia at 19.5% in a study involving 99,869 households based on the 2019 Poverty Line Income (PGK) calculation methodology 1. The top five districts in Sabah with the highest poverty percentages are Tongod, Pitas, Kota Marudu, Beluran and Telupid with 56.6%, 53.6%, 46.1%, 45.0% and 40.7% respectively. These figures generated by the national statistics department are distressing, as poverty unquestionably leads to the hindrance of children in accessing their right to education. The United Nations Convention on the Rights of the Child (UNRC) affirmed that children have their own rights which are a right to health including treatment of illness and rehabilitation, a right to education and a right to an adequate standard of living2. Poverty affects the realization of these rights. 

Poverty and its connection to the advancement of visual impairment.

According to figures furnished by the World Health Organization (2019), there are at least 1 billion people with unaddressed or preventable visual impairment, of which 80 million people were from South East Asia, East Asia and Oceania alone. This incidence is highly affected by the region as well as income level, of which the predominance is estimated to be four times higher in low- and middle-income regions than in high-income regions. Based on a population study involving children of varying socioeconomic standings, children in lower socio-economic quintiles and from households in poverty are less likely to have eyeglasses4. This can be justified by the fact that rural populations face vast impediments to access to eye care including further distances to travel and poor quality of roads 5. Therefore, it is important to acknowledge and implement cost-effective interventions such as health promotion, prevention, and treatment to reduce the ample personal and societal burden correlated with vision impairment and blindness.

Disability and Education.

Disability implies restrictions, limitations, and impairments3. It is estimated that 2.2 billion people of all ages may have vision impairment, worldwide. Of all disabilities, the most typical for children is the visual impairment. The World Report on Vision classifies seven common eye conditions that can cause vision impairment as refractive errors, specifically, myopia is noted to be most prevalent in children3. Refractive errors are conditions where light is not able to focus on the retina due to an abnormal shape or length of the eyeball, subsequently causing blurred vision. In the same report, it is stated that there are several types of refractive error, yet the most usually referred to are myopia and presbyopia.

So, what exactly myopia is and its association to children?

Myopia or also known as near-sightedness, is a condition where individuals with this impairment experience difficulty in seeing faraway objects. In a classroom setting, children with myopia would struggle i.e. blurred vision, to see distant objects such as the classroom blackboard. To make it worse, rapid development of myopia would also be precipitated by poor lighting in classrooms as well as extreme durations of close-range visual exertion such as reading6. A study suggested that globally there are around 312 million children who suffer from myopia7. Generally, it is mostly diagnosed in children between eight to twelve years old, nevertheless, it may affect them as early as six years old, and this condition may progress in teenage years if not treated at an early stage. Fortunately, 92 percent of visual impairment cases which are caused by uncorrected refractive errors can be corrected by a pair of eyeglasses3.

Myopia and Gift of Sight Junior Project.

Gift of Sight Junior was seeded when a Charismen on Anak Malaysia (previously known as Project Teringai-Temunda) noticed that one of her students had a short attention span and often had to sit next to her to get a clear view of what was written on her board. That is when she realised that the student had myopia and she believed that something needed to be done in order to address the issue, as there might be other kids that experience the same disabilities. Besides inattentiveness, myopia may eventually affect the child’s daily progress in the classroom which if not corrected, might be a major contributing factor to illiteracy in rural parts of the country4. Therefore, Gift of Sight Junior aims to further explore the issue with the intention to alleviate it by providing the most appropriate and feasible care. With vision corrected at an early age, we believe that the students can be empowered to pursue their academic interests without visual constraints.

References:

1. Geraldine, A. Sabah ranks as Malaysia’s poorest state, again. New Straits Time (2020).

2. Minto, H. & Ho, M. School Eye Health. Community Eye Heal. J. 30, 21–25 (2017).

3. WHO. World Report on Vision. World health Organization vol. 214 (2019).

4. Wodon, Q., Male, C., Nayihaouba, A. & Smith, E. Looking Ahead : Visual Impairment and School Eye Health Programs. Price Exclusion Disabil. Educ. Notes Ser. (2019).

5. Hariharan, L. et al. Reducing Blindness from Retinopathy of Prematurity (ROP) in Argentina Through  Collaboration, Advocacy and Policy Implementation. Health Policy Plan. 33, 654–665 (2018).

6. Dolgin, E. The Myopia Boom. Nature 519, 276–278 (2015).

7. Rudnicka, A. R. et al. Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention. Br. J. Ophthalmol. 100, 882–890 (2016).

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