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The idea of starting community eye care in NWFP, Pakistan,
was conceived in August 1987 in the holy city of Makkah,
Saudi Arabia when Professor Dr. Mohammad Daud Khan and Dr.
Mohammad Aman Kahn were both there to perform Hajj. In
1988 Dr. Mohammad Aman Khan received training in Community
Eye Health at the International Centre for Eye Health (ICEH)
London with the support of Sight Savers International (SSI),
UK. On his return to Pakistan, Dr. Mohammad Aman
immediately became involved in the first major community
eye care assignment; a population-based survey to
determine the prevalence, causes and regained distribution
of blindness in NWFP and the Federally Administered Tribal
Areas (FATA), Pakistan. The survey was sponsored by the
World Health Organization as part of its Pakistan
Prevention of Blindness Programme.
Dr. Aman’s next assignment was the establishment of a
small Centre for Community Eye Health at the Department of
Ophthalmology, Post Graduate Medical Institute, Lady
reading Hospital, Peshawar.
This centre was established
with the financial assistance of SSI in collaboration with
the Health Department of Govt. of NWFP. In addition to
offering training to doctors and paramedics, it actively
contributed to the preparation of the Pakistan National
Eye Care Programme for the prevention of blindness.
The main thrust of this programme was:
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Strengthening the eye departments of District
Headquarter and Agency Headquarter Hospitals.
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Extending
eye care to Tehsil Headquarter (THQ) hospitals
or to sub-district level for a defined population
of 200,000 to 250,000 people. |
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Initiating
and integrating Primary Eye Care into Primary Health
Care. |
The centre for Community Ophthalmology at Lady Reading
Hospital carried out a basic research to identify
the obstacles in providing eye care at district level.
A concept was developed and tested in a teaching hospital
providing infrastructure, appropriate human resources
and necessary instruments/equipment in a small operation
theatre. The number of surgeries increased to 1200
per year.This concept of strengthening an eye department
in a District Headquarter hospital as an integral
part of District Health Care was piloted in District
Bannu in 1994-95. The partners were Pakistan Institute
of Community Ophthalmology (PICO), Health Department
Govt. of NWFP and SSI, UK.
SSI evaluated this District Comprehensive Eye Care
programme in 1997 (Link to this evaluation report). The
evaluation report was positive and evaluation team
recommended the replication of this programme in other
districts country.
The centre started a one year training programme for
ophthalmic technicians in 1993, with the financial and
technical assistance of SSI and Christoffel Blindenmission
(CBM), Germany. The initial focus was retraining of
leprosy technicians in NWFP and re-designating them as
Leprosy Ophthalmic Technicians.The centre then began
examining ways of strengthening the concept of Community
ophthalmology, both within Pakistan and within the wider
region.In the meantime a number of recommendations came
out from the World Health Organization, EM region, the
World Health Organization headquarters in Geneva and
International Agency for the Prevention of Blindness
(Eastern Mediterranean Region) regarding the establishment
of a higher-level qualification in Community Ophthalmology
in this region.
The PICO was thus established with a mandate to start a
one year long course in Community Ophthalmology with MSc
from University of Peshawar. This was done with the help
of SSI and CBM, and in collaboration with the Health
Department, Government of North West Frontier Province,
Pakistan and International Centre for Eye Health,
Institute of Ophthalmology, London, United Kingdom.The
Institute has a local, national and international faculty
and with a well- designed curriculum and well-defined
learning objectives. It is engaged in the following
activities.
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Main Objectives of PICO |
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To train eye doctors as Community Ophthalmologists
in order to enable them to plain, implement, monitor
and evaluate comprehensive eye care services /
programmes at global, national, provincial and
district levels.
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To train Mid Level Eye Care Personnel (MLECP)
to assist the ophthalmologist at tertiary,
secondary and primary eye care levels in order
to improve the quantity and quality of eye
care services (detection, treatment and Referral,
management including rehabilitation).
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To conduct operational and epidemiological
research to improve the eye care services.
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To enhance the managerial skills of eye care
teams at different levels to optimally utilize
the available resources especially in eye
care.
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To plan programs for the training of general
doctors and general paramedics in primary
eye care so that they can deliver eye care
as part of Primary Health Care at community
and household levels.
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Advocacy with governmental and non governmental
organizations / agencies to make policies
so that eye care services are made available
and utilized by more than 90% of the population.
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Prof.
Muhammad Daud Khan
Director
General, PICO

Dr.
Muhammad Aman Khan
Executive
Director, PICO
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