World Sight Day Discussion Series 

Led by Claudia, Ravindra, Trish, Binita, and Chundak, the team hosted this year’s World Sight Day Discussion Series on October 2 and 17. Focused on integrating eye care into primary healthcare services and enhancing quality best practices, we saw record number of registrants eager to hear from our speakers: Dr. Shamiim Namwase from Lira Regional Referral Hospital, Dr. Don Baker from Sacred Circle Healthcare, Dr. Kiry Lom Orng from the National Program for Eye Health in Cambodia, Dr. Samina Zamindar from Zamindar Microsurgical Eye Centre, Dr. Evarista Mgaya from Bugando Medical Centre, and Dr. Kabindra Bajracharya from Lumbini Eye Institute. You can check them out through the links below: 

• Integrating eye care into primary health care services    

• Enhancing Quality Best Practices: Patient empowerment and safety 

Seva releases ground-breaking report on the importance of good vision for children 

Seva and IAPB released a report on World Sight Day that demonstrates why it is essential to invest in eye care for children. Just one of the astounding findings shows a 5-year-old who receives glasses in grade school and wears them has the potential to earn 78% more lifetime income than if they had never received glasses. You can read more about the report here. 

Representing Seva around the world 

In August, Njoki represented Seva at the COESCA Congress in Zimbabwe. In October, Heidi joined a convening on Assistive Technology that UNICEF organized in New York. Also in October, Jennifer and partners Minneapolis Public Schools and Tundra Health Initiative presented posters at the APHA conference in Minneapolis, MN. Njoki attended an IAPB/TCCV breakfast meeting in Nairobi to celebrate World Sight Day. 

Call for Ideas 

Jennifer launched the 2024 Native American Vision Call for Ideas addressing vision needs of Native Communities in the U.S. Seva is releasing awards up to $50,000 for programs of 1-3 years duration. Check out the flyer here. 

Vision Centers 

Also in October, Lauren launched the Vision Center Survey to partners to understand stakeholder perspectives on the impact vision centers have on a range of outcomes, including economic opportunities and quality of life for vision center staff, access to eye care especially for women and children, quality of care provided at vision centers, and community screening opportunities. 

Training & Capacity Building

During the month of August, the India Management Development Program Classroom Workshop took place over four days at Siliguri Greater Lions Eye Hospital. From September 20 – 21, HVD Pune initiated a two-day classroom training on Quality Consciousness.  

In September, Seva Nepal launched a new training initiative called “Mastering Mondays” where they focus on a specific topic each Monday as an additional resource to Nepali partners.  

The LAC Management Development Program continued through October, covering several different topics and reaching more than 50 participants.  

In October, Dr. Samina Zamindar, her team of doctors and experts from Seva including Dr. Binita, Dr. Diwa, and Arun hosted a four-day Training of Trainers - Six participants from six hospitals (SNC, Geta, Palpa, LEI, Bharatpur and TIO) from India and Nepal in Bengaluru, India. 

Guatemala Brillando 

Visualiza laid the foundation stone for the future Quiché Hospital and construction continues. This October, Kate had a chance to see the work happening on the ground as part of World Sight Day. We also launched the residency training program with three residents. They presented at the World Ophthalmology Congress about their work so far in August. 

Guatemala Brillando - How We’ll Get This Done

Nearly 75% of people who are blind in Guatemala suffer from preventable or curable causes. There are an estimated 2 million people with vision loss. Of these, 94,000 people are blind.

In partnership with Visualiza, “Guatemala Brillando” or “Brighter Guatemala” is a firstof-its-kind plan to systematically eliminate avoidable blindness throughout Guatemala. We are positioned to achieve it in just 10 years and the blueprint can be scaled across the world. Within these 10 years, Guatemala Brillando is estimated to develop 30 Vision Centers (VC) and 5 eye hospitals across the country. Today, there are 10 Vision Centers and plans to open a new hospital in the Quiché region.

New Children’s Eyecare Program in India

Providing quality refraction services on a continued basis is a challenge as it requires a dedicated team and continuous monitoring and follow-up. This project aims to focus on the need for refractive error services for children in the Drishti Sehi Duniya area of India via Vision Centres (VCs) and the base hospital. The proposed project will strengthen VCs, and teams will be based at VCs. 

On the day of examination at VCs, each child will undergo a complete eye check-up.  A prescription will be provided, and children can choose trendy frames. The delivery date will be three days from the refraction. Annual follow-up visits ensure that children requiring a new or changed prescription are covered, giving all children regular opportunities for eye checks.

Estimated Outputs

• Screening of 129,600 children

• Coverage of over 700 schools

• Orientation of 1,500+ school teachers

• Training of 3,000+ Vision Ambassadors

• Provision of 4,500 free or subsidized spectacles to children (estimated to meet the needs of

• approximately 3.5% of screened children)

• Performance of 75 surgeries

The Retinopathy of Prematurity (ROP) project employs a comprehensive approach to address the needs of premature infants in NICUs across Coochbihar, Darjeeling, and Jalpaiguri districts. Key components of the project include:

• Utilization of ROP fundus cameras and telemedicine services in level 3 and level 2 NICUs. 

• Deployment of a trained technical team. Assessment of ROP severity and determination of necessary treatments.

• Provision of laser therapy, injections, and vitrectomy treatments to infants diagnosed with severe ROP. Referral of identified cases to base hospitals for medical, surgical, and rehabilitative services.

• Training of 350 nurses and pediatricians in local NICUs on ROP identification and management protocols.Organization of quarterly Continuing Medical Education (CME) sessions for local pediatricians, neonatal care specialists, and gynecologists to enhance awareness and expertise in early ROP detection and preventive care.

Estimated Outputs

• Screen 5,800 babies for ROP

• Provide laser, injection, and vitrectomy treatment to 327 babies

• Train 350 nurses and pediatricians for ROP awareness
  

Accruals and Fiscal Year End 

We processed several agreements/payments throughout May and June and submitted our accrual sheet to the finance team. Programs worked hard to end the year strong and on budget. 

Conference Participation 

Chundak, Heidi, Heidy, Katie, Kieran, and Suzanne represented Seva at IAPB’s 2030 Insight Live event convened in Mexico City at the end of June.

Kuldeep, Arun, Saikat, and Shradha all represented Seva at the VISION202 India Conference in July. Kuldeep also represented in his capacity as treasurer for Vision 2020 India. Njoki attended the Africa Ophthalmic Congree in Kigali, Rwanda from July 26-28. 

Programs on the move 

Many team members traveled together in May. Katie, Claudia, Jennifer visited Sacred Circle in Utah. Njoki and Heidi visited KCCO in Tanzania. Heidi, Kuldeep and Ravindra traveled to Cambodia to assist with the Seva Cambodia office move in June. Parami, Rolando, and Giri also spent time in Cambodia at the end of July onboarding new staff and setting up the office. Heidi spent July with the Visualiza team in Guatemala. Njoki spent a week with current and potential partners in Malawi. Kuldeep and Shradha visited a number of partners across India.

Training

Arun launched the Eyexcel Advanced Workshop at SNC, Chitrakoot in June. The following month, he held the Management Development Program at HV Desai in Pune. He also represented Seva at the first Eyexcel Global Workshop under the Dr. Suzanne Gilbert Training Academy which was completed on July 25th. 

New Seva Cambodia office in Phnom Penh 

Seva Cambodia opened its new office in Capital City Phnom Penh. Previously, they were based in the Battambang Province. The Phnom Penh office will allow the team to better represent the work that is happening with our Ministry of Health partners. It is also more centrally located to our program work, which have expanded beyond the northwest part of the Cambodia. We are now positioned to do more networking and work closely with the government and other healthcare organizations, as well as organizations working in other sectors. This will further strengthen program capacities.   

Budget Budget Budget

From January – April, the program team spent time reviewing their work and preparing the budget for fiscal year 24-25. This year, the team incorporated budget descriptions to bring greater context as to why we are proposing these activities/projects. 

Updates from Cambodia

Seva provided replacement of cataract instruments to Battambang, Banteay Meanchey, Pursat, Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital.

Supported to have Reverse Osmosis (RO) Water System in Banteay Meanchey and Pursat eye units, Angkor Hospital for Children, and Caritas-Takeo Eye Hospital for quality improvement in eye care.

Printed and provided medical emergency posters with frames to partner eye units/hospitals (Battambang, Banteay Meanchey, Pursat and Kampot eye units, Siem Reap Regional Eye Hospital and Takeo Eye Hospital). These posters will be helpful for staff to follow the procedures in case of emergency.

Programs Operations Team met at the Seva office in June + more updates

 Seva brought the Program Ops team to Berkeley in June to meet for the first time since 2019. They focused on program planning for the coming fiscal year

Lavelle Fund for the Blind awarded Seva $1M to establish a Regional Training Center in support of Guatemala Brillando

Katie McMillan began working with Seva as the Technical Product Manager. She will take a lead role propelling our technology driver forward

IAPB organized its annual meeting in Singapore. Arun, Brad, Chundak, Jerry, and Suzanne presented Seva's work at various sessions

Seva co-sponsors International Agency for the Prevention of Blindness 2030

InSight Live Singapore

Seva had a strong presence at this in-person and virtual meeting convened during June 25 and 26 at the Singapore Eye Research Institute. In person talks were given by Seva consultant Dr. Jerry Vincent on fragile communities “From Crisis to Action” (with focus on Rohingya community) with commentary by Chundak Tenzing and Suzanne Gilbert on Technology for Access to Services (presented on the Vistaro IR retinal camera). Virtual presentations were given by Seva’s Arun Acharya and Dhivya Ramasamy to the IAPB Human Resources group and by Radhika Krishnan to the Diabetes Retinopathy working group, and by Consultant Brad Wong during a session on eye care financing. The newly formed Indigenous Peoples Special Interest Group met in Singapore with Seva’s Jennifer Leo joining virtually. The meeting was attending by 350 participants from over 40 countries.

Suzanne and Chundak note the value of getting to connect with representatives from more than a dozen Seva partner institutions while catching up in general on what is happening with WHO, Ministries of Health, and other eye care NGOs.

Updates from Nepal

This year’s target was to reach 3250 volunteers. Our partners have been successful in reaching 3605 Femal Community Health Volunteers, teachers and mothers’ groups.  This last quarter alone, partners reached 2622 volunteers. 4 Vision Centers became operational this quarter.

Updates from India on training

April: 37 Dr and AOPs (9 Women) from 10 Hospitals (India and Nepal) completed 5-day Eyexcel to help trainers train young trainees who deliver quality eye care services in underserved communities

May: 68 Dr, Admin and AOPs (25 Women) from 14 Hospitals in Nepal completed Eyexcel, Quality and Management Development workshop to deliver high-quality eye care in Seva partner hospitals

June: 35 Dr, Admin, AOPs (13 Women) from 12 Hospitals across India, Nepal and Cambodia completed the Observe-Understand-Change Workshop to improve Quality and Safety systems

Observe, Understand, and Change

Observe, Understand, and Change is a training program conducted twice a year, sponsored by Seva Foundation in partnership with Zamindar Microsurgical Eye Center, Bangalore, India. In June 2023, the third batch of participants (about 40) from three countries (India, Nepal and Cambodia) observed the standard operating procedures implemented at the center, followed by a group discussion. Participants then shared the current practices at their respective centers and presented the desired changes for improvement to maintain minimum standards for patient safety. The following video clip shows the program.

Financing 2 Eye Care Articles

Given there is limited high-quality data for global economic estimates in eye health, particularly for low-income and middle-income countries (LMICs), two years ago Seva started an initiative to bring the spotlight on the ‘cost of community and primary care in the eye health’ and ‘The economic and social costs of visual impairment and blindness’ with the aim to generate the firsthand evidence. As an outcome of these efforts led by Seva, two separate studies have been published by leading peer-reviewed journals.

- ‘The economic and social costs of visual impairment and blindness in India’ published by the Indian Journal of Ophthalmology

- ‘Strategies for cataract and uncorrected refractive error case finding in India: Costs and cost- effectiveness at scale’ published by The Lancet Regional Health - Southeast Asia – This is one of its kind study (in terms of scale and geography) to highlight the evidence on major eye health interventions championed by leading Seva partners (including Vision centers, School eye screening, eye camps, and door-to-door screening.)

Quality Workshop News

A workshop titled “Quality- Journey towards Patient Centric Care” was organized by Seva Quality Team. 34 participants representing all parts of Nepal received refresher training. These participants included Quality Champions from Seva and non-Seva partners. The workshop reviewed the existing quality initiatives, discussed the good practices, and drew a roadmap and action plans to ensure quality emphasizing on people-centered eye care in Nepal. We’re excited to have additional workshops lined up for December and January in India for hospitals across the Asia region.

Seva Foundation received 4 National Awards

Seva Foundation received 4 national awards from the Government of Cambodia, signed by the King and the Prime Minister. These Awards were conferred in recognition to Seva’s contributions in Eye-Care Services since 1999. It also recognized Seva’s special contributions in recently promulgated National Strategic Plan for Blindness Prevention and Control (NSP-BPC 2021-2030) and the Provincial Roadmap on Blindness Prevention and Control 2021-2030.

Vistaro Camera: The Camera that Saves Lives

Vistaro image quality compared favorably vs more expensive high end cameras.

Seva-Remidio team visit to Mozambique reinforced training on use of Vistaro and update on HIV and eye conditions.

Staff of YRG Care Center in Chennai were training in vision testing to enable adding visual acuity to patient monitoring.

Using evidence for program improvement

Seva published a Case Study on the Operations Research program and an article on small scale research in the Community Eye Health Journal. Three of the four Seva research teams published their project results or had their paper accepted. Conducted a survey of GSI mentors and selected other mature institutions to determine priority issues on use of routine administrative data. Seva's Introduction to Evidence Informed Practice course design & materials were completed. Strong interest by WHO and International Agency for the Prevention of Blindness in promoting the Seva course

Eyeglasses for Everyone

Seva joins Aurolab for strategic planning on affordable, quality eyeglass lenses

Aurolab inaugurated its Optical division, thus underscoring the commitment to quality, affordable eyeglasses. David Green and Suzanne Gilbert conducted a learning saloon on Opticals with the Board. Seva consultant reports are contributing to business planning and selection of manufacturing technologies. With Seva involvement, Aurolab has hired additional staff to head up Opticals sales & marketing. WHO and major global eyeglass providers are following this Opticals project with interest. 

Data, anyone? 

After two years of virtual research skill learning, Seva partners finally got to have an in-person data analysis workshop at Seva partner India Institute of Public Health - Hyderabad. The two week training built upon multiple online workshops and preparatory use of the Stata software so teams arrived ready to work. Research teams from Nepal and India are using the newfound skills to analyze results of their randomized control studies to improve service delivery. Services for kids, Vision Center patients, and people with Diabetes will be improved as a result.

Quick update on operations over the last quarter

More than 60 participants from 7 hospitals across Latin America gathered for EYExcel LA, a workshop designed for trainers to improve their training methods and results.

Through collaboration with Standard Chartered Bank, Seva and partners are establishing 65 new vision centers with partners in India. So far, 8 VCs started operating through this initiative.

As a result of our Call for Ideas, Seva began working with two new partners to bring eye care to Native Communities. The Minnesota Vision Health Task Force, created to build a comprehensive system of eye care in Minnesota, and to support and sustain capacity building for eye health within Native communities. This is a partnership of local health, education, and non-profit organizations aiming to prevent vision loss and blindness by aligning strategies that create equitable access to vision health care across Minnesota. Through a partnership with Seva, this program is focused on providing eye screenings care to Native school children within the state of Minnesota.  The Tundra Health Initiative provides access to eyecare in rural villages in western Alaska. This involves making trips, by air, to communities scattered throughout the region. During trips, vision screenings and services are provided. With support from Seva Foundation, Tundra is working in increase access to eyecare for remote communities Native communities in the areas around Nome, Alaska.

Domestic travel started up again this quarter with international travel starting up in July. We're excited to combine virtual meetings and discussions with some in-person consultations and exposure visits for staff and partners.

Vistaro Camera

Seva's Vistaro retinal camera went into high gear testing this past quarter with devices in use in Thailand, India, Ukraine (yes, Ukraine!!) and most recently, Mozambique. This second version of the camera already offers ease of focus and other functionality that improves over the original model. Remember, this device is designed for use frontline HIV workers who have never done an eye exam. Inputs from HIV clinics and eye departments inform Remidio Technology's design of version 3, to come out early 2023 for wider testing and examination data collection. Pleased to note that the large HIV center Seva is partnering with in Chennai requested eye exams for its very special patients: children who as babies contracted HIV from their mothers. Our friends at Aravind Eye Hospital, Chennai sent a team to examine 80 people including kids and their caregivers, with arrangements for follow up care at the eye hospital. For many of the children, this was their first eye exam. 

Organizational Development Training

An organizational development training program for SCEH (Dr. Shroff’s Charity Eye Hospital, New Delhi, India) was developed by Arun Acharya (Global Training Specialist, Seva Foundation) after consulting with their top management, HODs and Administrators.  

This program was needed to fill the gap in the number of skilled management personnel who could lead quality and process improvement projects. The purpose was to train their high potential employees such that SCEH becomes a Centre of Learning and Excellence in terms of high-quality patient-centered eye care. 

This initiative is part of the GSI as a global platform initiative and fuels one of Seva’s core drivers I.e., “Training and Job creation” 

“What is the Quality of the Surgery Being Performed?”

Seva’s Response to COVID-19, SOP Starter Kit

The COVID-19 SOP Starter Kit was developed by dedicated Nepali medical and paramedical personnel under the leadership of Dr. Samina Zamindar. This Starter Kit focused on outpatient care at the beginning of COVID-19, providing the eye hospitals with the groundwork in COVID preparedness, so our partner hospitals could easily adapt these SOPs into their own hospital operations. As the authors’ hospitals test and further refine these SOPs based on real-life applications, Seva will update and republish them accordingly.

Safety and Quality

The agreement with Medical Council members have been signed and finalized. Some of the members have started the mini grant project activities. Interested team members from N. India have been registered to participate at Dr. Zamindar eye center, Bangalore, in two days of Quality related workshop followed by three days of observation as per the requirement of the attending trainee.

Three Bucket System — Community Eye Health Journal

The article from The Community Eye Health Journal is supported by the Conrad Hilton Foundation, Sightsavers, CBM, Orbis, The Fred Hollows Foundation, Tijssen Foundation, Seva Foundation, BHVI and the International Trachoma Initiative.

The Community Eye Health Journal (international edition) is a quarterly publication sent free to over 22,000 health care providers worldwide, mainly in low and middle-income countries. The aim of the journal is to ensure that up‐to‐date and relevant information reaches eye care workers of all levels in the countries where the burden of eye disease and blindness is greatest. Journal readers often have little access to other sources of information. Our peer-reviewed articles are written by experts in the field and combine clinical issues with public health approaches, such as research, planning, management, training, technology, sustainability and advocacy.

All Call Thursday’s But Monday Workflows

Each week I sponsor what is called the ALL CALL. Recently, the Program team shared their new information management platform with the rest of the Seva team. If you want a 'peek' behind our management cupboard enjoy this insight into a portion of our weekly ALL CALL session!

Africa Landscape Analysis

Seva has been working in Africa since 2001. We started first in Tanzania through our partnership with KCCO in 2001. As we consider the vast eye care needs in the region, we recognized that there was more work than one partner alone could achieve. When we began working in India, we worked with Aravind. But in order to have the intended impact we needed to have to achieve our mission, we built our network of committed partners. Now we are fortunate to work with a diverse network of more than 50 partner clinics in India. That approach has happened in all of the regions we work in.

Given the vast needs across the continent and to achieve our mission, we want to build upon the work that is already happening. We are starting with people and partners we know as we look to diversify. At this time, we are not looking to expand into new countries but rather leverage and deepen our commitment in countries where we are already working, specifically those in eastern Africa. Allowing us to strengthen our overall investment. We are focusing on locally-led, clinical health providers.

Specifically we:

• Added a new partner hospital in Tanzania last year supported by Kilimanjaro Centre for Community Ophthalmology (KCCO) and in coordination with the Ministry of Health

• Decided to sunset our work in Benin by end of 2023

• Are finalizing a new two-year agreement with KCCO

• Began working with Centre Tertiaire de Sante Oculaire De L'enfantin Burundi, the local organization that Dr. Levy established

Beyond these initial steps, our work has been in stasis as we prioritized staffing for the Implementation team (successfully recruited three positions, including one new position to manage our work in Latin America) and are focused on realizing our bold solution for the Latin American region. We also decided not to make new major investments in the African region while travel and in-person consultations have been stopped or limited due to the ongoing COVID-19 pandemic.

During the coming fiscal year, Seva is positioned to refocus on this region. The Africa Landscape analysis Seva commissioned last year, will be used as a reference for undertaking this work.

IAPB’s Eye Health Hero and Future Leader, Kuldeep Singh!

Introduced at the 9th General Assembly in 2012, the Eye Health Hero program is a recognition of front-line staff whose work in the field and engagement in the community makes a real difference in aiding vision and restoring sight all around the globe.

Each hero is named by an IAPB member organization or their partners to recognize those exemplary workers whose efforts are seldom in the limelight. They are the change-makers, innovators, and emerging leaders from all areas and backgrounds in eye health. Eye Health Heroes are managers, community workers, health professionals, or government officials, those working in clinical, hospital, research, INGO/NGO, business, and public policy settings their efforts and stories deserve to be shared.

Spotlight on Training!

Seva staff celebrated the final ceremony for an Organization Development Program for Dr. Shroff's Charity Eye Hospital, Delhi in January 2022. Purpose: To build in house workforce capabilities in Eye Care Management focussing on 5 key themes that are aligned to SCEH Values:

1. Effective Interpersonal Communication Skills

2. Quality Consciousness (Customer-Focus)

3. Planning and Prioritizing, Organizing Skills

4. Implementation, Initiatives, and Challenges

5. Analytical Skills

The end outcome was to upskill participants as future master practitioners and trainers and thus build the SCEH workforce in delivering High-Quality Eye Care.

Participants: 18 senior eye care workers (2 Females, 16 Males); (Optoms, Nurse, Administrators, Eye Bank Manager, Quality Lead, Stores in charge, Finance Managers, HR, Outreach program manager, etc.). Also, indirectly their department heads (Clinicians, GMs, Assoc. Director, Optometry, and Exec Director) were involved in SMART goal settings, Feedback, and project planning and delivery.

Duration: ~18 months (Planned for 12 months - delays due to covid). 2-4 hours per week, ~150 professional development hours per participant.

Methodology: A blended online workshop that included

1. Social learning - Peer to peer in small groups

2. Didactic learning - Instructor-led training by Arun Acharya

3. Project-based learning - by solving real-world problems using SMART goals.

Outcome: An Executive Summary Report will follow in Feb 2022 (watch this space!) In the interim, I am elated to inform you that this program has led to the creation of a series of training assets (Slides, Videos, Action Learning Projects, and Mind Maps) that will form the foundation of a competency framework for future eye care workforce development across Seva GSI Partner Network

Arun Kumar Acharya

Global Training Specialist | Seva Foundation

April 2022

Seva Wins Kristof’s Holiday Impact Grand Prize!

“It feels miraculous to watch people regain their sight, but it's a miracle that we can all make happen. Seva Foundation, the Grand Prize Winner of this year’s Holiday Impact Prize, is transforming people’s lives for as little as $50 per cataract surgery. Seva works in more than 20 countries abroad and in Native American communities in the United States, and nothing is more joyous than seeing the impact of its work on people who had thought they would never see again.”

— Nicholas Kristof

The Life You Can Save - The Votes are In!

Renowned philanthropist Peter Singer gave away $100,000 to three of The Life You Can Save's recommended charities based on a public vote and after thousands of votes were cast, we are pleased to announce Seva was one of the three charities that received the most votes: Here are all the recipients.

1. Fistula Foundation, a global leader in treating obstetric fistula — a devastating childbirth injury that leaves women incontinent, humiliated and often shunned by their communities — received the most votes and will receive US$50,000.

2. The Seva Foundation, a global nonprofit eye care organization that transforms lives and strengthens communities by restoring sight and preventing blindness, came second and will receive US$30,000.

3. GiveDirectly — a nonprofit that provides unconditional cash transfers using cell phone technology to some of the world’s poorest people, as well as refugees, urban youth and disaster victims — was third and will receive US$20,000.

April 2022

Seva Foundation Vision Report - Part I of a four-part report

Seva is committed to ending avoidable blindness in our lifetime. This is the first of several reports that take a deep dive into the economic burden of blindness and its negative impact on one of the world’s largest economies. By the end of 2021, we will release the solutions - what will it cost to provide the bold solutions required to secure sight for all.

Seva Foundation Launches our Global Medical Director’s Council

Like most industries the field of ophthalmology is rapidly changing with new surgical techniques and technology (e.g telemedicine and AI), Seva has assembled the best local practicing ophthalmologists and optometrists in our newly minted Medical Director’s council. Meeting four times a  year to assist Seva Foundation Senior Program Staff as we evaluate our efforts, and prepare for the budgets to come.

What & Who:  An elite invitation-only, membership extended to practicing Ophthalmologists, Optometrists, and the newly minted Seva Foundation Global Fellow (read more on this below!) will give advice and support to the Seva Foundation program and leadership team.  

The council has members from every region and will report to the Seva Foundation Global Medical Director - Dr. Chundak Tenzing and the Executive Director.  Senior Program staff has access to this council for purposes of evaluating new directions, innovations, and otherwise novel interventions in communities where Seva Foundation GSI networks have programming.

February 2021

Budget Update: AIDS Camera that Saves Lives

In June 2020 the board of trustees approved a $300,000 budget to explore the supporting Seva Foundation’s AIDS Eye Initiative with a camera that could help detect CMV-retinitis as well as TB.

Why examine the eye to find CMV & TB?

Seva’s 30 AIDS EYE INITIATIVE workshops in 8 countries have revealed the importance of examining the eye.  AIDS-related CMV retinitis is a common clinical problem in patients with advanced HIV/AIDS in resource-limited settings, which includes most HIV/AIDS clinics in Asia, sub-Saharan Africa, and Eastern Europe. The disease causes >90% of AIDS-related blindness and contributes to mortality. In most settings, the disease is neglected, with delayed diagnosis and poor outcomes because diagnostic capacity is inadequate; timely access to specialty care (ophthalmologist) is typically not available. The solution is transfer of skills to the point of care, to the HIV clinician.  This strategy increases detection of CMV retinitis approximately tenfold; diagnosis is achieved within days of first entering medical care, permitting early treatment and better outcomes. Importantly, this same eye examination can detect TB in the eye, thus permitting early immediate treatment.  

Why is a camera needed?

A fundus camera looks at the back of the eye  (similar to looking at the inside of a ball) through a small hole (the eye pupil). Most fundus cameras have narrow vision and can only see the central part of the back of the eye. That view is all that is needed for macular degeneration, diabetic retinopathy, and glaucoma. However, signs of CMV and TB appear well away from the center.  A fundus camera that can see them is a much greater technical challenge.  It is this wide field of vision that our AIDS program requires.

In July 2020, Seva engaged two innovative for-profit organizations to address this challenge.

February 2021

Update on Seva HIV/AIDS Camera Development with Remidio.com

Remidio is an  Indian-based award-winning for-profit with a proven track record of adapting expensive medical equipment, including fundus cameras, at an affordable price and publishing results in the toe-to-toe comparisons with Zeiss and other high-end fundus cameras.  In keeping with the specifications from Seva, the Remidio HIV camera would require that the patient’s eyes be dilated. Remidio did its own proof of concept engineering and shared sample fundus images before agreeing to the project with Seva. Since then, the Remidio camera has completed its Alpha prototype phase and is into Beta prototype validation in HIV settings.

February 2021

Nanotechnology isn’t just for the science fiction books - Seva Foundation partnership with Professor Kannan.

Nanotechnology-based drugs can provide an essential platform for sustaining, releasing, and a specific targeting design to treat retinal diseases

Presentation: “Targeted systemic nanomedicines for age-related macular degeneration, diabetic retinopathy and beyond - from basic science towards clinical translation” -- Prof Kannan

In the Fall Seva Sr. Director for Research, Suzanne Gilbert along with David Green and Kate Moynihan set up a special presentation with the renowned Professor Kannan to further explore the benefits of Seva joining in exploration along with Ashvattha and Aurolab. 

As you listen to the link provided, enjoy the areas where we feel Seva inputs can effectively and radically improve access to otherwise unattainable therapies. Note to board readers, Seva investment/risk would be made only when the product is found to be viable.

What makes this so extraordinary?  Below are excerpts from David Green’s Oct 20 email which highlighted the extent to which Ashvattha is on a promising trajectory, however without Seva intervention and the Aurolab tie in they would not have a way to serve the LMIC market: 

1) Ashvattha via their animal studies has already accomplished a very robust proof of concept for a treatment that will be groundbreaking and state-of-the-art when it hits the market.  It will not only be a subcutaneous injection by the patient in their home, but it will be more effective than any other treatment for DR and AMD on the market today. 

2) It’s a great opportunity for Seva to be in on it from the start and to help formulate how a company can, from its inception,  have a bifurcated approach to the market where it is able to price the product affordably via a virtuous network for the developing world. 

3)  I’ve been working with Kannan and Sujatha to help them make the case to their team, board, and shareholders on an approach to address needs in the developing world in ways that do not jeopardize but enhance the company's overall financial position.   In the process of those discussions, I have shared with Kannan a lot about how we have developed both manufacturing and service delivery models that address needs for lower-income populations.   

4) I am working with Kannan and the Aurolab folks to preliminarily define development steps, regulatory pathway, and timing; and how Aurolab, Aravind, and other Indian partners can be of assistance for clinical trials, product launch, and training. 

Enjoy the presentation (click on the bottom left image) at your convenience - for the board only do not forward or share outside the Seva Foundation.  

February 2021

Fellowship in Global Ophthalmology

The Fellowship in Global Ophthalmology, a collaboration of CPMC Department of Ophthalmology, Pacific Vision Eye Institute, Seva Foundation in conjunction with Aravind Eye Care System.

The Opportunity: A “pilot Fellowship”, with an excellent candidate already identified to run, 1 April 2021 – 1 July 2022 

What is the Fellowship in Global Ophthalmology? Over the past 3 decades, there has been a steadily increasing interest in Global Ophthalmology. Five academic departments of Ophthalmology in the USA (Wills, Salt Lake City / Moran Eye Institute, Stanford, Emory, Chicago), have already established Global Ophthalmology Fellowships, which are primarily aimed at additional grooming for an academic career. Seva and PVF have participated in several planning sessions with directors of the other Fellowship programs and formative discussions with AAO and the Association of University Professors of Ophthalmology. Our Fellowship is similarly designed to take an individual who has already been fully trained in Ophthalmology as practiced in the United States. This will be a doctor who intends to spend a substantial part of their career working to prevent blindness in resource-limited settings. 

Our Fellowship will provide experience and granular understanding of how ophthalmology cares (or fails to care) for the world’s 3 billion people with the least economic, social, and political resources. The trainee will learn what innovative techniques have already come forward and what is needed; what bottlenecks are most problematic, and what social, medical, and political issues need to be understood and/or overcome. 

Why is this Fellowship unique? This is the first and only Fellowship in Global Ophthalmology to have the advancement of Humanitarian goals as the specific training priority. In the field of medicine we tend to assume that among medical activities in resource-limited settings, Academic work and Humanitarian work are the same things. In fact, they are complementary. Yet, the humanitarian community eye health is rarely an explicit focus. Academic work directly improves our body of knowledge. Humanitarian work directly improves a person’s life. 

What is the goal of this Fellowship? This Fellowship is designed to develop leaders in Global Ophthalmology who will give an insistent voice to Humanitarian priorities. What resources make this Fellowship unique and positioned to succeed? The Fellowship will succeed because of the people who are involved and will provide leadership; the personal relationships that have been developed over the past 40 years with the most vibrant and innovative eye hospitals worldwide; the extensive partnerships that have been developed with major Eye Care NGOs (Non-governmental organizations); the academic strengths of the department of Ophthalmology at CPMC and substantial legacy and global partner network of the Seva Foundation; and finally, the close working relationships with the leading humanitarian international institutions concerned with the prevention of blindness (World Health Organization, International Agency for the Prevention of Blindness).

February 2021

Seva's Key Impact Measurement Dashboard—Is Finally Here!

You can find access to the dashboard at the top navigation of the ED Blog. Please join me in a walkthrough of the dashboard before our budget meeting. There are two times to accommodate Board members from Boston to Madurai. Pencil me in on May 10, at 7:00 AM or a second virtual tour at 7:30 PM for those of you outside a USA zip code.

Click here for the 7 AM morning session.

Click here for the 7:30 PM evening session.

COVID-19 “Grab ‘n’ Go Reading List”

What’s the staff reading to keep on top of the shifting advice about this virus, you might ask? These are some of our top picks. During my weekly Program meeting, we update this listing and plan to have a curated list of must-read links available to our partners and staff on our website.  For now, here are a few of my favorites:

Bipartisan US Public Health leaders open letter to Congress

Dr. Larry Brilliant is the third signatory of the 15 leaders!! Step by step detail on what the US Govt needs to do.

Aravind DIY hand sanitizer dispenser step by step video.

Using PVC pipe and solvent, any hospital can create a safe hand sanitizer station. No wiring, no water, no fuss. It can be placed anywhere. What innovation!

Thank Goodness for LARRY LARRY LARRY!

He's terrific, and we like to brag to anyone who will listen, he is our founder!

Our very own founder and resident pandemic specialist is now the nation's go-to person for COVID-19. I've collected some of his most exciting and riveting interviews of late, enjoy! 

TIME interview with Dr. Larry Brilliant - Taped April 23, 2020. This segment immediately followed the TIME interview with Dr. Anthony Fauci.

Larry's convo with Chris Anderson - Taped April 24, 2020. Shared by me to the board via email on the same day. This is a 15 minute conversation with TED curator Chris Anderson on 15 years since Larry's TED Prize to end pandemics & NOW. 

Speaking of Just Now, this morning Larry agreed to do a second Covid-19 update with our partners hold June 12, 2020 @ 9:00 AM and look for more information by the end of May

Seva, IAPB, ICO and WHO

What We’re Up To…

Thanks to Suzanne's longevity in the field, we are front and center in many multilateral and bilateral organizations.

Seva on the emerging International Agency for the Prevention of Blindness (IAPB) Sector COVID workgroup: Seva’s discussion with the CEO of IAPB was on May 5, 2020.

The World Congress of Ophthalmology, organized by the International Council of Ophthalmology (ICO): Seva has been invited to convene on the Late-Breaking COVID update flash session during the last week of June. PAID CONFERENCE

Seva is positioned to launch the World Health Organizations (WHO) World Report on Vision in the US (July 15 at 9 AM to 12 PM, EST in DC or virtual) and Canada (June 26 at 11 AM virtual). This session is hosted by IAPB, North America Region, of which Suzanne is Chairperson. EVENT UPDATE TO COME

National Institutes of Health, National Eye Institute - Seva liaison re: COVID and eye response priorities within the US.

Update on Affordable Avastin

Those reading this will recall, 422 million individuals are affected by diabetes globally. 75% of these individuals live in Low and Middle-Income Countries (LMICs), which face significant challenges in diagnosis and treatment. By 2040, it is expected that 642 million will suffer from diabetes, threatening the vision of more than 70 million worldwide. India faces the greatest burden of this growing global threat. Avastin drug therapy can require nine injections per patient. In the US, the cost runs $2,200 per injection. Thanks to the approved budget from last year, Seva is helping to make Avastin affordable. 

The GOOD NEWS is that Seva is on target with the Feasibility plan from the Spring of 2019.

Our efforts and work with David Green and representatives from AuroLab have identified a source and vetted 20 companies to identify an optimal match with Seva's social mission and AuroLab's production capacity. 

So, what is ahead? We will seek regulatory approval for the safety of the drug with Indian regulatory authorities as well as in selected countries such as Guatemala. Additionally, we are getting the ecosystem to scale Avastin use. How? Today, Avastin is administered by ophthalmologist specialists. Seva, under Suzanne's leadership, is studying validated methods and approval processes for injection of Avastin by general ophthalmologists and well-trained allied ophthalmic personnel. We are studying the number of injections needed at different stages of Diabetic Retinopathy and other factors that will enable or prevent scaling of affordable Avastin in the communities we serve. If you are new to the board, scroll down to read Dr. Dick Litwin's message in my earlier blog from September.

Suzanne’s Answers to My Call to Action:

How Can We Build Seva Staff and Partner Research Capacity?

Capacity is a strategic focus for Seva. Together with Ken Basset from Seva Canada, Suzanne's work this past year has focused on partners in Nepal, India, and Cambodia with training and coaching from expert public health research faculty of the Indian Institute of Public Health – Hyderabad (IIPHH). This innovative 15-month program is the first Seva project specifically designed to build Seva staff and partner internal capacity to conduct practical inquiries into how to improve program decision making and impact. 

To date, four eye hospital teams plus three additional Seva partners are creating intervention studies to improve program performance on successful patient referrals from Vision Centers to referral eye hospitals. This includes follow up with children who require multiple hospital visits; follow up treatment of patients with Diabetic Retinopathy; strategies to increase vision center utilization and sustainability; and mechanisms to improve the effectiveness of community outreach, among others.

How's it going? All participating Seva teams are rapidly gaining skills and understandings in how to plan and conduct practical, systematic research. COVID impact -- This program is underway with activities redesigned to fit COVID lockdown realities. Seva staff, partners, and IIPHH Faculty guides continue to work via ZOOM with an emphasis now on producing robust research protocols for implementation when conditions permit. For the future success of Seva's research function – a cyber “hats off” to Suzanne for finding creative solutions to keep the work moving forward during this turbulent time.

Infectious Disease and Quality Controls - In a Time of Covid-19

Dr. Chundak has worked with me for the past 12 months to transition into the World Wide Medical Director. As part of this work, and before the virus was a world-wide pandemic - we had organized our first pilot training for Quality Champions in Nepal. Led by the extraordinary Dr. Samina Zamindar who finished the in-person portion of her quality training program and throughout the Covid-19 crisis has sponsored the weekly zoom sessions with the pilot cadre of trainees.  Dr. Marty Spencer is an active advisor and participant as well.  By the end of May, we anticipate publishing a "Starter-kit" SOP that we will distribute to partner hospitals and translate into Spanish for distribution to Latin America. I've asked Dr. Chundak and Dr. Samina to pen the forward to this workbook and starter kit.

Additionally and as part of the Quality Controls workshop Dr. Zamindar is leading with Nepal hospitals, the Seva staff launched a poster competition to communicate best practices around COVID preparedness on the following topics:

1. Hand Washing

2. Social Distancing

3. Wearing masks

4. Do not touch

5. Be mindful

A copy of the winning poster, as well as the starter kit SOP, will be distributed to the board when we distribute it to our partners.

Native Communities

September was a month of Native Community outreach and learning opportunities. John Plowright, who expressed interest from earlier blog invitations to join us in Alaska was unable to attend the Alaska-specific due to work-related reasons. We were able to invite him to join the NIHB (National Indian Health Bureau) conference in southern California. Thank you to Yvette Joseph who spoke with John in advance to further ready him for this learning experience.

Three Seva representatives — Ali Prince, our Native Community Program lead, Dr. Marvel our consultant and I had the opportunity to travel to Alaska.

The principle purpose for the Alaska trip was to meet and learn from our new partner Southcentral Foundation (SCF). Enjoy reading more about what we witnessed first-hand the Nuka System of Care Simply put, this remarkable organization reformed health care delivery to improve outcomes and reduce costs.

Southcentral Foundation (SCF) is an Alaska Native-owned, nonprofit health care organization serving nearly 65,000 Alaska Native and American Indian people living in Anchorage, Matanuska-Susitna Borough and 55 rural villages in the Anchorage Service Unit.

Click Here to learn more about the Alaska Native Health System and who SCF serves.

We were a busy delegation we also met with the Alaska Native Tribal Health Consortium (ANTHC): recognized as the largest, most comprehensive tribal health consortium in the US and the specific program departments of Alaska Dental Therapy Educational Program, The Alaska Community Health Aide Program, and AFHCAN Telemedicine Cart/Telehealth

Enjoy these links. As this work takes shape across Native Communities in the USA I’ll share more on Seva’s efforts.

The Americas

Leverage versus a lifeboat - that is the question Mr. Nagarajan asked me when I first came to Seva. Would we see the significant gift from Jerry Jones as a lifeboat or leverage to bigger things? The board is supportive of the staff exploring ways to leverage the good work of the Foundation and our talented partners. In doing so one area that quickly came to mind is the Americas. Seva has innovative and hard-working partnerships across Central and South America in addition to our expanded work with Native Communities here in the US. To help better tell our collective story we have developed the first-ever regional landing page. Click here to see the first edition of The Americas Page.

While focused on Guatemala for now, we envision by June 2020 to have a spotlight to our work in Mexico, Paraguay, Peru, Alaska, Wisconsin, Oklahoma, and New Mexico. For details on our expanded work with Native Communities see the blog entry (below) entitled Seva's Call for Ideas.

TOMS

A significant milestone reached and what this means for the people we serve.

Seva and TOMS first partnered in 2011 to launch TOMS One for One Sight Giving Program providing more than 400,000 eye care services throughout this partnership. In July 2016, TOMS and Seva built on lessons learned and introduced a more sustainable approach to the One for One Sight Giving Program. Our pivot — direct investment in Primary Eye Care Vision Centers. In June 2019 TOMS’ first investment in Primary Eye Care Vision Centers completed. Through Seva’s Gloval Sight Initiative partnerst we completed 22 PECVCs that provided more than 100,000 services. This month, we are starting our 10th funding cycle with TOMS and will establish 15 new primary eye care vision centers in the year ahead.

AIDS Camera and IOptix Technologies

A bold new partnership to take Seva's big idea to the next level.

Seva is exploring a partnership with Daniel Friedman a newly minted PhD in Biomechanical & Biomedical Engineer and Mike D'Ambrosio a PhD in Biochemical & Molecular Biology. David Heiden and long-time Seva colleague Rod Watkins (who cracked the code on low cost high quality ophthalmic imaging years ago) gave this Berkeley-lab team the specs for the AIDS Camera. Daniel and Mike have visited Seva and met with Kate and Suzanne. Early explorations look promising in terms of this team being the right fit for the project in terms of expertise and passion.

“Think Bigger, See Smaller”

The Berkeley team is in the process of creating “IOptix Technologies” with the tag line “Think Bigger, See Smaller.” Their aim is to design and build medical devices targeted to low resource areas. Their forte is non/minimally invasive automatic diagnostic devices for tropical diseases including TB. In fact, the Gates Foundation just granted the talented duo $2MM to scale and field test a handheld gizmo which screens blood for a parasite, giving on the spot results. The next few weeks will be pivotal in framing the project plan and ensuring that this is a fit for IOptix and Seva. It's looking good. And if all goes well, we anticipate a learning “break out session” at the Synergy Learning day prior to the fall board meeting.