¡VERAS!
VOSH International partners with
UNESCO Chair in Visual Health and Development Project dedicated to visual health for Central American school children

The name of this exciting project is: ¡VERAS! - Visión, Educación, Rendimiento, Aprendizaje, Sostenibilidad – in English, these words mean: Vision, Education, Achievement, Learning, and Sustainability. Happily, the Spanish word “VERAS” also means “Now I See.”

The VERAS project is the result of an intensive study of Central American visual health care. The first product of the study, sponsored by the UNESCO Chair in Visual Health and Development, was a landmark document entitled “Report of Visual Health and Development in Central America 2004.” This report was designed to increase knowledge on the quality and quantity of vision care in Central America and the political and economic factors determining such care. The Report recognized that in some Central American nations both the general population and the public institutions lack a great awareness about the relevance of visual health in relation to the complete development of the individual and society. Also, in certain nations, there is a huge lack in the visual health care sector of both professional human resources and relevant visual health materials. The public education and health centers which offer visual health services are limited mainly to national hospitals, located in the capitals, and, generally, Central American medical schools devote few resources to visual health. There are very few programs of preventive visual health care geared toward the population. Also, there is a significant lack of resources assigned to investigate or research visual health, as well as a lack of broad or trustworthy epidemiological data.

The UNESCO Chair’s “Report 2004” was the basis for thorough discussions of Central American visual health care at the “Forum on Visual Health and Development in Central America”. This forum, held during May, 2005 at NOVA-Southeastern University, was sponsored by Dr. Janet Leasher, a long time VOSH member, who is the Coordinator of the North America Associated Centre of the UNESCO Chair. At the 2005 Forum, multiple projects were presented to interested groups and collaboration was encouraged among those groups and individual attending. The VERAS project was one of the principal projects presented at the 2005 Forum. The VERAS project, as finally elaborated, calls for the development of a standardized protocol which can be utilized in any environment for the sight screening of pre-literate (first graders) children, the screening of 5,000 children in each participating country to validate the protocol developed, the in-depth diagnostic examination of each child “failing” the screening and the prescription and provision of new spectacles, as necessary, to correct refractive error.

Originally, only El Salvador and Guatemala were contemplated as participants in the VERAS project because no one from Nicaragua responded to the Chair’s call for attendance. However, several individual VOSH members attended the 2005 Forum because VOSH has always been interested in advancement of visual health in Central America. Among those VOSH members were a group who were seriously concerned that Nicaragua, the poorest country in Central America, was not included in the VERAS project. These VOSH members knew from their own personal experience and mission work that Nicaragua suffers a high poverty level and has an extremely low number of visual health providers. These VOSH members realized instantly that the VERAS project was tailor made for Nicaragua. .

Historically, VOSH chapters have conducted many short-term intensive medical missions delivering eye care and eyeglasses in Nicaragua. Through this collective experience VOSH came to recognize and provide answers to the huge need in Nicaragua for better sight care infrastructure and sustainable eye and vision care in local communities. Examples of this response are VOSH NECO funding a permanent eye clinic in San Juan del Sur and the help of other VOSH chapters with part-time clinics scattered throughout Nicaragua.

It was only natural, considering the rich history of VOSH experience in Nicaragua, that the VOSH International Board accepted the concerns of those VOSH members who attended the 2005 Forum. VOSH adopted VERAS as a special project and gained the concurrence and support of the Nicaraguan Ministers of Health and Education through the support of FOR Nicaraguan Health, the NGO founded by Dr. Rudy Vargas of Birmingham, AL.

The UNESCO Chair sponsored a VERAS project organizational meeting in San Salvador during September 2005. Several VOSH members participated at the meeting and writing the protocols for VERAS children’s vision screening, examination, and sight care education.

On November 30, 2005 VOSH-International formally joined the UNESCO Chair, the Nicaraguan Ministries of Health and Education and FOR Nicaraguan Health as partners in the VERAS project when the official agreement of the partners was signed at the Ministry of Health in Managua. Next, in January, 2006, VOSH members organized and coordinated a training session for participants from the three VERAS project countries at a special forum in Managua. Screening and data collection techniques were taught to “super trainers” from each of the three participating countries. These super trainers are now training teachers and health promoters how to screen and record screening results in their own countries.

The VERAS project is now under way. Because there are so very few vision care professionals in Nicaragua, VOSH members have agreed to help in the examination and treatment of school children in the province of Granada, the first site in Nicaragua for the pilot project. The first round of VOSH examinations took place in Granada the last week of February this year. Additional VOSH efforts in 2006 will be focused on an additional round of final examinations and on cooperation with local vision care providers and medical students to promote awareness of the need for more and better visual health care in Nicaragua.

One major accomplishment of the Project’s field work this year will be the testing of the screening protocol developed by the optometrists of the Project Team. The protocol will be tested through collecting data from all examined children in a standardized manner and validation and results will be available by October, 2006. A good protocol should be easily used by persons of diverse backgrounds and languages, should be easily administered to young children of diverse backgrounds and languages, and should have sufficient specificity and sensitivity to be cost efficient so that the children with vision problems may be referred to appropriate visual health providers. Development of a standard screening protocol for the examination of pre-literate children will be a first in international vision care. This protocol will be of incalculable value to worldwide child health care.

Some very important tangibles have been realized even this early in the project.
The firm “Goodlight” has produced and donated screening and examination sets using Lea Symbols. VOSH Florida has donated new children’s frames for use in the three participating countries of Nicaragua, El Salvador and Guatemala.

But there is still much work to be done this year – VOSH must seek donations of lenses and lab labor to cut and edge new lenses to prescription for each child who needs them. All VOSH chapters seeing children in Central America are welcome and encouraged to participate in this project by using the new standard screening and examination protocols. Use of these protocols can be easily incorporated into the work you already do in your VOSH missions, and every examination counts! For information on how you and your chapter can join in these VOSH efforts – please contact Dr. Patti Fuhr at pfuhr@mindspring.com 205-591-8165

¡VERAS!

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