A young boy calmly takes his Zithromax. ORBIS distributes Zithromax to prevent and treat  trachoma, a blinding disease that has devastat- ed much of rural Ethiopia.

The ORBIS Flying Eye Hospital has brought its blindness prevention and treatment skills to numerous countries in Africa, including Ethiopia, Uganda, Ghana, Nigeria, Cameroon, Tanzania, Mali, Malawi, Botsana, Kenya and Burkina Faso.

ORBIS opened a permanent office in Ethiopia in 1999 and began operating long-term, hospital-based programs in Ethiopia at that time. Ethiopia is the second most populous nation in Africa, following Nigeria.

The latest figures from Ethiopia indicate that 1.2 million Ethiopians are blind and close to 2.8 million have low vision. Because only 95 ophthalmologists are available for a country of 75 million population, eye care services are extremely limited throughout the country, particularly in rural areas.

ORBIS is working in Ethiopia to address the country’s high prevalence of avoidable blindness, as well as the country’s limited human resources and infrastructure. 

Key strategies include:

Alem Birhanu, a health extension worker from First Mekala kebele in Asore, measures a child's dose of Zithromax.

• Strengthening existing national institutions and eye care agendas
• Establishing eye banks
• Addressing the acute eye care needs of the rural population
• Aggressively tackling the infectious disease trachoma, a painful and ultimately blinding condition that disproportionately affects women and children

In Ethiopia during 2008:

• Nearly 9,500 doctors and other eye care staff received training
• Over 260,000 people received eye examinations
• More than 1.75 million children and adults received non-surgical ophthalmic medical treatments such as antibiotics or eyeglasses
• More than 27,000 eye surgeries were performed
• More than 614,000 individuals were educated about nprevention and eye health

ORBIS has achieved numerous “firsts” regarding blindness in Ethiopia:

• ORBIS established Ethiopia’s first pediatric ophthalmology center. The children’s eye care center is located at Menelik II Hospital in Addis Ababa.
  
  
• ORBIS developed an innovative rural eye care services delivery model in southern Ethiopia to address the leading causes of blindness in the area -- cataract, trachoma and refractive error -- where there were no ophthalmologists. This was the first large-scale rural eye care initiative implemented in the southern half of the country.
  
  
• ORBIS was the first to distribute the antibiotic azithromycin to rural populations in Ethiopia in order to treat trachoma, the leading cause of infectious blindness worldwide. Ten million adults and children across Ethiopia suffer from this highly contagious but preventable and treatable disease. More than one million people over age 15 are affected by trichiasis, the potentially blinding complication of trachoma in which the eyelids turn under, causing the eyelashes to painfully scrape against the cornea.
  
  
• ORBIS established Ethiopia’s first and only eye bank.
  
  
• ORBIS was the first to introduce to Ethiopia extra capsular cataract extraction with intraocular lens implantation, and later small incision cataract surgery (SICS). These techniques have greatly improved the quality and availability of cataract surgical services in Ethiopia.
  
  
• In an effort to address the need for skilled eye care professionals in the country, ORBIS trained the first pediatric ophthalmology, oculoplasty and anterior segment specialists in Ethiopia.
  
  
• ORBIS was the first in Ethiopia to initiate accredited training for optometrists and a category of para-professional called “cataract surgeon.”

The ORBIS Ethiopia office oversees capacity building and advocacy projects at the national level as well as tailored projects within the rural regions of Oromia and the Southern Nations, Nationalities and Peoples Region (SNNPR). The office also helps coordinate training in neighboring countries.

ORBIS partners in Ethiopia include:

Department of Ophthalmology, Medical Faculty, Addis Ababa University •  Ethiopian National Association for the Blind • Federal Ministry of Health/National Committee for the Prevention of Blindness • University of Gondar • Grarbet Tehadiso Mahiber • Hawassa University • National Eye Bank of Ethiopia •  Addis Ababa City Health Bureau/Menelik II Hospital •  Ophthalmological Society of Ethiopia • Health, Education, and Finance and Economic Development bureaus of the Southern Nations, Nationalities and Peoples Region •  Water Aid Ethiopia

Fact File

Population	81 million1
Population under 15	45%2
Population living below national poverty line	44.2%3
Life expectancy	47.84
Literacy rate	36%5
Rural population	666
Percentage of total ophthalmologists working in rural areas	37.8%7
Approximate number of practicing ophthalmologists	828
GDP per capita	$1149
Health expenditure per capita	$5.610
Health expenditure as % of total government expenditure	5%-6%11
Prevalence of blindness*	1.6%12
Blind population*	1,200,54613
Prevalence of low vision**	3.7%14
Population with low vision**	2,776,05415
Prevalence of blindness under 15 years	0.12416
Leading causes of blindness	Cataract (49.9%), trachomatous corneal opacity (11.5%), refractive error (7.8%), other corneal opacity (7.8%)17
Leading causes of childhood blindness	Corneal opacity mainly as a result of measles/vitamin A deficiency, refractive errors18
Ophthalmologists per million population	1.0919

Footnotes

*Blindness is defined as visual acuity of less than 3/60 or a corresponding visual field loss to less than 10 degrees in the better eye with best possible correction.
** Low vision is defined as visual acuity of less than 6/18 but equal to or better than 3/60, or a corresponding visual field loss to less than 20 degrees in the better eye with best possible correction.