Speech By The President Of India, Shri Pranab Mukherjee At The 28th Congress Of The Asia Pacific Academy Of Opthalmology

I am happy to be here today for the inauguration of the 28th Congress of the Asia Pacific Academy of Ophthalmology (APAO). I thank the Academy and the All India Ophthalmological Society (AIOS) for having invited me to share my views with this galaxy of ophthalmologists who have assembled here from across the world.

This Congress is being held in India for the second time, after a gap of nearly 28 years. That it is being held in India, is the result of the committed effort of the AIOS which has been collaborating closely with the APIO. I congratulate them for this effort.

Ophthalmologists occupy a special status and importance in society. You do so by being the doctors of eyes, the critical human organ necessary for the conduct of human affairs and pursuit of quality life. According to the ancient Indian scripture, the Vedas, the "Eye is the most important of senses” in our body. Recognizing this importance, India, as many of you may already know, has been one of the earliest contributors to its science.

Sushruta, the father of Indian surgery, who wrote the Sushruta Samhita or compilation of treatments, in 600 BC, had described 76 ocular diseases, including 51 surgical, as well as several ophthalmological surgical instruments and techniques.

The care for the eye has received focused attention since the beginning of recorded human history because of the debilitating impact blindness can have on individuals, the families to which they belong, their economic well-being, the society and the prosperity of nations. It also has very strong linkages with the incidence of poverty, particularly in less developed countries.

The World Health Organisation (WHO) in the Vision 2020 document, had by extrapolating the global data of 1975, estimated that in 1996 there would have been 45 million blind people and 135 million with low vision. The data was further extrapolated and it is now estimated that by 2020, there would be 76 million blind people indicating that visual impairment would double in the period 1990-2020.

It has been established that the vast majority of those who are visually impaired reside in developing countries. Poverty predisposes an individual to blindness and it increases the economic burden by curtailing employment opportunities and diversion of resources for its treatment. Empirical studies show that low incomes not only contribute to higher incidence of blindness but 64% of the disabled slip into to poverty after the onset of visual impairment.

Even households that do not suffer impoverishment are three times likely to slip into poverty in the first year of the onset of the impairment in comparison to the households that are not affected. The families affected by the disability have a lower probability of escaping the trap of poverty on account of increased expenditure for medical treatment. Thus, while poverty causes disability, disability too may cause poverty. Consequently, the economic impact on the individuals, or their families and the country as a whole is substantial. A study published in 1996 estimated that the cost in terms of annual worldwide productivity on account of blindness was US$168 billion.

Socially, the visually impaired suffer many handicaps. It has been reported that more than 50% of the blind people in impoverished countries felt that their social standing and decision making capabilities had diminished because of the impairment. The situation is worse when it comes to women as almost 80% of them have reported loss of authority within the family because of the impairment.

The impact of blindness is more debilitating on account of its direct and indirect impact on children. Though figures vary, it has been estimated that there are around 1.4 million blind children in the world and 1 million of them live in Asia and Africa. What is startling is that 60% of the children die in the first year of blindness.

It is another sad reality that every minute a child goes blind in the world. Besides, in developing countries, even when adults are sightless, children are often responsible for leading the adults. Consequently, such children find it difficult to attend school thereby restricting their prospects for education employment opportunities.

What is particularly disquieting is the conclusion of a University of California, San Francisco, study that about 85% of all visual impairment and 75% of blindness in the world could have been either prevented or cured. It has particular relevance for the less developed countries as around 90% of the world’s blind reside in developing countries.

As stated in the Vision 2020 document of WHO, the problem of blindness can only be combated through increased political commitment, professional commitment, provision of high quality eye care, increasing public awareness and support of non-governmental organizations and private sector. This is where I would request you all to step in.

The two ophthalmological organizations, the All India Ophthalmological Society and the Asia Pacific Academy of Ophthalmology have done creditable work to fight blindness. Individually and collectively, they have promoted better practice, and research and manpower development of ophthalmic sciences in India. Several programmes for controlling blindness have been launched in India like the National Programme for Control of Blindness. These programmes have yielded appreciable results. But, government alone would not be able to combat blindness as effectively as collaborative ventures or the initiatives the two can together forge.

Private sector companies and government institutions should, therefore, join hands to fight blindness and visual impairment. The private sector companies should not consider this a burden but as a way of discharging their social obligations. The private sector would also help in increasing their sales and earnings through reduction in the incidence of blindness and poverty and the resulting increase in the prosperity in the society.

The need for collaborative initiatives is important as even comparatively simple interventions at the appropriate time would help prevent blindness. For instance, cataract can be treated by a relatively simple surgery. In this effort, individual doctors also can contribute by sparing one or two days in a month for social service. With the help of other voluntary organizations, medical teams could travel to the interiors of the country in mobile operation theatres. If the local medical associations like the Indian Medical Association can take this initiative in collaboration with the non-governmental organizations in towns and districts, it would make a distinct difference.

You would agree that while we strive for personal excellence and well being, there can be no greater satisfaction than giving sight to the sightless. This is especially true as only 25% of the blindness in the world and 15% of all visual impairment are considered unpreventable or incurable. I would, therefore, urge you not to count your success in terms of the economic prosperity, but by the number of people who you can help prevent from becoming blind or by giving sight to those who live without it. I would, therefore, request you to work through your professional organizations in each of the districts, towns and cities, to achieve this laudable goal.

I am confident that this Congress, which I am told is being attended by over 9000 delegates from all over the world, will find solutions for providing greater medical access to the needy. I also hope that the technical sessions will provide the necessary platform for knowledge sharing and information dissemination. I wish the 28th Congress all the success. I also wish All India Ophthalmological Society and Asia Pacific Academy of Ophthalmology all the best for their future endeavours.