Thursday, June 26, 2014

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Tuesday, June 17, 2014

SSL Session I: Vision Screening


Primary classrooms in Humjibre may each have more than 40 students. These dimly lit spaces, furnished with little more than a blackboard and rows of desks, offer little support to Humjibre’s students. Students are arranged by height order. Those that cannot see their teacher or the blackboard simply do not learn.

Rolling E Charts were preferred to the Snellen variety since they do
not require alphabet knowledge.
 We have just completed our first Summer Serve and Learn session in Humjibre. This session, Vision Screening, performed by volunteers and students from University of Texas Houston’s Medical School, focused on identifying and correcting visual problems in school-aged children. Volunteers also got to experience life in Humjibre and all regular GHEI cultural activities.

GHEI’s common theme of local and global collaboration quickly became apparent during this session. Before screening any students, volunteers worked together to teach each other and our local staff how to properly conduct various eye tests and what kind of problems they should be looking for. Our days were planned as a group and decisions were made by consensus. In conducting the actual screenings, since all GHEI staff and volunteers knew each test, they were able to easily interchange positions and seamlessly move about the screening sites.

Registering students and conducting screening tests at D/A Primary
Our first screening day was at Humjibre’s District Assembly Primary school. At a cool playground area under some trees, we set up a registration table, an area for eye tests, and three Rolling E charts. It was a scene reminiscent of countless outdoor medical clinics in Ghana and other developing countries. Starting from the Primary 1 (P1) classroom, students were brought to the registration table in small groups to receive their cards they would carry throughout the screening. They then moved on to one of the three identical first screening stations, each led by a volunteer.

The vision program came about through the suggestion of
one our SSL alumni and the encouragement of local district officials.
The students were given two tests: the first required a penlight and three conditions to confirm that their pupils were equally round and reactive to light, and the second was used to identify strabismus. The students understood the tone of voice from our volunteers, but little of their English directions. To help explain the tests, each volunteer teamed with a local staff member; setting a trend that would be followed at every step of the process throughout our screenings.

Students were then sent to one of the three Rolling E charts to complete their next test. Afterwards, GHEI kept the completed cards, and the students went back to their classrooms. Using previously decided upon thresholds, students’ cards were placed in one of three categories: cleared, recommended seating change, or referral for a follow-up visit.

Anglican Primary students with their cards waiting to be screened
The screening process started slowly, but as we became surer of ourselves and fell into a rhythm, the teams became very efficient. The students, who were at first nervous in an unfamiliar situation, were calmed by the staff and volunteers’ confident and caring demeanor.

The next day we continued screenings at Humjibre’s other public primary school, St. Mark’s Anglican Primary. P1 through P4 students were screened at the nearby Humjibe Community Center.

In total, 293 students were screened. Each student’s results fell clearly into one of our three categories. Ninety percent cleared of any vision problems, nine had minor difficulties, and twenty were found to potentially have larger issues that would require a follow-up trip to the district optometrist.

GHEI staff visited the classrooms of those that had only minor problems to suggest changes in seating arrangements; placing those students with issues toward the front of the room.

Screening stations at D/A Primary
Those students that required a follow-up visit were split into two groups for trips to the eye clinic at the district capital, Bibiani. While GHEI was not able to cover all costs of treatment, we did help families cross initial barriers. We escorted students to the doctor’s office, providing transportation and negotiating their first visit. GHEI also helped facilitate the purchase of insurance through Ghana’s affordable National Health Insurance Scheme.

SSL Vision Screening and UCLA Soroano volunteers and local GHEI staff
Five students were found to need glasses, two were referred to other clinics and several others were found to have infections which are now being treated. Glasses will be provided to all five students by GHEI and the Vision Screening program.

Local opinion of the program is very positive. Students’ parents and those at the district clinic have praised GHEI staff and volunteers for their efforts in offering vision screenings and facilitating treatment. Both those involved locally and our international volunteers recognize that this is a two-week program that brings immediate tangible results.

Evaluation of the project will continue through discussion and more quantitative measures. At first glance however, the Vision Screening project felt very successful and will likely be continued in the future.

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