Traditional meets modern in Malawi eye program CMAJ 1997;157:1007 © 1997 Canadian Medical Association Paul Courtright, PhD, director of the BC Centre for Epidemiology and International Ophthalmology, is as much an anthropologist as epidemiologist. In 1991, during a 4-year stay in Malawi, he pioneered a collaborative program to prevent blindness in rural villages by bringing modern science and traditional healers together. Courtright, who works with his wife, ophthalmologist Susan Llewallen, recognized that the healers are a force to be reckoned with in Malawi's villages and that their support would be key in motivating people to have eye surgery. In Malawi, up to 4500 visits are made to traditional healers for each patient who seeks care from an ophthalmic medical assistant. Courtright estimates that about 10% of cases of blindness in the country are caused by toxic substances that have been deliberately placed directly in the eye because healers believed they would cure eye problems. Cataract surgery reverses blindness in an overwhelming number of these cases. Courtright began his program with a series of workshops in about 15% of Malawi's villages, which attracted 300 healers. He achieved a coup by persuading some them to undergo cataract surgery themselves. Most participants returned to their villages as enthusiastic advocates, and surgery rates increased by 80%. The program, now well established in Southern Malawi, is run by ophthalmic medical assistants. It will eventually spread to all southern villages, which have a combined population of 5 million people, as well as to a district in northern Malawi. Courtright plans to expand the program to Mozambique and West Africa, beginning in Niger. He organized a World Health Organization symposium in Malawi in September, which was attended by representatives from nongovernmental eye-care organizations, ophthalmologists, field workers and healers. The goal was to produce a manual to use as a template for establishing similar programs elsewhere. Courtright hopes new programs will look at traditional healers as positive forces for eye care. "If they reach the stage of 'let's collaborate,' " he says, "I'll be thrilled." -- © Heather Kent Send a letter to the editor responding to this article Envoyez une lettre à la rédaction au sujet de cet article | CMAJ October 15, 1997 (vol 157, no 8) / JAMC le 15 octobre 1997 (vol 157, no 8) |