Optometrist Rabiyyah Giga describes her experiences working for the Belize Council for the Visually Impaired in Central America
The Belize Council for the Visually Impaired (BCVI) is a non-profit organisation that was established in 1981. BCVI has three main areas: primary eye care, secondary eye care and rehabilitation and education. There are four full-time employed optometrists working in the five purpose-built clinics throughout the country and one ophthalmologist based primarily in Belize City. The rehabilitation department consists of five regional field officers also working throughout the country.
My job was to cover any leave of the regular optometrists and to conduct outreach clinics throughout the country in remote villages, islands off the coast and companies within Belize City. In this respect no working day in Belize was the same. In any one of my testing locations the patients spoke languages ranging from English and Creole (the main languages of the country), to Spanish, to any one of the 24 Mayan languages, to a type of Germanic language spoken only by the population of Mennonites in Belize.
Basic equipment
The main clinics are situated within the main towns in five out of the country's six districts - Belize City, Orange Walk, San Ignacio, Dangriga and Punta Gorda. They each had the basics - a slit lamp plus parts, a refracting chair and a focimeter. If they were lucky they also had an auto-refractor, phoroptor and illuminated test chart, rather than a paper wall chart. Portable equipment, which I carried to the villages and outreach locations, consisted of a paper wall chart, a trial lens set, a box of things like cotton buds and chloramphenicol, and a hand-held tonometer.
I spent much of my time in the southern district of Toledo at the main BCVI clinic in Punta Gorda, as well as doing outreach clinics in some of Toledo's poorest villages. In places where no one spoke English and no local translator was available, I used the illiterate E test chart, objective methods and hand movements to obtain a final prescription. The universal 'thumbs up' gesture worked well. Many of the villagers had never worn spectacles before, so when we provided them with a donated pair of closest match to their prescription, their amazement and delight was fantastic to see. Patient numbers depended on the village, ranging from eight to 15 patients. In one of the villages we even managed to screen 80 children.
Mexican influence
The northern districts of Orange Walk and Corozal have a strong Mexican influence and the eye examinations were carried out mainly in Spanish, a skill I gradually picked up on the job. In doing so, the townspeople and the villagers really appreciated the efforts to give them the best eye examination possible. We took along a supply of frames to the villages so that patients could choose what they wanted and give the necessary payment. The frames were then taken to a glazing laboratory.
In Belize City, I visited the Belize Prison, otherwise known as the Kolbe Foundation. They had a small medical centre in which I pinned up my test chart and carried out eye examinations over four days. Anywhere between 25 and 30 tests a day was normal. If the inmates needed spectacles, we were able to provide them at a reduced rate.
During my time, BCVI also targeted major companies within Belize City, to conduct eye examinations on the employees. Patient numbers were again quite high, ranging from 20-40 per day.
? For further information see www.bcvi.com
? Rabiyyah Giga is a UK-qualified optometrist