- By Julie Roegiers, General Manager, IRIS Mundial
IRIS Mundial seeks to establish permanent eye care services in developing countries. Its aim is to promote autonomy in terms of eye care through support to local partners and through respect of local cultures and the structures of the country. Following the November 2018 mission in Senegal during which 30 Canadian volunteers provided eye examinations and care to 2000 people, IRIS Mundial committed to support its partner, the Association St-Louisienne pour la Vue (ASV) in the implementation of their project which aims to offer accessible eye care services to the most disadvantaged people of the Saint-Louis region.  
Thanks to a grant from the Ministère des Relations Internationales et de la Francophonie of Quebec (MRIF), awarded by the Quebec International Development Program (PQDI), IRIS Mundial has been able to support the ASV in their solidarity initiative. The St-Louis Program for the Prevention and Fight against Blindness (PPFB) was launched on the 1st of January 2019 for an initial phase of 2 years. This program aims to establish sustainable eye care services in the region of Saint-Louis. 
“At least 2.2 billion people have vision impairment or blindness, of which over 1 billion cases could have been prevented or have yet to be addressed” – WHO World report on vision (2019).
CONTRIBUTION TO THE DEVELOPMENT
According to a report of the World Health Organisation1 (WHO), at least 2.2 billion people suffer from vision impairment or blindness. In at least 1 billion cases this vision impairment could have been prevented or has yet to be addressed. Furthermore, the burden of eye conditions and vision impairment is not spread evenly: people living in rural areas, those with low incomes, women, older people, people with disabilities, ethnic minorities and indigenous populations are often far more greatly affected. 
Among the main drivers of the most common eye conditions is late detection due to weak or poorly integrated eye care services. Many people lack access to routine checks that can detect conditions and lead to the delivery of appropriate preventive care or treatment. Yet, vision is the most dominant of the five senses and plays a crucial role in every facet of our lives. Globally, societies are built on the ability to see. Vision contributes towards everyday activities and enables people to prosper at every stage of life. Vision is pivotal to educational attainment, it facilitates participation in the workforce, supports the development of social skills, strengthens self-esteem and maintains well-being2. It is therefore quite clear that from an economic perspective, improving the visual health of the beneficiary population will help to improve their mobility, their productivity, their employment possibilities and therefore their income. With the PPFB, we seek to improve the quality of life of beneficiaries and therefore contribute to their active participation in the socioeconomic development of their community. 
AN INTEGRATED PROGRAM FOR THE MOST DISADVANTAGED
Thanks to the PPFB, the population of Saint-Louis region will benefit from an integrated eye care service: from prevention to care and treatment, the program team is committed to ensuring the most disadvantaged have access to services. 
In terms of prevention services, awareness-raising sessions on visual and ocular health and visual hygiene are organised in public places and in schools. In addition to sessions given by the members of the PPFB team, key people in each community also deliver messages on awareness. Trained upstream by the program team, these individuals are either schoolteachers or Badiénou Gokh (a system of “community godmothers” implemented by the government support to health structures). These contact persons also play a role in referrals for screening. In order to carry out screenings, mobile clinics are organised in remote communities and schools to offer primary eye care and to refer those who need it for an in-depth eye examination by an ophthalmologist. 
Those who have been referred are examined at the Sanar community ophthalmologic center at monthly ophthalmologic clinics. One of the few ophthalmologists in Saint-Louis is present on those days to give an in-depth examination and prescribe corrective eyeglasses or, if needed, surgeries at the Saint-Louis regional hospital (surgeries are also funded through the program).
In addition to training given on a voluntary basis to the program staff by optometrists and opticians, IRIS Mundial has contributed to the construction of the Sanar community ophthalmologic center and the installation of its equipment thanks to various donations: eyeglasses, optometric and optic equipment, etc.
FINANCIAL SUPPORT AND CONTINUING EDUCATION
Thanks to the grant received from the MRIF, IRIS Mundial is able to financially support the ASV in the implementation of its ambitious programme. The Sanar community center was built and equipped: slit lamp, autorefractor, phoropter, examination seat, etc. Moreover, IRIS Mundial supports the transfer of knowledge and continuing education of local professionals. Since the beginning of the program, four volunteer trainers have been to Saint-Louis to train the PPFB team. In March 2019, two optometrists began training the nurses and the optician on primary eye care. In November 2019, an optician and an optometrist continued the training on primary eye care and are set to being training of the program optician. 
IRIS Mundial wants these services to remain in place and will send a volunteer in February 2020 to work with the partner on ensuring financial autonomy. It is important to start this process early on in the program in order to ensure its sustainability. 
Thank you to our partners and volunteers!
Thank you to the Ministère des Relations internationales et de la Francophonie of Quebec for the two-year grant which enabled IRIS Mundial to start this program. Thank you also to IRIS The Visual Group for its annual financial support that also funds part of this program. Thank you also to all the partners that bring their non-financial contribution to the program: Essilor for checking and wrapping equipment and for giving remote technical support for long periods. Air Canada Foundation for allowing us to travel with excess luggage to bring equipment, the NGO DESI for providing volunteers with expertise in development, the Book Humanitaire for their upstream work in the design of the program, the IRIS store of Rouyn-Noranda and IRIS The Visual Group for their donation of  equipment, Innova and Kleargo. 
Thank you to our partner, the Association St-Louisienne pour la Vue and its team for the excellent work they are doing in building the framework of this program.  
Thank you to our volunteers who generously contribute to the training of the program team: 
- Dre Marie-Chantal Hudon, optometrist (training given in March 2019)
- Dre Nicole Vachon, optometrist (training given in March 2019)
- Dre Francine Lavallée, optometrist (training given in November 2019)
- Sophie Duchesne, optician (training given in November 2019)
- André Racine, expert in organizational management (training given in February 2020)
Finally, thank you to all the other volunteers at IRIS Mundial who work hard behind the scenes but without whom this kind of program could not exist: the volunteers on the board of directors, the volunteers who prepare the eyeglasses and equipment, the volunteers who help with fundraising, etc. 
Since 2001, IRIS Mundial has carried out 21 training missions, 24 one-time projects and establishedtwo permanent programs in Haiti. IRIS Mundial projects have helped more than 89,000 people over the years. We help thousands of people to better see the world!