Country Statement Sri Lanka is an Island located within the Indian Ocean. The countries capital, Colombo, is located on the Western Province where nearly 30% of the population is concentrated. Sri Lanka encompasses one of the best social and human development indicators within the South Asia region, ranking 76 out of 189 countries in the United Nations Development Programme (UNDP) 2018 Development Index. Eye health within Sri Lanka remains a challenge, as the National blindness survey conducted in 2014-2015 showed that approximately 350,000 are classified as blind and another 340,000 are estimated to have severe vision impairment. Numerous face limited access to eye care means, hence many Sri Lankan’s suffer from avoidable blindness. Program Statement We began our work in Sri Lanka as a response to the humanitarian crisis created by the 2004 tsunami. Initial interventions were to provide emergency eye care and simply replace people’s glasses that had been lost. However, we quickly realised that the overwhelming majority of people in tsunami affected areas hadn’t lost their glasses – they’d never owned any.As an initiative, the Sri Lanka country office was established and registered in 2008 and programs to help fill eye care provision gaps in the existing health care system were set in place.In 2009, we opened three vision centres located in the Kegalle District, at Warakapola, Yatiyanthota and Deraniyagala. In partnership with the Lions Golden Jubilee Hospital, the Foundation also established a vision centre in the Gampaha District which is now owned and operated by Lions.The Colombo Urban Comprehensive Eyecare Project 2009-2014, a Standard Chartered Bank Seeing is Believing initiative, was launched in selected urban slum areas of Colombo – Kolonnawa and Dehiwela and two vision centres in the same areas were set up. In 2016, the country office and Dehiwala Vision Centre were reestablished at the Wattala of Gampaha district. At the time, the Dehiwela vision centre was re-named as Wattala vision centre.An optical workshop which provides free spectacles to poor and deserving beneficiaries, most of whom would not have the funds to purchase a pair of spectacles was established in and donated to the National Eye Hospital Sri Lanka. Scholarships were awarded to individuals to train in India to become vision technicians and optometrists. In addition, the workforce development in eye care occurred through the various approaches such as volunteer training on primary eye screening, supporting to the staff in following the optometry courses, facilitating the eye care related institutions to provide the training for eye care professionals. Program Highlights Increase of accessible eye care services among the rural and semi urban communities We use the social franchise model as a key approach to increase and deliver good quality and affordable eye care services to the rural and semi urban communities of Sri Lanka. Our four vision centres located at Warakapola, Yatiyanthota, Kolonnawa and Wattala operate according to the social franchise approach and are financially viable and sustainable. Our centres provide culturally appropriate, good quality eye care services for those in need. We target service provision for children, the elderly, people with disabilities and underprivileged members of the community who are often marginalised and have limited access to services. The vision centres currently function as the eye care service provider in both rural and urban contexts and offer divers services such as free comprehensive eye examinations, free low vision assessments, free blood pressure and random glucose tests, affordable spectacles and low vision devices. Our outreach activities are a dynamic approach to provide good quality eye care services in otherwise inaccessible communities. In our Sri Lanka program, the outreach activities mostly focus on delivering volunteer training on primary eye screenings, community eye care awareness and community eye camps. The public private and community partnerships are integrated in implementing the outreach activities which creates a conducive environment for resource sharing and partnerships. By establishing these models of delivering eye care, the Sri Lanka program has provided... Eye health services to over 130,000 people Dispensed over 69,000 pairs of spectacles Referred more than 27,000 individuals for secondary or tertiary eye care services Conducted awareness programs that have reached over two million community members Child Eye Health Sri Lanka lacks a functional integrated school eye health system in existing schools. Considering that refractive errors and eye diseases contribute to school dropouts and poor education outcomes it has become vital to incorporate child eye health activities and interventions in the Sri Lanka program. Child focused eye care provision has subsequently become one of the major highlights of the program.We work in close cooperation with the respective government agencies and non-for-profit organisations to address child eye health issues and implement child eye health programs at school and village level. Besides contributing to an efficient and successful delivery of child eye health interventions, our collaborative and integrated approach allows us to acquire special funding and resources in order to promote child eye health in the existing school and community system.So far, our child eye health programs have been successfully completed with our key partners such as World Vision Lanka, Deaflink, CBM International, Muslim Hand Sri Lanka, Karuna Trust in different parts of the island. These programs have been launched in the most remote districts of the country. Our interventions aim to:provide comprehensive eye care for students and school stafftrain schoolteachers in eye health, including eye screening and child eye health awarenesspromote health educationestablish a functioning and comprehensive eye health system in schools across the islandThrough the child eye health programs, more than 40,000 children have been directed to primary eye screenings and over 3,500 children have benefited from free spectacles, assisting them in overcoming their vision impairment. Eye-health Workforce in Sri Lanka We invest in the eye care education of locals so they can become part of the eye-health workforce and develop and increase the workforce capacity in Sri Lanka. We are supporting education workshops for ophthalmic technologists, ophthalmic nurses, spectacle technicians and bio medical engineers in areas such as: ophthalmic equipment repair and maintenance, spectacle lens cutting and fitting, prescribing low vision devices and low vision patient management. Till date, over 800 personnel have been trained in primary eye care & vision screenings, and low vision management. Cross Cutting Issues Gender Equity A key achievement of our program in Sri Lanka is the integration of gender equity in all aspects of our program development and implementation. We empower women to look after their eye-health by creating supportive services, structures, and incentives. The average ratio of women and young girls accessing eye care services at our vision centres is 54% – this has been achieved by integrating gender responsive strategies; training women to be their own agents of change; creating a supportive environment, and engaging the local community to build ownership for sustainability. Environment We recognise and acknowledge that environmental degradation and climate change affect eye health and vision, with the greatest effect on poor and marginalized people. We advocate whenever possible for actions that will decrease environmental harm and strive to avoid any detrimental environmental impacts in the implementation of our core activities. Our Sri Lanka program considers the effects of the environment on eye health and incorporates strategical measures to mitigate the environmental impact.During the facilitation of community awareness sessions, our team presents key points and facts regarding the effect of climate change and other environmental factors on eye health. Banners and various advertising materials are used to present to officials and raise their awareness of the relationship between the environment and eye health. All our vision centres display posters and banners to achieve the same goal within the communities we work with. Environmental values are integrated in our program operation and development activities. We consider and mitigate our own impact on the environment in our program delivery and have established environmentally friendly practices. All our vision centres in Sri Lanka use biodegradable non-woven fabric bags instead of polythene bags to provide spectacles to our customers. Our country office’s and vision centre’s waste management is in full compliance with local regulations.