Geta Hospital's old blue bus does double duty for vision testing at a Seva eye camp in the western hill of Nepal. Photo courtesy of Susan Erdmann

Seva needs a magic bus!

Seva Canada is raising funds to purchase a new TATA bus for Geta Eye Hospital that will be used to perform everyday miracles.

The bus will transport surgical eye care teams to remote regions of western Nepal to conduct 10-12 surgical eye camps and 20-30 eye screening camps  annually. The bus will also be used to transport patients to and from Geta Eye Hospital.

The western hill districts of Nepal form one of the poorest and most inaccessible regions of the world. There’s a high rate of preventable and treatable blindness.

Restoring a person’s sight is one of the most cost-effective ways of reducing poverty according to the World Health Organization.

Geta Eye Hospital, located in Dhangarhi in the SW corner of Nepal, provides eye care to this part of country but relies on an old blue bus that is over 10 years old and is constantly breaking down. It needs to be replaced urgently.

Seva is seeking support to provide a new 25-passenger TATA bus for the hospital at a cost of $17,300. Generous donors have provided $11,720 so far,  so we have just $5,580 left to raise.

Seva Canada has been providing eye care in Nepal since 1982 and has helped create one of the most comprehensive eye care programs in the world, through partnerships with the Government of Nepal, the World Health Organization and other international organizations.

“Seva has worked to make Nepal fully sustainable in eye care. I cannot imagine the present sight restoration program in Nepal without Seva.” — Dr. S.P. Dhital, Founding Director, Lumbini Eye Hospital

To learn more about the bus and how you can help, please contact 604-713-6622.

Tanzanian boy with low vision using a magnifier at school. Photo courtesy of David de Wit

Next week, Seva will ship 122 special low vision devices such as magnifiers to Tanzania.

The equipment, worth $4,000, was generously donated to Seva by the Children’s Low Vision Project of British Columbia. We are very grateful to Lynn Langille, the Program Coordinator at the Children’s Low Vision project, and her colleagues.

The low vision devices are being sent to Seva’s partner in eastern Africa, the Kilimanjaro Centre for Community Ophthalmology, and will be distributed by KCCO to various eye care programs and blind schools in Tanzania and Malawi.

Normal vision is known as “20/20″. This simply means that the eye being tested is able to see an object at 20 feet as well as any eye with very good vision. If you have 20/60 vision, this means you can see at 20 feet what a person with good vision can see at 60 feet. If you have vision that is between 20/60 and 20/190, it is called being partially sighted or having low vision.

Children with uncorrected vision conditions or eye health problems face many barriers in life, especially in developing countries. Vision doesn’t just happen. A child’s brain learns how to use eyes to see, just like it learns how to use legs to walk or a mouth to talk. The longer a vision problem goes undiagnosed and untreated, the more a child’s brain learns to accommodate the vision problem.

Seva Canada’s vision is a world in which no one is needlessly blind or visually impaired and where those with unavoidable vision loss can achieve their full potential.

Thank you also to Air France – KLM Cargo and to Worldwide Animal Travel of Vancouver for once again shipping vital eye care materials to Tanzania.

African boy with low vision trying to read. Photo courtesy of David de Wit

Tibetans wearing sunglasses after eye surgery at the Nakchu eye camp in Tibet

Thank you to Mountain Equipment Co-op for the recent donation of both children’s and adult’s sunglasses for Seva’s eye care programs in Tibet.

This generous donation of $5209-worth of high-quality sunglasses will be very much appreciated by patients in Tibet who have received cataract surgery.

Tibet has one of the highest rates of blindness in the world, mainly due to cataracts. Each year, Seva conducts thousands of sight-restoring cataract surgeries in Tibet.

This photo shows patients at a Seva eye camp in Nagchu on the Tibetan plateau wearing glasses after surgery. The sunglasses not only protect their sensitive eyes from the  strong UV light, but also help to shield their eyes from dust and rubbing as they are healing.

Thank you, MEC! The glasses will be taken to Tibet this fall.

For more information about Seva’s work in Tibet, visit our website.

Specifically, $4000 will be used to help support the development of a comprehensive eye care program for the children of Malawi and based in the Queen Elizabeth Central Hospital in the capital city of Blantyre.

Africa has one of the highest rates of childhood blindness in the world and most of that blindness is due to cataract.  The children most at risk are those below five years old. Up to 60% die within one year of becoming blind and those who survive can expect to spend on average 40 years without sight. Over 90% of blind children receive no schooling and the great majority will be unable to realize their full potential. Thus, blindness in children accounts for nearly one third of the economic cost of blindness, although it represents less that 4% of the overall magnitude of blindness. The human cost in terms of suffering is immeasurable.

Objectives of this pediatric program include:

• increasing by 50% the number of children referred to the hospital who are blind or severely visually impaired;
• increasing by 50% the number of surgeries for congenital and developmental cataracts each year for the next three years;
• ensuring that 100% of children who need glasses after surgery get them;
• ensuring that over 80% of children receive intraocular lens implants during cataract surgery; and
• ensuring that 100% of children get the follow up they need.

The remaining $11,900 from the golf tournament will be used to support the ‘Sentinel’ system in the Kilimanjaro and Arusha regions of Tanzania. This system was created as a means to reach more women and girls and provide them with the eye care services they require.

Two-thirds of all blind people are women, primarily because they are treated less than half as often as men. This disparity is even more pronounced between girls and boys. Seva Canada has taken explicit leadership in the gender and blindness global initiative. All Seva-led projects work towards achieving gender equity by focusing on overcoming traditional barriers to women’s and girls’ access.

This project focuses on increasing the use of eye care services by women living in the Kilimanjaro and Arusha Regions. This community intervention involves women, identified within their communities as leaders, acting as “sentinels”. Thirty-two women have been trained in counselling, community mobilization, awareness creation and data collection. The sentinels identify women with visual disability in their community and offer appropriate counselling and referral to the nearest eye care services.  This model has been very effective and has increased the uptake of eye care services by women and girls by as much as 100% in many areas.

Thank you again to Diane Hardouin, Chair of the tournament and to Committee Members Esther Adamson, Dianne Cook, Sue Biddle, Naz Remtulla, Louise Forsythe, Lynn Neilsen, Carolyn Butt, Margaret Gillis and Michele Holwill. Kudos to David Hardouin and his hardworking group of guys; Tim Tait and his great team of professionals; Wade Hawksworth and his links crew; Haymond Ng and the clubhouse staff; and Ron Pauls and the office personnel. Special thanks to Kara Koszman, and a huge thank-you to Michele Greatrex for her undying support and optimism. Thank you to all the players, donors and sponsors.

giant eyeball sculpture by Tony Tasset

Seva Canada board member, Susan Erdmann, spotted this giant eyeball sculpture. The 30-foot tall sculpture is by artist Tony Tasset and is on display in Prtizker Park in Chicago, Illinois until October 31st, 2010.

As Susan said, it’s our kind of sculpture, darling!

“Eye” was made using over 8,000 pounds of fiberglass and another 9,000 pounds of steel, according to one blog post.

If you want to know more about how it was created see the YouTube video.

We think we should get one for Vancouver.

We wanted to share with you the picture album below and to update you on the outcome of Seva Canada’s fundraising efforts and the use of your gifts. If you can’t access the pictures, let us know by emailing admin@seva.ca. These photos were taken by Kunga, Seva Tibet’s Program Director.

As a recap – 100 per cent of the Seva Canada board and staff donated specifically to the immediate relief efforts, together with some close Seva family, raising a total of $7,100. In addition, generous Seva donors contributed $5,072 towards the rebuilding of the eye care programs in the Yushu region. The pictures below show our relief efforts. The rebuilding of the eye care programs is a longer-term effort.

The Seva team and convoy of three trucks led by Kunga distributed 70 tons of food, water, clothing and tents for those severely affected. Our convoy was the first to arrive with tsampa (roasted barley flour), yak butter and black tea – the traditional food of the area. Shortly thereafter, the princess Rinzin Wangmu (the late Panchen Lama’s daughter) led a relief convoy of nine trucks and our team stayed on site to assist with that distribution. The princess summoned around 300 monks at the mass funeral to pray for those who lost their lives during the earthquake. There are pictures of all of this in the album below including the procession and the cremation site.

The hospital where our eye unit was located is being torn down due to structural damage. They are using a field hospital now and have short-term plans for a series of prefab buildings and eventually a new hospital. There is a picture of Dr. Norwu, the eye doctor we trained, sitting with Kunga in front of his tent… he too lost everything. The eye department is housed in a tent now but most of the equipment was removed in the immediate aftermath of the quake and warehoused. We have not been able to locate it (as of last month). The Zeiss microscope we had provided fell and the head was damaged. It will go to Beijing for repairs as soon as we can recover it from the same warehouse.

Next steps – we continue to work on re-establishing eye services to the community. We are planning to buy some new equipment and to fully re-supply the clinic with the funds raised. We’ll be doing our usual eye camps that include screening and surgery for Yushu and the surrounding communities. Hopefully there will be a prefab structure soon where the eye department can be housed before the onset of winter.

If you would like to contribute to the rebuilding of the eye care programs in this area, please visit https://app.etapestry.com/hosted/SevaCanada/OnlineDonation.html

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Italian researchers have demonstrated the long term effectiveness of using stem cells to cure corneal blindness. From 1998 to 2006 the team, headed by Graziella Pellegrini at the University of Modena, performed 125 stem cell procedures on 112 patients, all who had lost partial or complete vision due to chemical or thermal burns. Stem cells were taken from the limbus in the patient’s own eye, cultured, and then grafted back on the eye. As recently published in the New England Journal of Medicine, the grafts had a success rate of 76.6% – leading to restored or improved vision. Better still, the positive results have lasted – one patient has been followed for more than 10 years and still has healthy vision. That’s remarkable. This work represents a real group of people who have already had their lives radically changed through stem cell treatments. More patients all around the world may see benefits from this technique soon.

Using grafts of stem cells to treat corneal blindness isn’t a new idea. Pellegrini and collaborators like Michele De Luca, were pioneering different versions of the technique back in 1997. We’ve seen related approaches to restoring damaged corneas, most notably in New South Whales. This report in NEJM, however, has something that few (if any) have presented before: a relatively large sample set that shows positive results verified over the long-term. Ten years for a successful stem cell transplant? Outside of bone marrow grafts, almost no one has that kind of follow-up history for stem cells. It’s a great sign that what Pellegrini and colleagues are doing is a viable long term cure for corneal blindness.

These before and after pictures are astounding. The top example required no further surgery to correct vision, but the others need keratoplasty.Notice the small notations in the right picture that indicate how long after treatment the images were taken. The arrows in the last row highlight that blood vessels no longer intrude onto the cornea.

The NEJM article also describes an important development in being able to predict the success of a stem cell treatment. Many of the patients in the study had mild to severe limbal damage, limiting the amount of healthy stem cells that could be harvested and cultured. Pellegrini’s team monitored levels of p63 transcription factor in the stem cells they harvested from patients. When the number of ‘p63-bright’ cells was greater than 3%, the success rate of the eventual transplant ended up around 78%. When it was less than 3%, the outcome was successful only 11% of the time. This work demonstrates that very little of the limbus need remain healthy for the stem cell transplant to still work. Using p63 levels as a metric could allow doctors to present patients with a better idea if a corneal stem cell transplant would be successful. It also hints that p63 transcription factor could be augmented or controlled in some way to improve stem cell therapies of this kind.

Amidst all the success in this recent report, we must also face some serious limitations of the work. First, these stem cell treatments were only used for corneal blindness. Not only that, but a very specific cause of corneal blindness – burns. Chemical and thermal burns can cause a wide variety of injuries to the eye, but often leave all parts of the inner eye and optic nerve functioning. Some patients retain some form of (very limited) vision. Also, because of the nature of the causes of these injuries, more than 78% of the 112 patients were men. While thousands lose their vision to chemical accidents every year, there’s a huge number of people with vision problems related to other corneal damage, retinal damage, and nerve damage that are unlikely to benefit from this technique in stem cell transplantation.

It’s also important to note that while the study followed one patient for more than 10 years, the average follow-up was closer to three years (with large variation). That’s still pretty good, but it’s not the same as saying that all 112 patients were tracked for a decade. As always, smaller data sets mean data has to be taken with a grain of salt.

Finally, I should point out that the term ‘positive results’ covers a wide range of changes in vision. A few went from seeing nothing to having restored vision. Some patients went from only being able to see the vague outline of fingers to actually being able to read and determine fine shapes. Others saw more modest improvements, and 24% failed to benefit. These changes didn’t happen overnight; they often took many weeks or more than a year to develop. About half of patients needed keratoplasty (reshaping of the cornea) to correct their vision, though that is a relatively simple procedure these days. Bottom line, it wasn’t like these patients got an injection of their own stem cells and could miraculously see the next day. Stem cells taken directly from their eyes had to be cultured and then grafted onto the cornea, and there was a sustained period of follow-up and further medical care before doctors or patients knew how successful (if at all) the procedure would be.

Still, these results are real world examples of how stem cells are already treating a loss of vision. Pellegrini and her colleagues may be able to adapt their technique to treat other (more common) forms of corneal blindness with the same impressive outcomes. Their confirmation of the importance of p63 transcription factor could also prove helpful in the wider field of regenerative medicine. This work is another victory for stem cells and another step towards being able to regenerate or regrow every part of the human body. I’m deeply impressed.

[image credits: Rama et al NEJM 2010]
[source: Rama et al NEJM 2010]

The Marine Drive Ladies Golf Tournament, organized by Diane Hardouin, was a resounding success and raised $15,700 to provide eye care through Seva’s programs in Tanzania.

Our thanks to Diane Hardouin for her months of hard work and to her fellow committee members, Esther Adamson, Dianne Cook, Sue Biddle, Naz Remtulla, Louise Forsythe, Lynn Neilsen, Carolyn Butt, Margaret Gillis and Michele Holwill. Kudos to David Hardouin and his hardworking  group of guys; Tim Tait and his great team of professionals; Wade Hawksworth and his links crew; Haymond Ng and the clubhouse staff; and Ron Pauls and the office personnel. Special thanks to Kara Koszman, and a huge thank-you to Michele Greatrex for her undying support and optimism.

Our thanks also to all the golfers and to these generous donors:

Esther Adamson
Marj Allen-Balance Group, Macdonald Realty
Mayzelle Allen
Susan Biddle
Joanne Brydon
Lynn Buntain, Buntain Insurance
Carolyn Butt
Canaccord Wealth Management
Tosh Chu
Judy Clarke
Dianne Cook
Rose Chung
David Hunter Garden Centres
Teri Dwane
Dynamic Funds
Deb Faurot, Unique Gift Baskets
Rosemarie Gallagher
Haida Forest Products
Scott Hall, Hall Wealth Management
Michele Holwill and Ken Labron, Assante
Dave Mills, Hub International TOS Limited
Picton Mahoney Asset Management
Al and Naz Remtulla
Riverside Golf Centre
Sentry Select Capital
Linda Sung
Lorraine Sung
Tim Taint, T2 Development Inc.
Tradewinds Consulting & EDRT Environmental Response
Bryan Uyesugi, Freshpoint
Peeyush Varshney
Nosh and Nina Vellani
Vertexone
Barb Whidden
Alan Wong

Tournament organizer, Diane Hardouin (left) with Seva's Executive Director, Penny Lyons

For the month of June they are donating $30 to Seva Canada for every pair of glasses sold.

For 40 years, Delta Optical has been providing exemplary customer service and has built lasting relationships with their customers. The small optical chain provides service in Square One, Fairview Mall, Hillcrest Mall and Oakville, Ontario.

Here’s their wonderful poster:

This blind Tibetan man is one of the first patients at the new Kham Eye Center in Dartsedo. He will receive cataract surgery to restore his sight.

The region has one of the highest rates of preventable and treatable blindness in the world and the need for care is huge. The high prevalence of age related cataract blindness among Tibetans is perhaps due to high altitude ultraviolet light exposure. According to a study in the British Journal of Ophthalmology, blindness and visual impairment in the Tibet Autonomous Region are significant public health problems, with the most elderly having rates of blindness between 12% and 33%. Women in Tibet bear two thirds of the burden of blindness.The Kham Eye Centre is the first dedicated eye hospital on the Tibetan plateau.

Kham Eye Center is the brainchild of Dr. Dorjee, chief ophthalmologist and director of Kandze Prefecture People’s Hospital. Dr. Dorjee is an extremely dedicated and compassionate eye surgeon. When the devastating earthquake struck the Yushu area in April, Dr. Dorjee was in the region conducting surgical eye camps. He and his medical team rushed to the earthquake zone to offer emergency assistance and, in the first day alone, treated 800 earthquake victims.

Blind patients arriving at the Kham Eye Center in Dartsedo for eye surgery

The Kham Eye Center is a non-profit eye care institution specializing in clinical services, research, teaching and prevention and treatment of eye disease. Seva is funding the human resource development, technical and managerial mentorship, and provision of ophthalmic equipment instruments and supplies.

The goals of the Kham Eye Center are:

1. to conduct a minimum of 14,000 cataract sight restoring surgeries over the next 5 years;
2. to establish 10 vision centers by 2010;
3. to train 10 eye doctors and 10 county level nurses;
4. to establish the Center as a standard national eye hospital, using state-of-the-art technology;
5. to become the model eye care program in the Kham region;
6. to become an eye care training center;
7. and to develop as a community ophthalmology center.