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Training ophthalmologists for developing economies: an African-German partnership
  1. M Schulze Schwering1,2,
  2. M S Spitzer1,2,
  3. K Kalua1,3,
  4. H N Batumba1
  1. 1Department of Ophthalmology within Surgery, College of Medicine, Blantyre, Malawi
  2. 2Department of Ophthalmology, University of Tübingen, Tübingen, Germany
  3. 3Blantyre Institute of Community Ophthalmology, BICO, Blantyre, Malawi
  1. Correspondence to Dr med. M Schulze Schwering, FEBO, Department of Ophthalmology within Surgery, College of Medicine, University of Malawi, Blantyre 3, Malawi; mssoculus{at}

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Globally, 32.4 million people (95% CI 29.4 to 36.5 million people; 60% women) were blind in 2010, and 191 million people (95% CI 174 to 230 million people; 57% women) had moderate or severe visual impairment (MSVI).1 The most common cause of blindness is cataract, which contributes to about 48% of all blindness in the world. ‘VISION 2020: The Right to Sight’ is a global initiative that aims to eliminate avoidable blindness by the year 2020.2–4 The three pillars of VISION 2020 are: (1) disease control; (2) human resource development for eye care at all levels; and (3) provision of infrastructure and appropriate technology.

VISION 2020 is the global initiative for the elimination of avoidable blindness, a joint programme of the WHO and the International Agency for the Prevention of Blindness (IAPB), with an international membership of NGOs, professional associations, eye care institutions and corporations.

Sub Saharan Africa faces severe shortages of eye care workers at all levels,5 ,6 with countries such as Malawi having only one ophthalmologist for every 1.5 million people.7 The VISION 2020 minimum target for the number of ophthalmologists in Africa is four per million population. Malawi now has only 10 ophthalmologists (seven Malawian and three expatriates) for a population of 15 million people, so it is 50 short of the recommended number of ophthalmologists. Reaching Malawi's 2020 target depends on significant increases in training capacity for specialist ophthalmologists. Before the programme started in 2006, only three ophthalmologists were working in Malawi.

Developing countries have three options for training surgeons: train them themselves, join a regional network for training, or send doctors to more developed countries for specialist training.8 Until 2006, Malawian doctors went abroad for specialist training in ophthalmology. However, these doctors tended to not return. Therefore, Malawi's College …

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