President’s Insights May 2020

May 5, 2020 marked the annual World Health Organization’s (WHO) 2020 Save Lives: Clean Your Hands campaign. This time, they dedicated the effort to nurses and midwives, quite appropriately in the current circumstances, but clearly the effort applies to all health care workers and volunteers including vision and eye care professionals.

One of the most prevalent causes of preventable vision loss is trachoma. Trachoma is a bacterial infection that affects. your eyes.  It’s caused by the bacterium Chlamydia trachomatis. Trachoma is contagious, spreading through contact with the eyes, eyelids, and nose or throat secretions of infected people. Through public health education efforts including hand and face washing, there has been great success in controlling this disease. The WHO Alliance for the Global Elimination of Trachoma have announced that the number of people requiring surgery for trachomatous trichiasis, the blinding stage of trachoma, has dropped from 7.6 million in 2002 to 2.5 million in 2019, a reduction of 68%.

Another contagious eye disease is epidemic keratoconjunctivitis (EKC), caused by an adenovirus, and one of the most contagious and common eye infections in the world. This adenovirus spreads via contact with hands or surfaces contaminated with ocular secretions. Outbreaks are often traced to public venues or from instrumentation at health and eye clinics. This is why many clinics have instituted programs focused on prevention via hand washing, avoiding touching the eyes or face, and ophthalmic equipment sanitization.

The World Health Organization has released “My 5 Moments of Hand Hygiene” which defines the key moments health care workers and volunteers should perform hand hygiene. This concise guide is evidence-based, field-tested, and is applicable in a wide range of settings including eye clinics. This approach recommends that we clean our hands,

  • Before touching a patient,
  • Before clean/aseptic procedures,
  • After body fluid exposure/risk including tears, After touching a patient,
  • After touching patient surroundings.

In times of COVID-19, handwashing takes a renewed significance. As VOSH/International considers guidelines for safe and effective clinics, effective hand washing technique and supplies will be of upmost importance. For more information, here are further references.

https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf

 

Daniel Twelker, OD, PhD, FAAO, FVI
President, VOSH/International

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Updated COVID-19 and VOSH Humanitarian Clinics Advice

VOSH/International recently consulted its US and International Chapters about the feasibility and timing to restart our humanitarian clinics. While the vaccination process continues with different levels of success depending on availability and acceptance, it is evident that vaccine inequity and the availability and reliability of data in several countries are issues we need to consider.

Even if already vaccinated, our chapters are still concerned about the wellbeing of our volunteers and patients.  Some chapters, are organizing clinics locally where they are better able to comply with the existing safety requirements and respective state/country regulations.

The COVID-19 pandemic is being experienced quite differently depending on state, region, country, vaccine availability, vaccine acceptance, and the spread of SARS-COV-2 variants. Most VOSH chapters are not holding clinics or traveling internationally in 2021.

Thus, VOSH/International is slightly moderating its overall guidance against clinics and travel issued in late March 2020 and renewed in January 2021. This will be reviewed and communicated on a quarterly basis.

If a VOSH Chapter choses to hold a clinic or travel internationally, we highly recommend that the chapter performs due diligence to comply fully with the requirements established by the visited country, ensures all VOSH volunteers are aware of and follow strict safety guidelines and all existing protocols and regulations of the country, and keeps the principle of “do no harm” embedded in all its decision making. As always, the wellbeing and safety for VOSH volunteers and our patients is of utmost importance and central to any decision-making process. We have published our updated clinic guidelines with best practices to be observed in this new context. VOSH chapters in specific countries are using protocols that need to be considered as well. You can download VOSH/International clinic guidelines here.

*VOSH/International is formed by autonomous US and international chapters that are fully and only responsible for their activities, fundraising and decision-making.  VOSH/International can only provide recommendations based on our best knowledge and information at the time.

Also please keep checking the following sites with official and most recent updates:

World Health Organisation: https://www.who.int/emergencies/diseases/novel-coronavirus-2019

US CDC: https://www.cdc.gov/coronavirus/2019-ncov/travelers/when-to-delay-travel.html

US Government Travel Advise: https://travel.state.gov/content/travel/en/traveladvisories/COVID-19-Country-Specific-Information.html

Thank you for your hard work and dedication to improving vision and eye health throughout the world.

John Daniel Twelker, OD, PhD, FAAO, FVI

President, VOSH/International

July 2021