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An Orthoptists Journey

The following article was published in the newsletter of The British and Irish Orthoptic Society’s monthly newsletter in August:

The Gambia-Swansea VISION 2020 Link

In February 2008 the ophthalmology department in Singleton Hospital Swansea became involved in a very exciting project. We were invited to form a link with The Sheikh Zayed Regional Eye Care Centre (SZRECC) in Banjul in The Gambia as part of the V2020 Links Programme. This programme was established at the International Centre for Eye Health in 2004 with the aim of improving the quality and quantity of eye health training in Africa through needs-based partnerships or links. There are currently 18 V2020 links in the UK/Africa.

Once the decision was made to accept the offer of forming a link we were visited by Marcia Zondervann, V2020 Links Programme Manager who made a presentation to the ophthalmology/orthoptic team outlining what would be involved. The Gambian team had identified teaching and education as the main focus of the link with an emphasis on children’s eye care services and glaucoma initially. They were lucky enough to have benefited from a generous donation which enabled SZRECC to be built and become a tertiary centre for eye health for the whole of The Gambia. However the centre was still understaffed and the staff wanted to improve their knowledge in all areas of ophthalmology and identified paediatrics as a top priority.

The Gambia is Africa’s smallest country and is half the size of Wales. The country is famous for its wildlife and beautiful scenery and the people are extremely friendly. English is the official language due to the fact that it was a British colony until 1965 and the population is 1.6 million 90% of whom are Muslim.  The Gambia had already formed a link with Swansea through the University so it was a natural progression to form an eye link with our hospital and strengthen that partnership.

After hearing Marcia speak those of us who quickly saw a chance to broaden our horizons whilst benefiting a less developed African country formed a steering committee and the link was born. The Swansea V2020 link committee consisted of two ophthalmologists, a nurse manager, an ophthalmic trained nurse, two orthoptists and two optometrists.

Our first task as a committee was to organise a scoping visit to The Gambia. which took place in April 2008.  Friendships were formed and when the team returned they were full of enthusiasm for the link. They quickly identified some areas where they felt we could really make a difference.

The Gambian team made a return visit to Swansea in July. During this busy week we put together a programme of lectures, clinical observation and visits to local optometrists and a GP practice. As part of the links process we also spent time writing a memorandum of understanding which is a contract between the two link countries, and a detailed three year activity plan. This identified the teaching needs, described time scales and specified relevant personnel for each topic who would ensure that the outcomes would be achieved. The main aim was to make the clinic a centre of excellence for the whole of West Africa in just three years!

Then the hard work started. To carry out our aims we needed to raise money which would be required to fund the visits to the Gambia and return visits to Swansea. We had no idea how to do this but with Marcia’s help and lots of enthusiasm we planned various fund raising events such as a Charity Ball, Golf Day and Quiz Night. Advice was sought on how to access grants and after completing several complicated forms we were lucky enough to receive a seedcorn grant from THET (the Tropical Health and Education Trust) and funding from the Welsh Assembly “Wales for Africa” initiative. The Standard Chartered Bank ‘Seeing is Believing’ programme has also sponsored our link for some of our upcoming training visits between the two links for 2009 and 2010.  However we still need to find additional matching funds for these visits.

The link also received money from a Rotary Club and a playgroup. For publicity purposes we designed a website, poster and banner and seemed to be spending every spare minute involved in making the link a success.

Once we had some money we could plan our first teaching visit as part of the three year activity plan. As the first objective was paediatric ophthalmology we were delighted that Cheryl Madeira-Cole my Orthoptic colleague and I were lucky enough to visit in March along with David Laws, paediatric ophthalmologist, Lyndsay Bater, optometrist and Stella Elliott, retired nurse manager who has a background in ophthalmology.

The visit was both rewarding and hard work and was the icing on the cake after all the hard work we had done. At last we could see the ethos behind the links programme and how our link would benefit us and the staff and patients in The Gambia. It all suddenly began to make sense.

The conditions in SZRECC were more basic than ours but some of the systems were more forward thinking. For instance there was a counsellor who was part of the eye care team who supported patients who had a diagnosis of partial sight or blindness something that is only just coming to fruition in our department thanks to the RNIB. The hospital was cleaned from top to bottom after clinics finished and the staff and patients never seemed to complain about the long waits or lack of treatment options. It was a truly humbling experience.

Cheryl and I taught the refractionists basic Orthoptics – vision testing and cover test whilst the optometrist refined their refraction techniques. Our consultant assisted in paediatric and general clinics and carried out a theatre list. We were welcomed with open arms and treated like royalty so much so that we were all very sad to leave at the end of the week but felt that the visit was truly worthwhile.

So we have only just started on our link “journey” but hopefully things will go from strength to strength and we will all continue to benefit from the team working, improved teaching skills and enhanced quality of services whilst feeling that we really are contributing to a programme that is making a difference. The tedious parts are the report writing, applying for grants and finding the time however this is outweighed by the benefits. I would thoroughly recommend becoming involved if you have an opportunity.

If you are interested in forming a V2020 link first you need to have support from your eye care team – you need keen orthoptists, ophthalmologists, nurses and optometrists then contact the International Centre for Eye Health specifically the V2020 Links Programme ( and they will start you off. If there is no support in your hospital you could always join with a neighbouring V2020 eye link to assist them in their specific link activities.

If you want to find out about our activities please visit our website or contact me via the BIOS office.

We would like to thank our orthoptic colleagues in Swansea who have patiently listened to Cheryl and I talk incessantly about the link over the past year and have supported our fund raising events. Hopefully the link has been as rewarding for them as it has been for us.

Suzanne Martin

Deputy Head Orthoptist

Singleton Hospital


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