Operation Yeelen / by Björn Thylefors

''Operation Yeelen '' The "Operation Yeelen " van arrives in a village in Mali. This is the community's first point of contact with the team, whose task is to determine the frequency of eyesight problems and then to find how best to prevent them. Below : it is vital to convince the village elders of the value of this work. The programme team explain their task and seek the fullest possible collaboration of the community itself. There is rarely any dissenting voice. by Bjbrn Thylefors 1Jhe Republic of Mali is one of the many countries in Africa which face the problem of an overburden of blindness-and most of it could be avoided . The four major global causes of blindness, namely trachoma, vitamin A deficiency, onchocerciasis (river blindness) and unoperated cataract, are all present in this country, which stretches from the Sahara Desert in the north through Sahel areas down to the savannah in the south. Mali is one of the countries participat- ing in the Onchocerciasis Control Pro- gramme, so most blindness caused by that disease will eventually disappear. However, a collaborative programme to combat other causes of blindness in Mali was set up in 1979 under the name of "Yeelen", which means "light" in the local Bambara language. This pro- gramme involves nongovernmental or- ganizations (the Malian Association for the Blind, and the Organization for the Prevention of Blindness in France), the Ministry of Health and Social Affairs, and the Institute of Tropical Ophthal- mology in Africa, located in Bamako, the capital of Mali . "Operation Light" seeks to prevent blinding diseases through a network of regional eye health centres, with out- reach services to rural areas for early detection and treatment of eye dis- orders and for health education. Each regional eye centre can also carry out surgery against common causes of visual loss, such as cataract. So the programme is responsible for training personnel in eye care, whether at the specialist level or for nurses and health workers at the village level. Much of this training is conducted at the Institute of Tropical Ophthalmology in Bamako, which is also a WHO Collaborating Centre for the Prevention of Blindness . In 1983, the Arab Gulf Programme for United Nations Development Organiz- ations (AGFUND) joined in supporting the "Yeelen" programme through the WHO Programme for the Prevention of Blindness . The contribution from AGFUND has allowed for increased train- ing activities, and for the rapid estab- lishment or strengthening of the re- gional eye centres . W oRLD HEALTH, July 1986 Above : Village children line up as one of the visitors checks their eyes for signs of trachoma. Below : Adults take their turn next, gesturing with their own hand if they can clearly see the model displayed. Foot of page: A small boy awaits treatment for an eye injury. Right: Another success for Operation Light: a cataract operation and a pair of glasses have given back this patient's sight. Today there are six such centres in full operation in Mali, working in rural areas through mobile teams . In 1984, these centres, together with the I nsti- tute in Bamako, carried out more than 340,000 examinations and treatments for eye diseases all over the country. In the same period, a total of 5,865 eye operations were performed, including more than 1 ,000 cataract operations to restore sight to the curable blind. Dr Bjorn Thylefors is the Mana- ger of WHo's Programme for the Prevention of Blindness. As from 1986, national staff and re- sources are assuming full responsibility for this highly successful programme, which is demonstrating the value of collaborative efforts between non-gov- ernmental organizations, funding and technical agencies, and the national health authorities. Similar programmes, based on the experience gained, are now being planned for certain other African countries . • W ORLD HEALTH, July 1986 Photos by Pierre Pittet