Cataracts a health scourge for China's poor

Xilinhot, CHINA (Reuters) - Wulanqiqige, a shepherd in Inner Mongolia, has had trouble minding her flock since she went blind in her left eye about three years ago.

But in an operation that took less than 10 minutes, Wulanqiqige had her sight restored. She is among around 4.5 million people in China who are blind or severely visually impaired due to cataracts.

"What I want to see right now are my animals, I haven't been able to enjoy them for so long," the 55-year-old ethnic Mongolian grandmother said, beaming widely when she realized that she could see again after doctors removed her eyepatch.

Cataracts -- the clouding of the lens of the eye which blocks out light eventually causing blindness -- is a major health problem in China.

Country folk are more susceptible because they are constantly exposed to ultra-violet light from the sun which is among the causes of cataracts, and they are often too poor to afford corrective surgery.

There are at least 1 million new cataract cases each year in China. The total number of cases could balloon to 167 million by 2020 because of an ageing population, according to ORBIS, a group that aims to treat and prevent blindness in developing countries.

Cataracts, which often affect older people, cause blindness if left untreated. These days, cataracts are easily treated in developed countries, but treatment is far from accessible and often far too expensive in developing nations.

"There is a lack of medical services in the countryside and most rural folk are poor and can't afford the medical fees," said Dennis Lam, a leading Hong Kong ophthalmologist, who has set up a non-profit charity called "Project Vision" which aims to treat cataract sufferers in rural China.

China has 5 million patients awaiting cataract surgery but only 600,000 are performed a year, or 400 surgeries per million people - a fraction of what is seen in many other countries.

In India, 3,900 cataract surgeries are performed for every million people, while the figures stands at a staggering 10,000 in the United States.

According to the World Health Organisation, 37 million people were blind in 2006 and 124 million had low vision globally. Cataracts was the cause in half of all these cases.

CATARACT TREATMENT

In China, 80 percent of people who need treatment for cataracts live in rural areas, while 70 percent of China's 24,000 eye doctors live and work in cities.

Hospitals in China charge between 2,000 yuan (US$253) and over 10,000 yuan for treating a cataract in one eye -- almost the average annual salary in rural China. The fees are simply unaffordable for many in the country of 1.3 billion people.

Many put off treatment until they get a bumper harvest or can sell the family cow at a good price.

Jia Fongming tolerated the blindness in his right eye for over a year until he couldn't even pour himself a drink.

"I couldn't see and I poured it all over the table, that's when I decided to see a doctor," said the 74-year-old Mongolian.

The demand for cataract surgeries -- and the lure of extra money -- has triggered a flood of local eye doctors to the countryside to carry out the most basic forms of this surgery, which do not require sophisticated equipment.

Skilled surgeons can complete an operation -- which involves removing a clouded lens and inserting an artificial one permanently in the eye -- in just over 10 minutes. They charge between a few hundred yuan and 1,000 yuan for an eye.

"One doctor holds the record for doing over 80 operations in a single day," said eye doctor Daniel Chen, who is based in Guangzhou city in southern China.

Project Vision aims to establish 100 "eye centers" over the next few years, staffed by qualified Chinese eye doctors who would be trained to perform cataract surgeries. The aim is for 1,000 surgeries to be carried out each year in each eye centre.

Its first centre opened over the weekend in Xilinhot, where Mongolian grandmother Wulanqiqige was treated. Patients are charged 700 yuan for each eye, which Lam said would help the centers become self-funding.

"It would be possible to achieve higher surgery rates if quality and affordable surgery can be carried out close to where people live," said Lam.