100 and Change: 2019 Supporting Documents

100&Change Supporting Documents - Round One Application 

“Every operation is an enormous opportunity to change a person’s life.” - Dr. Sanduk Ruit, The Barefoot Surgeon, p.114

Our Team

Organizational History & Structure


Clinical and Training Collaborators
  • Tilganga Institute of Ophthalmology
  • LV Prasad Eye Institute
Program Collaborators and Organizational Scaling Consultants
  • Helen Keller International
  • Kanava
HCP|CureBlindness Partnerships, Affiliations, and Memberships

What's the Problem and How Will You Solve It?

Problem Statement References

Eye Health Global Action Plan

What's the Evidence That Your Solution Will Work?

Peer-Reviewed Articles
  • Ruit, S., Tabin,G., Chang, D., Bajracharya, L., Kline, D.C., Richheimer, W., Shrestha, M., Paudyal, G. (2007). A Prospective Randomized Clinical Trial of Phacoemulsification vs Manual Sutureless Small-Incision Extracapsular Cataract Surgery in Nepal. American Journal of Ophthalmology, 143 (1), 32-38.e2. Comparative study proved small incision extracapsular cataract surgery to be the best solution for high-volume developing world surgery, with equally good outcomes, compared to phacoemulsification technique.
    • This article cited in 93 subsequent articles and a 2013 Cochrane review. List of full references
  • Ravilla, Thulasiraj, and Dhivya Ramasamy (2014). Efficient high-volume cataract services: the Aravind model. Community Eye Health, 27.85: 7–8.
  • Rao GN, Khanna RC, Athota SM, Rajshekar V, Rani PK (2012 Sept - Oct). Integrated model of primary and secondary eye care for underserved rural areas: the L V Prasad Eye Institute experience. Indian Journal of Ophthalmology, 60(5): 396-400.
  • Thomas, B.J, et al. (2016). Blindness, Cataract Surgery and Mortality in Ethiopia (.pdf). British Journal of Ophthalmology, 100, 1157-1162. Findings: mortality risk was significantly elevated in older cataract-blind patients compared to non-cataract-blind patients. This elevated risk was not noted in studied cohort who had cataract surgery.
  • RAND Corporation Report (.pdf) - October 2014 research conducted to analyze the costs of blindness and the impacts of cataract surgery.
Accolades & Awards
  • Gripper, Ali (2019). The Barefoot Surgeon: The Inspirational Story of Dr. Sanduk Ruit, the Eye Surgeon Giving Sight and Hope to the World's Poor. Sydney, Australia: Allen & Unwin.
  • Relin, D.O. (2013). Second Suns: Two Doctors and their Amazing Quest to Restore Sight and Save Lives. New York, NY: Random House, Inc.
  • Mehta, P.K., Shenoy, S. (2011). Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion. Oakland, CA: Berrett-Koehler Publishers.
  • Sanduk Ruit, Geoffrey C. Tabin, Charles C. Wykoff (2006). Fighting Global Blindness: Improving World Vision Through Cataract Elimination. American Public Health Association (APHA) Press.

Glossary of Terms

  • What is Ophthalmology? Ophthalmology is the branch of medicine that deals with the anatomy, functions, pathology and treatment of the eye.
  • What is a cataract?
  • Definition of “Brain Drain”: “a situation in which many educated or professional people leave a particular place or profession and move to another one that gives them better pay or living conditions” - Merriam Webster
  • What is refractive surgery? Refractive surgery islaser surgery to improve vision, akin to the effect of corrective lenses. Laser correction has greater economic impact vs. spectacles in resource-limited locales, where regular spectacle replacement is unrealistic.
  • What is an Auto Refractor: An autorefractor or automated refractor is a computer-controlled machine used during an eye examination to provide an objective measurement of a person's refractive errorand prescription for glasses or contact lenses. This is achieved by measuring how light is changed as it enters a person's eye.
  • The Four Levels of Visual Function
  • The Three Most Common Causes of Visual Impairment


“I had surrendered to remaining in the darkness before I came here. But now I have my life back.”- Francis Kiiza, Rwanda

“All my eyes were good for was making water. Life became very sour for me.” - Kamisya Tamang, Nepal

“One woman had been blind for about ten years, and had never laid eyes on three of her own children. When her bandages came off and she saw them, we all just sat there and cried -- me, Ruit, the woman, and her children. It was just so emotional.” - Les Douglas, Australian Ambassador to Nepal

“...a beacon of light...our medical Buddha.” - His Holiness, Tenzin Gyatso, the Fourteenth Dalai Lama, on Dr. Sanduk Ruit

“Cataract is the 800-pound gorilla of visual impairment and blindness in the developing world.” - Dr. Alfred Sommer, Dean Emeritus, Johns Hopkins Bloomberg School of Public Health

“...if a five-minute procedure exists that can restore sight for $20 a patient, then it is the world’s most effective way to combat blindness in developing countries.” - Dr. David Chang, Clinical Professor of Ophthalmology, University of California

“Cataract surgery is one of the most cost effective of all health interventions.” - World Health Organization (WHO)

“Each of us started our four-year ophthalmology residency program with a lot of enthusiasm, energy and passion of becoming a better ophthalmologist. And most importantly we are aiming to become part of the solution in the alleviation of the huge burden of blindness in Ethiopia. The financial support has greatly helped us to concentrate on our studies and will play a crucial role in our success.” - Dr Daniel Getenah, Ophthalmology Resident, Ethiopia

“This fellowship gives me a lot of insights and experiences in corneal and external eye diseases. I hope to become a good and capable corneal specialist by using this experiences and further learning.” - Dr. Aye Chan, Myanmar, Cornea Fellow

“My experiences as a retina fellow at Tilganga was wonderful with the mentorship of great vitreo-retinal surgeons who helped me gained valuable skills and achieved most of my expectations. Hopeful to transfer this experience and elevate the eye care services of our country.” - Dr. Alemu Kerie, Ethiopia, Retina Fellow


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3 Lloyd-Sherlock, P. (2000). Population Ageing in Developed and Developing Regions: Implications for Health Policy. Social Science & Medicine, 51(6), 887-895.

4 Investing in Vision – Comparing the Costs and Benefits of Eliminating Avoidable Blindness and Visual Impairment (Rep.). (2013).

Retrieved from https://www.cbm.de/static/medien/Summary-Investing...

5 Brilliant, L.B., et al. (1985). Epidemiology of Blindness in Nepal. Bulletin of the World Health Organization, 63(2), 375-386.

6 Sapkota, YD (2012). The Epidemiology and Blindness in Nepal 2012 Report. Nepal Netra Jyoti Sangh.

7 Rao, G. N., et al. (2012 Sept - Oct). Integrated Model of Primary and Secondary Eye Care for Underserved Rural Areas: the LV Prasad Eye Institute Experience. Indian Journal of Ophthalmology, 60(5): 396-400.

8 Bhandari, A., et al. (2008). Specialty Care Systems: A Pioneering Vision For Global Health. Health A airs, 27(4), 964-976.

9 Rajak, S. N., et al. (2012). Why Do People Not Attend for Treatment for Trachomatous Trichiasis in Ethiopia? A Study of Barriers to Surgery. PLoS Neglected Tropical Diseases, 6(8).

10 Vincent,J.E.,et al.(2007).The Rationale for Shifting from a Voluntary Clinical Approach to a Public Health Approach in Addressing Refractive Errors. Clinical and Experimental Optometry, 90(6), 429-433.

11 Naidoo,K.S.,etal.(2010).The Challenge of Uncorrected Refractive Error: Driving the Agenda of the Durban Declaration on Refractive Error and Service Development. Clinical and Experimental Optometry, 93(3), 131-136.

12 Bamashmus,M.A.,etal.(2015). Functional Outcome and Patient Satisfaction after Laser In Situ Keratomileusis for Correction of Myopia and Myopic Astigmatism. Middle East African Journal of Ophthalmology, 22(1), 108–114.

13 Glick,P.,etal.(2014).The Costs of Blindness and the Impacts of Cataract Surgery: Final Report (pp. 1-108, Rep.). RAND Corporation Report (.pdf )

14 Glick,P.,etal.(2015).The Individual and Household Impacts of Cataract Surgery on Older Blind Adults in Ethiopia. Manuscript submitted for publication.

15 Thylefors,B.(1998). A Global Initiative for the Elimination of Avoidable Blindness. American Journal of Ophthalmology, 125(1), 90-93.

16 Thomas,B.J, et al.(2016).Blindness, Cataract Surgery and Mortality in Ethiopia (.pdf). British Journal of Ophthalmology, 100, 1157-1162.

18 Kumar,B.(2013).Pioneering Innovation in Affordable HealthCare: Case Studies from India. IPE Journal of Management, 3(2), 95-114.

20 Gothwal, V. K., et al. (2003). The Development of the LV Prasad-Functional Vision Questionnaire: A Measure of Functional Vision Performance of Visually Impaired Children. Investigative Ophthalmology & Visual Science, 44(9), 4131.

21 Chang, D.F.(2005).Tackling the Greatest Challenge in Cataract Surgery. British Journal of Ophthalmology, 89(9), 1073-1077.

22 Mwabu, G., et al. (1993). Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis. The Journal of Human Resources, 28(4), 838.

23 Akin, J. S., et al. (1995). Quality of Services and Demand for Health Care in Nigeria: A Multinomial Probit Estimation. Social Science & Medicine, 40(11), 1527-1537.

24 Sen, P. (2007). Ashoka’s Big Idea: Transforming the World Through Social Entrepreneurship. Futures, 39(5), 534-553.

25 Ruit, S., et al. (1999). Low-Cost High-Volume Extracapsular Cataract Extraction with Posterior Chamber Intraocular Lens Implantation in Nepal. Ophthalmology, 106(10), 1887-1892.

26 Ruit, S., et al. (2007). A Prospective Randomized Clinical Trial of Phacoemulsification vs Manual Sutureless Small-Incision Extracapsular Cataract Surgery in Nepal. American Journal of Ophthalmology, 143(1), 32-38.e2.

27 Thomas, R.(2009). Role of Small Incision Cataract Surgery in the Indian Scenario. Indian Journal of Ophthalmology, 57(1), 1-2.

28 Jaggernath, J., et al.. (2013). Comparison of Cataract Surgery Techniques: Safety, Efficacy, and Cost-effectiveness. European Journal of Ophthalmology, 24(4), 520-526.

29 ASCRS•ASOA 2016 Annual Report (pp.1-18, Rep.). (2016).

30 Benefits of Partnering with IAPB. (n.d.). Retrieved from https://www.iapb.org/partnerships/ benefits

31 Partnerships: Impact. (n.d.). Retrieved from https://www.iapb.org/partnerships/impact

32 Cataract Surgery Protocol in Nepal (pp. 1-39, Rep.). (2015). Nepal Ophthalmic Society.

34 Tracking Universal Health Coverage: First Global Monitoring Report (Rep.). (2015, June). Retrieved https://www.iapb.org/sites/iapb.org/files/uhc_repo...

35 Bettadapura,G.S., et al.(2013). Barriers to the Uptake of Cataract Surgery in a Rural Population of South Karnataka, India. International Journal of Current Research and Review, 5(12), 77-82.

36 Mehari, Z. A., et al. (2013). Barriers to Cataract Surgical Uptake in Central Ethiopia. Middle East African Journal of Ophthalmology, 20(3), 229–233.

42 Ethiopia Scales Up Community-based Health Insurance - HFG. (n.d.). Retrieved from https:// www.bing.com/cr?IG=D41A6CB533E24F5DA63596... 9009E82B57AD16B21&rd=1&h=LF0C-gEgAuT80b4gKSB9AaOoqiafDkzkfSXkH7YgzB4& v=1&r=https%3a%2f%2fwww.hfgproject.org%2fethiopia-scales-community-bas... insurance%2f&p=DevEx,5064.1

43 Feleke, S. (2015). Ethiopia’s Community-based Health Insurance: A Step on the Road to Universal Health Coverage (pp. 1-12, Rep.).

44 Courtright, P, & Lewallen, S.(2007). Improving Gender Equity in Eye Care: Advocating for the Needs of Women 20(64), 68-69

45 Managing Risk in Global Health: Mapping the Way Forward (Rep.). (n.d.). Retrieved


46 Singh, A., & Strauss, G.H. (2015). High-Fidelity Cataract Surgery Simulation and Third World Blindness. Surgical Innovation, 22(2), 189-193.

47 Haripriya, A., et al. (2016). Efficacy of Intracameral Moxifloxacin Endophthalmitis Prophylaxis at Aravind Eye Hospital. Ophthalmology, 123(2), 302-308.

49 Schwering, M.S., et al. (2014). Training Ophthalmologists for Developing Economies: An African-German Partnership. Postgraduate Medical Journal, 90(1060), 61-62.

50 Nkanga, D., et al. (2015). Outcome of Surgery in a Manual Small Incision Cataract Surgery Training in Calabar, Nigeria. Archives of International Surgery, 5(2), 96-100.

51 Dean,W.H. (2015). Quality of Small Incision Cataract Surgery. Community Eye Health, 28(90), 30–31.

52 Venkatesh, R., et al. (2016). Carbon Footprint and Cost–Effectiveness of Cataract Surgery. Current Opinion in Ophthalmology, 27(1), 82-88.

53 Pearce, M.G., & Pearce,N. (2012). Addressing Refractive Error Visual Impairment: Volunteer Organisations’ Alignment with Vision 2020 and Public Health Principles. Clinical and Experimental Optometry, 95(6), 583-589.

54 Ehlke, G. L., & Krueger, R. R. (2016). Laser Vision Correction in Treating Myopia. Asia-Pacific Journal of Ophthalmology, 5(6), 434-437.