Hans Rosling famously declaimed that there is no skill which the professionals of the developing world cannot apply – given the training, equipment and funding. The privilege of working and teaching in many countries has confirmed this for many.
The backlog of treatable blindness can and should ultimately be managed by the local communities and their support teams. The role of good neighbours is to support the transition to independence. Such support cannot rigidly enforce systems with which we are familiar and comfortable if they are to be effective. Our perceptions of the “best” options must not exclude good, sound alternatives..
There is an extraordinary resourcefulness within these communities. Appropriate, affordable and sustainable technology combine well with clinical skills and in-depth knowledge of basic sciences. One can and must devise realistic ways to investigate and treat refractive errors, cataracts, glaucoma, headaches and many other challenges.