The Problem of Access
There are hundreds of millions of children, youth, and adults throughout the developing world who suffer from refractive errors. Although the ideal solution to this problem would be to have optometrists and ophthalmologists with a presence in every low income community, as we know, this isn’t the reality and is unlikely to be so anytime soon. As such, how can we reach these people in need of a high-quality and economically sustainable way whereby they can access vision solutions that they so desperately need? Certainly mission trips by good-willed optometrists play an important role. However, in addition to this, we believe that local social enterprises should and must play a key role in this effort. They act as the essential “bridge to the last mile” and are commonly the only organizations reaching populations in need in the most marginalized corners of the world.
The Social Enterprise Solution
The social enterprise movement has been gaining steam for the past decade or so and there are now hundreds, if not thousands, of great organizations (for profit and non profit) in the developing world who define themselves as social enterprises. These entrepreneurial organizations are intelligently solving the health, education, energy, agricultural and economic needs (amongst others) of marginalized communities at scale. They do this by empowering local (typically women) entrepreneurs/community health workers to serve their neighbors by creating awareness, educating, promoting and selling “livelihood” solutions. To date, social enterprises have proven successful in creating first-time access to myriad solutions such as improved cook stoves, solar lamps, water filters, oral rehydration salts, and the like. And in no small part, as a result of the initiative of our good friends at VisionSpring, a growing number of these organizations are successfully getting people 35 years old and over reading glasses for the first time throughout the world. The impact of this work cannot be overstated. However, how can we address the refractive errors of people younger than 35 years old? How do we help the ten year old girl who drops out of school and becomes “stuck” in the vicious cycle of poverty simply because she can’t see the white board? To date it has been exceedingly difficult for social enterprises to solve this problem. The missing element to getting this girl the glasses she needs is that an appropriate, low-cost technology for diagnosing refractive errors that is portable, easy to use and accurate simply hasn’t existed. Smart Vision Labs has now solved this problem and is proving that social enterprises, equipped with the SVOne, a backpack of glasses and training in basic vision problems and solutions, can efficiently get glasses to people for the first time in their lives. How do we know this? We know this because we have been proving it in the field in the Dominican Republic, Haiti, Nicaragua, Ecuador and Guatemala working with the professionals at Community Enterprise Solutions and the locally-owned social enterprise they founded and support called Soluciones Comunitarias. We share in our next post some recent examples of success that demonstrate the power of the SVOne as a social enterprise solution. However, let us first a bit how a Smart Vision Labs social enterprise model can work.
The Smart Vision Labs Social Enterprise Field Methodology
Within the model that Smart Vision Labs is developing, the local social enterprise and its trained entrepreneurs (“Vision Advisors” (VA’s)) promote a “vision campaign” with local community leaders and/or organizations who set up a space at a school, in someone’s home, or in the town hall (really anywhere central where people convene). Here is how a typical vision campaign works. On the designated day the fully-equipped VA’s arrive in the community (assuming they don’t live there) where they have been promoted and are greeted by a line of people who have self-identified as having vision problems. The VA’s set up their work area and then begin by gathering client information and providing visual acuity exams for free (teachers can play a preliminary screening role as well). If someone can see clearly to 20/40 they “pass”. If not, assuming they don’t simply need reading glasses, they are offered the opportunity to be diagnosed with the SVOne. In some cases the social enterprise may charge a reasonable amount for the SVOne diagnosis and in other cases it may not. This is up to the social enterprise and we are testing both models. (Critical note – If at any time in the process it appears that a client has other visual health issues they are referred to the nearest vision professional.) For those who choose to get the SVOne service, both eyes are then tested to ascertain the sphere, cylinder, axis and, as a result, spherical equivalent. If the client is diagnosed as having a need that can be solved with between +3.00 and -4.00 lenses, the VA then uses this SVOne produced data and the client tries on the appropriate pair of glasses from the VA’s backpack. Next, with the glasses on, the client is asked to repeat the visual acuity exam. The goal is that this person can now reach 20/40 at worst, 20/20 ideally and most certainly, 20/Happy. If this is not achieved, the VA iterates to get the right pair of glasses. If for some reason this result cannot be achieved, the client’s information is noted and he or she is referred to the nearest vision professional.
Assuming the client achieves the desired result, he or she is then offered the opportunity to try on different styles, walk around a bit and, if all goes well, buy what is likely his or her first pair of glasses. Different prices are charged depending on the age of the client and style of the glasses. Through this process people are able to get the glasses that they need and/or are referred whilst an income generating opportunity is created for the both local VA and social enterprise. Ideally everyone wins. But there is one more key element here that speaks to the power of social enterprise. Because the VA’s are from the community they are serving or one in close proximity, they speak the local language of their clients and can follow-up periodically to ensure that the glasses are actually solving the problem. This is of critical importance. The goal is that people can use the SVOne as a catalyzing tool to obtain glasses that they like, that serve their needs and that they actually use. This is the kind of “sustainability” that really matters.
Finally, to be clear, this approach is in no way obviates the need for an eye health check by a professional. As noted above, at times there may be a vision clinic within a few hours. However, often times this isn’t the case. Ideally the social enterprise and VA’s are able to work with clinics somewhere in country and/or with groups such as VOSH, OneSight and the like to schedule comprehensive vision exam visits on a periodic basis.
So, that is how it works. Now stay tuned for our next blog post to see how this social enterprise concept has been turned into reality in Guatemala and the Dominican Republic!
If you are interested in exploring a social enterprise model with Smart Vision Labs please contact firstname.lastname@example.org.