Learning to See Clearly

Jamie Clearfield's Musings on Evaluation and Development

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Evaluation Transitions: Nepal Bound…

I apologize for the silence on the blogosphere…it has been a hectic few months. And while my thoughts are always churning on evaluation, they sometimes take awhile to formulate into something that is worth writing or comprehensible. I have been thinking a lot about transitions, since that is where I am in my personal life. My husband I are about to embark on a 6 month international stint working with the Himalaya Cataract Project. The Himalaya Cataract Project (HCP) works to cure and combat preventable blindness globally, focusing specifically on sustainability. They invest in infrastructure and more importantly education and training of doctors, nurses, techs, and other medical personnel needed to make their work as cost effective and efficient as possible. Through innovations by Dr. Sanduk Ruit and many others, cataract surgery can be performed for as low as $20 (compared to over a $1000 in the United States). This is due in part to advances in surgical technique and local production of necessary technology, but also organizationally focusing on efficiency and training people up to perform the highest level task that they can with their given education. This has allowed the hospital supported by HCP, Tilganga Eye Institute of Ophthalmology, and others throughout India and Nepal (most notably Aravind) to operate on a cost recovery model. Within this model, everyone receives the same high quality opthalmologic care; extra amenitites cost extra. Using different figures based on local GDP, generally a percentage of people seeking care pay above cost, some at-cost, and the rest are far below or covered for free.

We’re incredibly honored and tremendously excited to embark on this trip which is taking us to Nepal, Ethiopia, Ghana, and potentially India. My husband Z will be working on the medical side of things, I will be working on a number of different evaluations with the organization.

Transitioning from the United States overseas is always an adventure. I am also playing some mind games thinking about the differences in working with a healthcare organization versus an educational program. While I have previously worked in public health, it was with an HIV education program. Direct services were not provided, rather critical support services and education. I am particularly struct by how easy it is to discuss what we will be doing; there is no hard “sell” for curing blindness. Watching videos from the field and from cataract camps of people who may have been blind for years suddenly able to see their children, parents, friends, homeland once more and be able to work and participate again in communal life once more – that moment is awe-inspiring, a rebirth.

What is harder for HCP and so many other organizations is to find the funding and support for everything else that must take place to get a patient to the operating table.The backstage of any non-profit or NGO is frought with highs and lows, crisis and triumphs. I have seen this cycle with Kibera Girls’ Soccer Academy and other education organizations, where the end result cannot be truly defined and any measure you do use takes a long time to see any result. This transition to HCP is revolutionary for me, yet I know there is so much to learn and so much more to try to understand.

So we’re off … I will do my best to post updates on evaluations from the field, as well as pictures. I look forward to embarking on this new adventure through a broader evaluative lense, and to learning, living, experiencing all that these new transitions will bring!