Dr. Baah developed a proposal to establish a new clinic in October 2008, and Save The Nation’s Sight Clinic was inaugurated in January 2009. The clinic is based in Accra and provides some care to patients in the Accra region. For much of the year, Dr. Baah identifies regions in Ghana that lack ophthalmologists but do have district ophthalmic nurses. He links up with Regional Directors of Health Services, District Directors of Health Services, Medical Superintendents of Government or Mission Hospitals, District Chief Executives, traditional and opinion leaders in communities, and with local NGOs and other stakeholders in the provision of health services. Patients with operable cataracts are identified, and operations are undertaken in nearby hospitals. The district ophthalmic nurses continue to provide postoperative care for the patients after Dr. Baah’s team departs the region.
Dr. Baah’s logistics and coordination efforts prior to each outreach are immense and noteworthy. He develops an extensive outreach team consisting of local ophthalmic nurses, community members, cooks, drivers, and other personnel. He must personally visit each location to coordinate all of the details, to receive permission to operate there, and to coordinate with the local district to utilize their hospital facilities to provide cataract surgery, pterygium surgery, and other surgical operations. Since Dr. Baah’s teams are constantly providing care to new regions and working with different health personnel throughout the country, the logistics are quite complex and time consuming. Dr. Baah’s commitment and dedication to reach new regions is laudable.
When the program begins in the designated region, the team is usually based near the district hospital. Each day, the outreach team is split into approximately 6 separate outreach teams who go to separate villages/towns in order to reach the patients who are hardest to reach. In each village/town, the team usually sees 25-100 patients per day, and the individual village teams therefore collectively see a range of 150-600 depending on the totals seen by each of the 6 village teams.
Most importantly, Dr. Baah has developed a sustainable eye care system that is not reliant on outside sources. He is an example of an extraordinary social entrepreneur. Approximately 1/3 of the patients seen in the villages have Ghanaian health insurance, and their eye surgeries are therefore fully covered by the local health insurance scheme. While the new health insurance scheme is promising, many patients do not have health insurance, and the government’s health insurance reimbursements take many months to process which puts a strain on the health clinics awaiting reimbursement. For patients without health insurance, it would take more than 6 months for them to be approved for the government’s insurance, and it would not be appropriate for the patients to be told to wait until they receive insurance before they can receive eye care. Therefore, Unite For Sight funds the surgical expenses for those patients so that they can receive immediate care.
In addition to the surgical expenses that are funded by the health insurance scheme or by Unite For Sight, each outreach day incurs significant expenses that Dr. Baah’s sustainable system is able to internally cover.
Save The Nation’s Sight daily self-funded outreach expenses include:
Hiring of vehicles
Fuel for the outreach vehicles
Supplies for screening patients (medication, spectacles, stationary, etc)
Payment for use of facility (district hospitals)
Accommodation for outreach team’s staff (rental of guest houses)
Meals for participants
Stipends for local outreach team
Dr. Baah purchases medication from local sources, and patients receiving medication are required by the clinic to pay the costs for the medication. Likewise, Dr. Baah purchases eyeglasses for patients, and those receiving eyeglasses are also required to pay for the glasses. Glasses transported to Ghana by volunteers are added to Dr. Baah’s eyeglass inventory and helps to expand the resources available to his clinic and to the patients. Proceeds from the sale of the medication and glasses are able to fund the daily expenses of Save The Nation’s Sight. Dr. Baah emphasizes that while the patients receiving sponsored surgery are blind and unable to work and earn an income, those receiving glasses and medication are not disabled, have sources of income, and are able to afford the expense for the medication and eyeglasses. Having grown up in extreme poverty, Dr. Baah notes the importance of engaging communities in sustainable health care provision that does not rely on charity. He explains that those purchasing reading glasses contribute to keeping the outreach program running so that the clinic is able to continue finding and helping those who are needlessly blind.