For many years now I have been wondering at something.... Whenever I meet an unknown worker for the blind (I dislike that term; I can't help it!), or an agency administrator, or a policy-maker from the blindness system (another one of those disgusting terms!) they usually surprise me by expressing that their primary concern is "prevention of blindness" or, as it is called more positively: "the preservation of sight". In Grand Cayman, during the opening sessions of the Annual General Meeting of the Caribbean Council for the Blind, the main topic was: sight preservation and while reading through the little report from Grenada in the October issue of Caribbean Vision, it was obvious that the Grenadian group has been very active, but.... only in the field of health care, eye care, sight preservation.

     I can't help it, but I always feel a little taken aback at such occasions. You see... I'm blind and there is no sight that can be preserved in me, except my insight, but nobody seems to worry about that. (I shouldn't say that, of course!) I do not deny that there are millions of people in the world who are needlessly blind or whose sight is needlessly impaired to such an extent that they are doomed to live in miserable circumstances, especially in the very poor countries. I do not deny for one moment that it is extremely important to try and combat such needless visual impairement but, on the other hand, there are also millions and millions of blind and partially sighted people in this world of ours whose sight cannot be restored by any human means. Even the needlessly blind for the greater part cannot have their sight restored by any means.


     Unnecessary diseases are, to a great extent, poverty related same as the lack of medical care and treatment, though, it is also true that many a physical defect has ignorance as its origin. Health care and prevention of health problems and physical defects for that reason requires in the very first place an all-out war against poverty and ignorance. It seems to me that as yet, the wealthier and wealthy peoples in the world simply refuse to accept this insight. They have the insight all right, but the consequences of preserving it are too demanding on their wealth! That's why they salve their consciences by combatting symptoms instead of diseases!

     Do we really want to preserve the sight of the hungry or do we want to feed them and teach them how to feed themselves? That is the big question, worth a heck of a lot more than 36 thousand dollars! And the same thing goes for those who have lost their sight, or whose sight has become seriously impaired. Do we want to give them a chance to live a decent life, worthy of any human being? The agencies in our territories have to be honest to themselves and to others. We have to put a few basic questions before ourselves and come up with some basic and honest replies and then decide what we really want to do.

1 - What is our basic goal: sight preservation or rehabilitation of those whose sight cannot be restored?

2 - If the answer is "both", let's ponder the question whether we really have the financial and human resources to do them both well?

3 - If the answer is "no", hadn't we better choose one objective and do it as well as possible with the limited resources we have?

4 - If the answer is "yes" the next question is: do we want to work on behalf of the visually handicapped or on behalf of those who run the risk of becoming visually handicapped?


     You will not hear me say that we should abandon sight preservation altogether. As agencies, engaged in services to the visually handicapped, we must certainly be active in advocating sight preservation programmes, but, in my opinion it should be directed upon promoting sight preservation programmes in the general health care services of our territories or countries. If our health services are not adequate, that is a general problem .

     Eye diseases and anomalies are only one aspect of it, and in some places even a minor aspect. We can do a lot about that, without having to exert all our limited forces on it. We can approach the authorities and private health care institutions and try to convince them that they simply must include sight preservation in their overall packages. If we do have a task in the field of preservation of sight -- and I think we do! -- I also believe that we should not exhaust our limited resources on it, but demand from those who have the responsibility for national or regional health care, to put sight preservation on their list of priorities and act upon it by attacking the causes at their roots instead of only the symptoms.

     That can be done, if we dare to be bold enough to speak out the truth. As I have always said: if you want to wake up someone who is fast asleep, you got to ring a loud alarm! That, to my mind, is our task in the field of sight preservation. Ring the alarm!


     That brings me to our primary goal, for which we have to apply our limited financial and human resources: rehabilitation, integration of blind and partially sighted persons, from the very young -- the new-born blind or visually impaired baby -- to the very old whose sight is failing them as a consequence of their age. There should not be such a thing as a "blindness system"; there should be agencies serving all those who have serious sight problems to teach them to live their own lives and be responsible for themselves and for others around them, in spite of their loss of sight. We should develop all those services that will enable the visually handicapped to be an integral part of society as a whole, not as a burden for themselves and society but as responsible and self-conscious citizens who are prepared to accept their responsibilities, to themselves, their families and society.

     Far too often, especially the totally blind become a burden for themselves, for their families and for society and almost as often, they are taught to accept that position and be satisfied with it, by surrounding them with what is called welfare, care and by stowing them away in sheltered workshops!

     Let's face it: It is simply impossible to do a lot of things well. So, if we want to do a good job, we shall have to make a choice. Do we want to be involved in the field of sight preservation, than that's fine, but in that case, we shouldn't present ourselves as working for the blind and visually impaired. And if we want to be active in the field of education and rehabilitation and integration of the visually handicapped, then let's realize ourselves very well, that that is a very demanding goal, that requires so much expert and professional attention, that we can hardly allow ourselves the luxury of undertaking another, also extremely important task as well.

     That's the point I want to make; I am not minimalizing either of the two. I have made my choice because I want to do one thing well!