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Situation
Children identified as having
visual impairment in East Africa are educated in residential schools for
the blind or integrated programmes. Christoffel Blindenmission (CBM) supports
9 residential schools (6 in Kenya, 2 in Tanzania and 1 in Uganda) and 2
integrated programmes. Sight Savers International supports most of the
integrated programmes in East Africa.
The Kenya Government initiated
40 assessment centers in collaboration with DANIDA which are responsible
for assessing all children with impairments in general and refer the individual
student to the most appropriate educational institution, this also applies
to those children with visual impairments.
In Kenya and Uganda institutes
for special education were established under the sponsorship of DANIDA,
where teachers can be trained in a 3 months or 2 year course in special
education for visually impaired children. From 1995, Kenyatta University
has been offering a 4 years course in special education .
In April 1994, Christoffel
Blindenmission (CBM) established a Low Vision Project based at Kikuyu Eye
Unit, which has the mandate to improve the overall standard of education
of children with low vision. For the last 3 years the Low Vision Project
has been offering services to children with low vision and special training
for teachers in the field.
In a survey conducted by
the Low Vision Project in 1994, 1083 children attending special schools
and programmes were assessed. It was found that 68% benefit from low vision
services. Almost 80% of the children with low vision have useful remaining
sight to learn print, 35% by the use of OLVDs and 45% through special reading
and writing training
Categories
Children with visual impairments
can be categorized in 4 different categories according to their special
education needs.
The categories were developed
by the Low Vision Project in 1994 and are based on the working definition
of the World Health Organization developed in 1992.
There was also a need to
create a fifth category for children attending special schools and programmes
who were not visually impaired (since they were mono eyed or wearing high
power glasses).
The categories are as follows:
a. Category 1
Totally blind children with
no perception of light, who need training in orientation and mobility and
should be educated in braille.
b. Category 2
Children with low vision
which is not enough to read print, who need visual stimulation, functional
vision training or/and training in visual orientation, and who should be
educated in braille.
c. Category 3
Children with low vision
who can be trained to use their sight for reading and writing print with
the aid of optical low vision devices, meaning that these children require
magnification to cope with regular print.
d. Category 4
Children with low vision
who can be educated in print using special techniques and methods without
OLVD to read and write regular print efficiently and fluently.
e. Category 5
Children who are not low
vision because their sight is above 6/18 and they do not have a severe
visual field defect. These children can almost function like normal sighted
students and they do not really need special education as long as their
sight is constant.
NB Non optical LVDs can be supplied to children from Cat II to Cat. IV.
Children assessed by the
Low Vision Project are always grouped in these 5 categories. In the first
3 years, 3182 low vision assessments have been done on 2589 patients who
are children and adults.
These children were supplied
with non optical low vision devices and special low vision training in
different areas if needed. Children in Cat. III were also supplied with
optical low vision devices and were trained on how to use these tools effectively.
Materials Supplied
Optical low vision devices
supplied for Cat. III patients are mostly locally produced according to
the CBM low vision assessment kit developed by Peter Spoerer in 1991.
Special print exercise books
were developed by the Low Vision Project in 1996 and they are given out
to the children with contrast problems who cannot see the lines in normal
lined exercise books.
If needed we supply children
with low vision also with special desks, CBM reading stands, felt pens,
tape recorders and electric lights.
Each time we give out any
kind of low vision device we advise the teacher to make sure that the child
is properly trained on how to use the devices effectively.
Work Organization
The Low Vision Project has
two co-ordinators. One, Dr. Michael Njoroge is a special educator and myself
a low vision therapist/orthoptist. Both work closely with the Project Director
Dr. Mark Wood, a consultant ophthalmologist based at Kikuyu Eye Unit. The
Low Vision Team spends half of their working time at the base in Kikuyu
Eye Unit and the other half in special schools and integrated programmes
in East Africa.
For example in 1996 212
patients with low vision were assessed in the clinic. 66 of these were
supplied with optical low vision devices and 40 were referred to special
schools and programmes for the visually impaired.
A further 365 children were
assessed in special schools and programmes. 80 of them got optical low
vision devices.
Optical low vision devices
are produced in the Kikuyu Eye Unit optical workshop.
Training Programme
To guarantee appropriate
follow up for low vision students and programmes we offered special training
through seminars for teachers in the field. Up to now we have identified
a group of 25 teachers who come from different parts of Kenya, who get
regular follow up training in low vision therapy. These special teachers
are low vision assistants for the Low Vision Project.
Further we offered a one
year training for two low vision trainees who became low vision therapists.
They completed their training
in May this year and are now integrated staff of the Low Vision Project.
One was originally a teacher in an integrated programme for visually impaired
and the other one an eye nurse. We have chosen these two professions to
find out which is more appropriate for low vision therapy. Both have completed
their course successfully and we think that both professions can be accepted
for training in low vision therapy.
Low Vision Assessment Kits
The Low Vision Project is
in the process of developing 2 different types of low vision kits.
One to be used by low vision
assistants and the other by regular or special teachers with basic low
vision knowledge.
The first mentioned kit
is an assessment kit which includes all different assessment materials
to identify individual needs of the child and training material to teach
the child to use the vision effectively which can be used by special trained
low vision personnel. The second kit is a screening kit which includes
materials to help find out the category of the child.
Plan For The Future
Through the co-operation
of the Ministry of Education and the Ministry of Health we hope that the
low vision work will be acknowledged in Kenya and that the role of the
low vision assistants and therapists will be officially established and
recognized by the relevant Ministry within the Kenyan Government.
Further training is planned for special teachers working in schools/programmes for the blind. The Low Vision Team is also planning to hold a seminar for medical eye workers who are based at hospitals and clinics.
Low vision rehabilitation should become an essential part in the system of special education for the visually impaired in East Africa so that children with low vision are prepared to cope in the sighted world as independent as possible.
Goal of Low Vision Work
The final goal of the Low
Vision Project will be achieved when at least one teacher in every school
or programme of visually impaired is trained in low vision and when low
vision work gets fully acceptable and children with low vision get appropriate
service on low vision and educational services.