“AT THE end of the day I would be anxious,”
says Anil Awasthi, a 44-year-old garment worker in Delhi, “thinking what
mistakes of mine would be pointed out.” He was worried about what was going to
happen as his sight deteriorated, until—courtesy of VisionSpring, an American
social enterprise—he got reading glasses. “I’m confident now that my work will
meet my boss’s expectations,” he says. “I go home satisfied.”
For the rich,
the worst consequence of long sightedness is having to wear the world’s most
ageing accessory. For the poor, things are more serious. “It’s the 42-year-old
seamstress or tailor,” says Jordan Kassalow, VisionSpring’s founder. “If they
can’t see, they can’t do their jobs, and if they can’t do their jobs they end
up breaking rocks by the side of the road.”
The first
randomised control trial to measure the impact on productivity of reading
glasses was carried out recently in a tea estate in Assam, in north-eastern
India, paid for by Clearly, a charity. Nathan Congdon, a professor of
ophthalmology at Queen’s University, Belfast, and his colleagues gave spectacles
to half of a group of 751 tea-pickers aged over 40. The other half got none.
Over 11 weeks, the productivity of those whose sight had been corrected rose by
39%. It rose for the others, too, showing the importance in such trials of
having a control group. But that rise was only 18%. The rise in productivity
for those with glasses was the largest caused by a medical intervention that
has ever been shown in such a trial (others have been of mosquito nets and
micronutrients). Since tea-picking is piecework, productivity translates
directly into money.
Before Dr
Congdon’s trial, none of the 751 had worn glasses. Given the potential gain in
income, and the cheapness and simplicity of spectacles, that seems odd. It is
not, however, unusual. Some 1.1bn people suffer from uncorrected long sight. In
this, as in many areas of health, both governments and the market fail the
poor.
Poverty is one
explanation. Liberia, says Dr Congdon, has two eye doctors, both in the
capital. Even in China, which is far better-served, half of those with poor
sight do not have the glasses they need.
VisionSpring uses
the “Avon-lady” model. It introduces middle-aged women to glasses, and then
provides them with the supplies to sell them door-to-door. That idea is
spreading slowly, but clear sight is a surprisingly hard sell.
From The Economist
