#Best Piles Doctor in Nepal

[nishesgurung]

Dr. Subarna Poudel’s clinic specializes in the treatment of hemorrhoids, fissures, and fistulas, with a mission to promote a society free from these conditions. Located in Kalanki, Kathmandu, the clinic provides expert, compassionate care using modern techniques to ensure patients achieve a pain-free life. With accessible services and patient-focused solutions, the clinic emphasizes education, prevention, and effective treatment options.

[vesuvian-american]

The Next Right Thing

I guess you could say this is a Disney Prompt, but I was listening to this last night and thought about Asra maybe singing this song when he finds out that MC had passed away because of the plague. Thus, this fic was born. You get Asra, you get some Muriel, you get some you, stove Salamander saved, Faust, Nepal, bad dreams! You get angst. 

Words: 1571

Something had shifted. It was an oddly cool day in Nepal. Asra awoke that morning from the strangest dream. Unbearable heat swallowing him up, nowhere to run. He was overcome with sadness, a grief he couldn’t escape. Longing, mistakes he felt he couldn’t correct. Then nothing. Silence, everything was still for what felt like an eternity all until a blood curdling scream in the distance shook him awake and he fell from the comfort of his bed. His heart felt heavy. He couldn’t imagine falling back asleep. He made sure to travel into town right then to find the source of that scream. Yet, there too it was silent, nothing out of place nothing out of the ordinary. The townsfolk were safe and all accounted for, all except for Asra himself. Deep in his gut he felt something was off, he felt uneasy. Like he’d lost something very dear to him but he couldn’t imagine what that dream meant. For the days after that he never felt better. Still he feared sleeping. The dreams were different now. He just felt a complete and utter emptiness, he wondered if this is what death felt like. Each night the dreams slightly changed, a soft crying sound growing louder and louder. His last night in Nepal the crying in his dreams turned into a loud disturbing wailing so loud he couldn’t fall asleep for even a second or the wailing would start again. If nothing was wrong in Nepal maybe it was---

It was time to return to Vesuvia. By time he made it to the forest a dark storm cloud was over head. Thunder rumbled in the distance as he entered Muriel’s hut. Empty, but the magical wards overhead were charged and working properly, Muriel was safe. “He’s probably out looking for firewood, Faust.” Asra gives his familiar a wry smile as her cool scales slither over his shoulder. “Let’s head to the shop and check on our friend.” Friend! It had been a long time since Asra saw you. You both had argued on whether to stay in Vesuvia or run away from the plague. How were you doing, where you safe? Did you actually find a cure? He thought. Something in his heart told him that wasn’t the case. But he fought off the negative thoughts, He just wanted to see you and hold you close. Apologize for everything, apologize for leaving you alone here. He should have been stronger than his fear. The fear never escaped him even as he left. He was safe but you weren't. His anxiety ate him up inside while he hid in Nepal. Never did a day go by where he didn’t think about you, and miss you. He still loved you, he just needed to come back and right all his wrong and. What's this? No magical shield on the door? Protective charms, most likely Muriel’s, left in a pile on the doorstep never picked up. His heart sank but he swallowed his fear and lifted his shaky hand to the door handle. The door was chilly, the inside felt still. He trembled so hard the door started to shake as well. He twisted the handle and the darkness from inside his shop spilled out. He stayed there; eyes closed with the door cracked open for a long moment. It was only the rain drops that finally started to fall over the city dropping on his head that urged him forward and into the shop.

 Using magic, he gave himself some light. A thin layer of dust covered the shop. Books and paperwork with scribbled writing littered the floors and counter tops. Your handwriting. Ilya’s handwriting. The tiniest bit of relief washed over him. You probably moved into the palace to work with the other doctors on the cure. No. That was wrong too, he had to investigate more. He travelled upstairs to check your shared bedroom. Nothing here. In the kitchenette, there was a small pitter patter sound. Not the rain but like—CRASH! A dish falls from the cabinet, knocked off but by what. He peers inside and finds the stove salamander. Very thin, very frail and dull in color, looking sickly. He scoops them up in his hands and finds him something to eat. You would never neglect the salamander. If you headed to the palace, you’d take them with you of course. Leaving Faust and the salamander in the kitchen to snack and rest he rushed into the bedroom, ripping the pillows and the blankets from the bed. He had to find something, anything that would tell him where you were. What happened! Shaking he finally sees it. A single note. It’s your handwriting but messier than he remembers as if you had no energy to write.  

“Dearest Asra,

I’m sorry. I’m sorry for everything. For not leaving with you. I felt my duty was here to Vesuvia, to find a cure, to save our home. I wasn’t strong enough. I wasn’t smart enough. I wasn’t fast enough. I’m sick. Very sick. Muriel doesn’t know, he still visits the front door but I haven't gone downstairs in days. You need each other to live through this. If you read this don’t stay. Run back to Nepal. Take Muriel. Take anybody that’s still healthy and leave. I hope to be some of the last few to be lost due to the plague. Please for me, stay away. I don’t have much energy left to do anything. I don’t know what day it is, what month, what year. All I know is you, Muriel, Julian. The poor citizens of Vesuvia, and our home. This letter will be the last thing I do. I’m using everything I have to get all my thoughts, wishes, and love into this letter for you. A piece of me hopes you never find it, at least not until Vesuvia is saved again. I don’t want you to come back here to get sick. Please don’t go any further. Turn back to Nepal with Muriel and Faust.  

                                                                         I will love you always.”

You tried to finish off with your name but had no energy at all to continue. The worst can be assumed. Asra cried. He screamed. He ran. He didn’t stop until he was at the docks, begging for it to not be true. He cries turned to choked sobs. He was out of breath and energy. He slept there for who knows how long. Muffled footsteps walked to him and sat by his side. They stayed silent, and Asra felt back asleep without any regard for who was by him. Muriel looked down to his friend with puffy eyes, red from tears he shed himself. Seeing his best friend like this broke him. He made sure to stay there for his friend. Whenever he was ready to wake up and face his fears. He’s be there for him no matter what he decided to do. He’d follow him and protect him from any more grief and anguish. Asra was his everything. Muriel was going to be there to help him stand up and get through this and live, just as you wanted. “I feel numb.” Asra’s voice was weak and hoarse. Muriel said nothing, this was time for Asra to speak and out his feelings into words. “I’ve seen dark before, but not like this.” He rolls onto his back to look up at his friend. He recognized it was Muriel a long time ago. “How.. How could this happen, Muriel?” A tear shed down Muriel’s face, and he turned his head and grunted in response. Asra saw him trembling. “What are we going to do?” Asra sounded so pitiful. Broken. Muriel wanted to hold him and shield him from these feelings while ignoring his own. Just as he started to warm up to you and consider you someone worth getting to know. You die. “How am I supposed to go on?” Asra whimpers looking up the stars. He reaches his hand out as if to grasp a time where you were still alive and tangible, and here with him. Muriel glances back at his friend, this bottom lip wobbling as he fights back the unshed tears in his eyes. He curls in on himself tighter than before. Pulling his knees closer into his chest and wrapping his cloak around him even more. He lets out a shaky breath and hides his face, he can’t fight these feelings anymore. He finally lets the tears falls, albeit hidden from his closet friend. Asra lets his hand fall into the sand, kicking up dust and clouding his senses for a moment. Yet, in that moment everything was made clear to him. For the first time in days he sees your smiling face clearly, this wasn’t a memory. It was the future. He’d have you back. Nothing will be the same with you gone. As the dust settles you image falls away as well, but stays locked in his mind. He stands up, weakly but the look on his face is strong.  

“Let’s go Muriel. Y/N needs us.” He turns back to his friend and holds his hand out, putting on a brave face for Muriel, giving him a weary smile. Muriel then lifts his head and takes Asra’s hand. Wiping the tears from his eyes he sees Asra heading for a boat. They’re headed to the Lazaret.  

[adreamfromnevermore]

Stephen Strange Harry Potter Fusion

https://doctorstrangeaskblog.tumblr.com/post/178659583397/omg-i-had-a-cool-harry-potter-verse-doctor-strange

@doctorstrangeaskblog They game this idea! if you check the link above it’s the original post that I took inspiration from. 

1- Stephen Strange, New York, requested entry to Hogwarts. Accepted. 

2- The sorting hat first chose Slytherin. Stephen later requested a transfer to Ravenclaw, sighting the Slytherins refusal to accept a muggleborn into their ranks as one of the reasons as well as the widespread belief in “pureblood” supremacy. The Slytherins gladly agree, claiming the boy is the sole problem and that it has little to do with blood status. As a parting barb Mr. Strange begins to sight the many different problems that may result from inbreeding.

3- Stephen Strange excels in most classes even with his lack of care for the rules and regulations of the school. he has been caught twice trying to enter the restricted section in the library but has not been seen a third time. His main issue seems to be his lack of respect for the teachers, on more than one occasion he has claimed them to be stagnant, and unwilling to either experiment or evolve what they have learned. 

4- Nearing the end of his first year, Mr. Strange has lost his house more points than any other students in any of the other houses. Many of his house mates have begun to ostracize him, some have even requested that he be punished in other ways as clearly the point system does not matter to him. 

5- Mr. Strange has begun his second year with a series of claims that range from the supposed “stagnation” of the magical community and a claim that pureblood has no effect on magical ability. In fact, he claims that it may actually result more commonly in stunted magical growth. this has brought more attention to Mr. Strange from the Wizengamot and much if the Pureblood society. Including the Sacred Twenty-Eight.

6- Some have begun protesting Hogwarts continued admittance of Mr. Strange as he had clearly proven to be problematic to the wizarding community and according to some should be expelled and obliviated of all knowledge of magic. Alongside this, Mr. Strange has been involved in a series of altercations with other students, many of them in years above him. More often than not they of either the Ravenclaw, or Slytherin house. It has been noted that even his own house refrains from defending him against other students aggression.  

7- Strange has surpassed all of the students in his year, and according to many of his teachers, the students of the third and fourth years as well. Flitwick, head of Ravenclaw house, believes that the boy is on track to overtake all of the students in Ravenclaw within the next few years. 

8- Mr. Strange has begun his third year, over the course of the first half he has proven to be the most dangerous student within the house. Some have taken this as the sign that he should have remained in Slytherin house and taken the chance to refuse to name him as a Ravenclaw students. Though Professor Flitwick has tried to reign this in he has not been entirely successful. Despite the previous altercations he has been part of, many of the students have begun avoiding Mr. Strange.

9- It has come to the Headmasters attention that the Wizengamot have begun watching Mr. Strange. It should be noted that Mr. Strange noticed before the staff of Hogwarts were made aware. This has only been used as another point that the Wizengamot places as a reason to watch Mr. Strange. The staff have begun questioning if more serious action should be taken to defend Mr. Strange’s privacy. 

10- Despite it being his 4th year some are convinced that Mr. Strange has grown too powerful. The Ministry is moving to have him named a menace to society and a danger to the balance between the magical and non-magical worlds. If they succeed Mr. Strange will be removed from Hogwarts and sent to Azkaban to await trial. 

11- Over the Christmas break of his 4th year Mr. Strange was caught using magic in the muggle world, he states that it was in defense of himself and a small number of younger muggle teenagers who were attacked by a number of magical creatures. Mr. Strange also alleges to the presence of a number of wizards also taking part in the attack. Hogwarts has so far refused to comment save that they do not believe that the boy should be prosecuted as he acted in defense of himself and others. Many of those in the Ministry are calling for the boy’s wand to be snapped and request that he be sentenced to Azkaban.

12- As the Ministry threatens Hogwarts with more definite action if Mr. Strange is not handled he has been separated from the rest of the student body and placed under watch in a room that has been altered to act as a sleeping chamber. Professor Flitwick has delivered books from the library to his room on three separate occasions. 

13- Evidence has been brought forward that the attack perpetrated against Mr. Strange that prompted him to act in front of muggle witnesses was in fact sent by the Council. Many have begun questioning the actions of the council. They have announced the intent to arrest Mr. Strange and have detached a team of Aurors to Hogwarts to retrieve him before the end of his fourth year. 

14- Though he was not offered aid by any of the Staff or students at Hogwarts, Mr. Strange was able to escape. He is on the run for nearly a month before he is captured by the Ministry. The Ministry, over this month has quieted the dissenters to Mr. Strange’s arrest and has begun referring to him as “Public Enemy #1.”

15- Mr. Strange is held within the Ministry for a little over two weeks before attempting yet another escape two days before his trial is scheduled to take place. He manages to evade capture through the use of a stolen wand for one and a half more weeks before he is captured by a team of five aurors. Of those five, three are left with minor injuries, one is sent to St. Mungo’s for curse removal and the last one manages to capture him while he is distracted. 

16- In response to Mr. Strange’s escape attempt those in charge of keeping Mr. Strange in custody decide that, since he has proven capable of using stolen wand it is decided that the best way to keep Mr. Strange in custody is to ensure that he cannot use a wand. (This is not common knowledge) Mr. Strange is informed that they will be visiting the healers, while there the healers use a series of spells to permanently damage Mr. Strange’s hands. Over the next two weeks before his newly rescheduled trial Mr. Strange is routinely taken to the healers to that they may ensure that his hands have not begun to repair the damage. On more than one occasion it is decided that they should inflict more damage to stunt any healing that may have occurred.

17- At Mr. Strange’s trial he is sentenced nearly unanimously to Azkaban. Many decide to vote with the majority to avoid being targeted by a series of attacks. Anti-Muggle sentiment begins to spread, many blame Mr. Strange’s muggle upbringing as the reason for his failings. 

18- Mr. Strange is sent one last time to the healers, they check to ensure that his hands have not tried to heal themselves and are satisfied with their findings. Mr. Strange is sent to Azkaban. He is there for less than a week when he disappears. 

19- Though they spend much time searching for the missing teen he reaches his fifteenth birthday. While on the run Mr. Strange grows adept at avoiding the Auror teams that are sent after him, after a time they are given new orders and the focus shifts from capture, to neutralize. While on the run Mr. Strange compiles a list of rules he uses to avoid capture. 

20.1- Avoid front doors of any location, be it anything from a house to a pub.

20.2- If the Aurors catch up, the best way to escape is to stop running. They do not expect someone standing in the corner, they expect someone running.

20.3- Avoid contact with anyone, if they have reason to believe you have spoken they will be a threat to innocent people.

20.4- Wizards rarely look up. if necessary take the high ground. 

21- A week after escaping Stephen ends up slipping into a small gas station in the hopes of stealing some bandages for his hands. The cashier there, a teenage girl most likely not that much older than him, catches him. Instead of taking it and kicking him out, she decides to give him a small bag. In the bag is a roll of bandages, a small pile of snack bags (mostly trail mix and a few bags of crackers), and a couple of bottles of water. Stephen accepts it but tries to find something return the favor. When he is unsuccessful he commits the location to memory and swears to return to somehow pay the girl back.

21.1- He is careful to ensure that no auror goes to question the girl as he refuses to allow others to be brought into his struggle. 

22- It is two months after his fifteenth birthday when Stephen reaches Nepal. He is spotted by a traveling wizard who turns in a tip to the Ministry. When the Aurors arrive Stephen follows rule 4 and takes to climbing the roof tops to avoid the Aurors. (He has discovered that if he focuses enough it is possible to use magic. All he has managed so far was a shield similar to protego and some form of defensive attack that forced those around him away)

23- Nearing midnight Stephen is spotted, it has been three days since he has eaten and he has barely slept. Though he believes that he has a few hours before he reaches critical levels of dehydration. As he is being chased, he slips. The Aurors later claim that he dissapeared from their sight. When they reached the spot they believed he had fallen from, they found only an empty alley way.

To Be Continued

[borrowedbackpack]

That Time I Got Very Sick in Nepal

Hello from the Hong Kong airport and welcome back back once again to Borrowed Backpack. I apologize for the interruption in our regularly scheduled trekking content, but a) trekking is kind of boring (how many different ways can I say that I walked, ate, and petted dogs?) and b) I have exciting tales from a real live Foreign Medical Emergency! Let me walk you through it:

September 5th, 2019, Morning

           I am living my best air-conditioned Kathmandu life! My hair and skin love the humidity! My mouth loves the pancakes! My body loves the coffee! Hooray! I go to a nice café where I eat my Last Meal. I cannot describe this because, while I don’t believe it was what made me sick, thinking about it makes me gag since it was the last thing I ate before becoming Very Sick. I even have a picture of it because it was very pretty, and I think I’m going to have to get someone to go into my phone and delete it because if I look at it I will die. You probably understand this I don’t have to explain it to you.

           I enjoyed a couple games of cards and the café because I am an Old Person and then went for a walk around. On my walk around my legs started to hurt and I started to feel hot and tired. So I pounded a litre of water and embarked on a food tour. Of course.

A dog I met on the tour.

           The food tour guides were very nice and sweet and knew everything about Nepal (one of them was a guide and one of them was a guide in training). Once I told the guide-in-training that I loved dogs he started pointing out all the dogs to me which I appreciated. Also he knew facts about some of the dogs. Like which ones were related and such. Which I also appreciated. I made it through 2 stops on this tour although it definitely was not my Best Eating Work because at this point I was not feeling amazing and was in survival mode. I had some tea and then a lentil pancake (the lentil pancake was so heckin good even in my horrible state). Then they took us to momos and I tried to persevere because I love momos. And these were high quality ones in sauce. But 1/3 through my first momo I was like “I can’t do this everyone I am so sick” and then immediately zoomed (probably didn’t zoom) to a nearby pile of wet garbage to gag into. I would like everyone to know that at this point I was basically actively throwing up and the tour guide came over and PATTED ME and tried to reassure me. The level of service and attentiveness these people provide for like $10 is wild. Then they went to the trouble of locating a taxi and negotiating a reasonable rate with the driver and trying to explain to them where my hotel was. Amazing.

           Anyways then I had to survive the taxi ride to the hotel, which, in case you have never been in a KTM taxi before, is very treacherous. “There are much bumps” the driver told me apologetically.

“Yes” I said.

Several eternities later and after near misses with countless people, dogs, motorbikes, and other cars, we arrived back in AC land. I limped up the stairs and collapsed directly on my face into my bed. The only times I moved for the next several hours were to barf or to try to move my body into a more comfortable position so that all my limbs didn’t feel like they were exploding.

 At some time during the early afternoon or evening, I started saying things that didn’t make sense/were unnecessary.

“how many people even live in Australia? Why are they all here?”

Then I saw the Zipper Octopus. It is like an octopus, but he has zippers on his tentacles so he can go from a uni-tentacle octopus to a normal octopus to change up his look. Innovative. I believe he also had a hat.

  Then I slept a little bit. Then at 1:30am I started screaming for medical attention and also that I wasn’t going to survive the night. I think Chris agreed with this sentiment so he found a hospital, the kind I wouldn’t die at (I’ve seen some YouTube videos about hospitals in the developing world). But then I fell asleep again. 3:45am or something I woke up and did some more screaming/howling (P.S. I am so sorry to all of the other guests on the first floor and probably the other floors of the Timber House Hotel in Kathmandu, Nepal. I truly thought I was dying and I guess my final wish was to go out screaming). So then a taxi was summoned and I inexplicably donned my bright orange GoreTex jacket in preparation. I put in an absolutely massive effort to walk down one flight of stairs, out the door, and into the taxi. I then slumped in the taxi for like 3 years while Chris, the taxi driver, the hotel security guard, and the hotel front desk guy all tried to figure out where the hospital was. I guess it was eventually decided upon because we soon drove away on a Very Much Bumpy road. “careful of the dogs” I mumbled to myself.

           When we arrived at the hospital a guard had to let us in through a big gate. Sadly I was too ill to appreciate this moment of exclusivity. I used my final strength reserves to basically tuck and roll out of the taxi and get into that hospital as quickly as I could.

“Hi” I said gravely to the reception dude “I am very sick”

“Okay!” he said cheerily. “Let’s go to the emergency room then!”

So then I got to go to the emergency room where I blessedly was able to lie down under a lot of blankets (I was very chilly despite my GoreTex gear). Immediately a nurse started attending to me. First she took me temperature and was like “whoa! High fever!”*

*I prefer if medical professionals don’t remark about my Condition but okay.

Then she remarked about my low blood pressure, high pulse, etc etc etc basically I was in rough shape. Then she drew some blood and started an IV to rehydrate me but that was a bit of an issue because I have bad veins. Eventually she got a good stab in and I began hydrating.*

*I would like to take this time to thank modern medicine. As soon as I had a bag of fluid in me I started feeling a lot better. I think a lot of my problems were compounded by the fact that I had been too tired and nauseous to drink water for a lot of the night.

Then the doctor came in and he was very nice and apologized about the IV. Then he started asking me about my trip to Nepal, etc etc. When trekking came up, he was like “oh! How was the Lukla flight?” and I was like this is not the time to discuss the Lukla flight. Anyways, I guess between the doctor, the nurse, and the nice receptionist it was decided that I was sick and could stay. So I got to go in a wheelchair upstairs to a nice room overlooking some embassy (there was a guy with a big gun pacing back and forth there all day).

           They proceeded to give me lots of drugs through the IV, which contributed to me feeling a lot better in a relatively short amount of time. Again, modern medicine is a miracle. Also since there were no other patients there in the early morning/night, I think everyone was kind of bored so I got waited on a lot, especially when a bunch more nurses came in the morning. Like I got tucked in once and hour and stuff. This was a nice touch.

I legit don’t remember taking this disgusting picture but in case you’re wondering what you look like after they pump fluids into you for 30 ish hours while you lay in bed...it’s this.

           The rest is not too terribly interesting. In the afternoon I started feeling sick again and my fever went up so the doctor decided I should probably change my flight (I was supposed to fly back to Canada that night). Happily my mom and sponsor Jen took care of that for me back in Canada. I slept through most of the rest of the stay, started to feel better in the mid-morning of the next day, and was freed from my IV line to go for a walk around the hallways (the nice nurse freed me even though the nice doctor told me I didn’t look very good and should stay another night). I went for a nice walk and saw a white guy downstairs requesting a rabies vaccine. Hopefully it was the pre-exposure one.

I was trying to walk around shoeless and the nurse came chasing after me like “Anna! Anna! we have the shoes for you!” Sadly I did not get to keep The Shoes.

After that I got to go on an outdoor walk, which was weird because I hadn’t seen the light of day in like 30+ hours. Chris took me on a tour of the fancy embassy/ex-pat neighbourhood that he had wandered around for many hours looking for the “plain noodle soup” I had kept requesting during my illness. I even got to make a triumphant appearance at the home of the soup:

“Here’s my girlfriend! She’s still alive!”

“ah ha!” said the soup guy “how was your soup?”

After passing all the walking tests (I am an excellent walker), I was officially freed from the hospital. I would like to note that my entire stay at this bougie* hospital didn’t cost any cash money at all, thanks to my parents’ sweet Canadian travel health insurance and also the hospital for being good at dealing insurance companies.

*100% nicer than any medical facility I have visited in Canada

And this is what you look like after you walk a little bit and the fluid relocates. And when the hospital lobby has good lightning. Highly recommend the selfie lightning at CIWEC.

So thank you CIWEC Hospital in Kathmandu for bringing me back from what I thought was the brink of death (but probably wasn’t), thank you to my parents insurance and my parents for remaining calm, switching my flights, and dealing with all that stuff on the other side of the world, and thank you to my boyfriend Christopher who doesn’t read the blog but sure dealt with a lot of screaming, located the noodle soup, put my hair in a horrible bun, found out how many people live in Australia for me, and otherwise waited on me day and night for quite a while. All absolute legends.

[newstfionline]

A Simple Way to Improve a Billion Lives: Eyeglasses

By Andrew Jacobs, NY Times, May 5, 2018

PANIPAT, India--Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up.

Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school.

“Sometimes I don’t see a motorbike until it’s almost in my face,” he said.

As his grades flagged, so did his dreams of becoming a pilot. “You can’t fly a plane if you’re blind,” he noted glumly.

The fix for Shivam’s declining vision, it turns out, was remarkably simple.

He needed glasses.

More than a billion people around the world need eyeglasses but don’t have them, researchers say, an affliction long overlooked on lists of public health priorities. Some estimates put that figure closer to 2.5 billion people. They include thousands of nearsighted Nigerian truck drivers who strain to see pedestrians darting across the road and middle-aged coffee farmers in Bolivia whose inability to see objects up close makes it hard to spot ripe beans for harvest.

Then there are the tens of millions of children like Shivam across the world whose families cannot afford an eye exam or the prescription eyeglasses that would help them excel in school.

“Many of these kids are classified as poor learners or just dumb and therefore don’t progress at school,” said Kovin Naidoo, global director of Our Children’s Vision, an organization that provides free or inexpensive eyeglasses across Africa. “That just adds another hurdle to countries struggling to break the cycle of poverty.”

In an era when millions of people still perish from preventable or treatable illness, many major donors devote their largess to combating killers like AIDS, malaria and tuberculosis. In 2015, only $37 million was spent on delivering eyeglasses to people in the developing world, less than one percent of resources devoted to global health issues, according to EYElliance, a nonprofit group trying to raise money and bring attention to the problem of uncorrected vision.

So far, the group’s own fund-raising has yielded only a few million dollars, according to its organizers. It has enlisted Ellen Johnson Sirleaf, the former Liberian president, Elaine L. Chao, the transportation secretary for the United States and Paul Polman, the chief executive of Unilever, among others, in an attempt to catapult the issue onto global development wish lists. They contend that an investment in improving sight would pay off. The World Health Organization has estimated the problem costs the global economy more than $200 billion annually in lost productivity.

“Lack of access to eye care prevents billions of people around the world from achieving their potential, and is a major barrier to economic and human progress,” said Madeleine K. Albright, the former secretary of state who is also involved in the group.

Hubert Sagnieres, the chief executive of Essilor, a French eyeglass company and a partner in the fund-raising campaign, said he often confronts ambivalence when pitching the cause to big-name philanthropists.

In an interview, he recalled a recent conversation with Bill Gates, whose foundation has spent tens of billions of dollars battling infectious diseases in the developing world. He said he reminded Mr. Gates of his own childhood nearsightedness, noting that without glasses, he might have faltered in school and perhaps never gone on to start Microsoft. Mr. Gates, he said, politely demurred, saying he had other priorities. A spokeswoman for the Gates Foundation declined to comment.

The initiative’s backers point out that responding to the world’s vision crisis does not require the invention of new drugs or solving nettlesome issues like distributing refrigerated vaccines in countries with poor infrastructure. Factories in Thailand, China and the Philippines can manufacture so-called readers for less than 50 cents a pair; prescription glasses that correct nearsightedness can be produced for $1.50.

But money alone won’t easily solve systemic challenges faced by countries like Uganda, which has just 45 eye doctors for a nation of 41 million. In rural India, glasses are seen as a sign of infirmity, and in many places, a hindrance for young women seeking to get married. Until last year, Liberia did not have a single eye clinic.

“People in rural areas have never even seen a child wearing glasses,” said Ms. Sirleaf, who was president of Liberia from 2006 to this year. “Drivers don’t even know they have a deficiency. They just drive the best they can.”

On a recent afternoon, hundreds of children in powder-blue uniforms giddily jostled one another in the dusty courtyard of a high school in Panipat, two hours north of New Delhi. The students, all from poor families, were having their eyesight checked by VisionSpring, a nonprofit group started by Jordan Kassalow, a New York optometrist who helped set up EYElliance, that works with local governments to distribute subsidized eyeglasses in Asia and Africa.

For most, it was the first time anyone had checked their eyesight. The students were both excited and terrified. Roughly 12 percent were flagged as having weak vision and sent to an adjacent classroom where workers using refractor lenses conducted more tests.

Shivam, the boy who dreamed of being a pilot, walked away with a pair of purple-framed spectacles donated by Warby Parker, the American eyewear company, which also paid for the screenings.

“Everything is so clear,” Shivam exclaimed as he looked with wonder around the classroom.

Anshu Taneja, VisonSpring’s India director, said that providing that first pair of glasses is pivotal; people who have experienced the benefits of corrected vision will often buy a second pair if their prescription changes or they lose the glasses they have come to depend on.

Ratan Singh, 45, a sharecropper who recently got his first pair of reading glasses, said he could not imagine living without them now. Standing in a field of ripening wheat, he said his inability to see tiny pests on the stalks of his crop had led to decreasing yields. He sheepishly recalled the time he sprayed the wrong insecticide because he couldn’t read the label. “I was always asking other people to help me read but I was becoming a burden,” he said.

Last month, after he accidentally broke his glasses, Mr. Singh, who supports his wife and six daughters, did not hesitate to fork out the 60 rupees, roughly 90 cents, for a new pair.

Most adults over 50 need reading glasses--more than a billion people in the developing world, according to the International Agency for the Prevention of Blindness--though the vast majority simply accept their creeping disability.

That’s what happened to D. Periyanayakam, 56, a power company employee whose job requires him to read electrical meters. His failing eyesight also made it hard to drive or respond to text messages from customers and co-workers.

“I figured it was a only matter of time before they suspended me,” he said during a visit to a mobile eye clinic run by Aravind Eye Hospital, a nonprofit institution that screened his vision and told him he would soon need cataract surgery.

Mr. Periyanayakam returned to work that day with a $2 pair of glasses. He was among 400 people who showed up at a daylong clinic in a high school run by ophthalmologists, lens grinders and vision screeners.

Aravind dispenses 600,000 pairs of glasses each year in India and has expanded its efforts to Nepal, Bangladesh and countries in Africa through local partners.

The hospital trains its own vision screeners, most of them young women; a separate program trains primary schoolteachers to test their students’ sight using eye charts.

Then there is the matter of road safety. Surveys show that a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.

Experts say a significant number of India’s roughly 200,000 traffic deaths each year are tied to poor vision. In a country with a huge number of drivers, among them nine million truckers, the government agencies that administer licenses are ill-equipped to deal with the problem of declining vision, critics say.

Sightsavers, a British nonprofit that has been treating cataract-related blindness in India since the 1960s, has spent the past two years trying to get glasses to commercial drivers. It operates mobile eye-screening camps at truck stops and tollbooths in 16 cities. A driver who has his eyes examined at a clinic in north India can pick up his glasses 10 days later at a clinic in the far south.

“These men are always on the move and they are pressed for time, so we try to make it as easy as possible for them,” said Ameen, a Sightsaver employee who uses a single name.

[nebris]

Unlearning the myth of American innocence

When she was 30,  Suzy Hansen left the US for Istanbul – and began to realise that Americans will never understand their own country until they see it as the rest of the world does 

My mother recently found piles of my notebooks from when I was a small child that were filled with plans for my future. I was very ambitious. I wrote out what I would do at every age: when I would get married and when I would have kids and when I would open a dance studio.

When I left my small hometown for college, this sort of planning stopped. The experience of going to a radically new place, as college was to me, upended my sense of the world and its possibilities. The same thing happened when I moved to New York after college, and a few years later when I moved to Istanbul. All change is dramatic for provincial people. But the last move was the hardest. In Turkey, the upheaval was far more unsettling: after a while, I began to feel that the entire foundation of my consciousness was a lie.

For all their patriotism, Americans rarely think about how their national identities relate to their personal ones. This indifference is particular to the psychology of white Americans and has a history unique to the US. In recent years, however, this national identity has become more difficult to ignore. Americans can no longer travel in foreign countries without noticing the strange weight we carry with us. In these years after the wars in Iraq and Afghanistan, and the many wars that followed, it has become more difficult to gallivant across the world absorbing its wisdom and resources for one’s own personal use. Americans abroad now do not have the same swagger, the easy, enormous smiles. You no longer want to speak so loud. There is always the vague risk of breaking something.

Some years after I moved to Istanbul, I bought a notebook, and unlike that confident child, I wrote down not plans but a question: who do we become if we don’t become Americans? If we discover that our identity as we understood it had been a myth? I asked it because my years as an American abroad in the 21st century were not a joyous romp of self-discovery and romance. Mine were more of a shattering and a shame, and even now, I still don’t know myself.

I grew up in Wall, a town located by the Jersey Shore, two hours’ drive from New York. Much of it was a landscape of concrete and parking lots, plastic signs and Dunkin’ Donuts. There was no centre, no Main Street, as there was in most of the pleasant beach towns nearby, no tiny old movie theatre or architecture suggesting some sort of history or memory.

Most of my friends’ parents were teachers, nurses, cops or electricians, except for the rare father who worked in “the City”, and a handful of Italian families who did less legal things. My parents were descendants of working-class Danish, Italian and Irish immigrants who had little memory of their European origins, and my extended family ran an inexpensive public golf course, where I worked as a hot-dog girl in the summers. The politics I heard about as a kid had to do with taxes and immigrants, and not much else. Bill Clinton was not popular in my house. (In 2016, most of Wall voted Trump.)

We were all patriotic, but I can’t even conceive of what else we could have been, because our entire experience was domestic, interior, American. We went to church on Sundays, until church time was usurped by soccer games. I don’t remember a strong sense of civic engagement. Instead I had the feeling that people could take things from you if you didn’t stay vigilant. Our goals remained local: homecoming queen, state champs, a scholarship to Trenton State, barbecues in the backyard. The lone Asian kid in our class studied hard and went to Berkeley; the Indian went to Yale. Black people never came to Wall. The world was white, Christian; the world was us.

We did not study world maps, because international geography, as a subject, had been phased out of many state curriculums long before. There was no sense of the US being one country on a planet of many countries. Even the Soviet Union seemed something more like the Death Star – flying overhead, ready to laser us to smithereens – than a country with people in it.

I have TV memories of world events. Even in my mind, they appear on a screen: Oliver North testifying in the Iran-Contra hearings; the scarred, evil-seeming face of Panama’s dictator Manuel Noriega; the movie-like footage, all flashes of light, of the bombing of Baghdad during the first Gulf war. Mostly what I remember of that war in Iraq was singing God Bless the USA on the school bus – I was 13 – wearing little yellow ribbons and becoming teary-eyed as I remembered the video of the song I had seen on MTV.

And I’m proud to be an American Where at least I know I’m free

That “at least��� is funny. We were free – at the very least we were that. Everyone else was a chump, because they didn’t even have that obvious thing. Whatever it meant, it was the thing that we had, and no one else did. It was our God-given gift, our superpower.

By the time I got to high school, I knew that communism had gone away, but never learned what communism had actually been (“bad” was enough). Religion, politics, race – they washed over me like troubled things that obviously meant something to someone somewhere, but that had no relationship to me, to Wall, to America. I certainly had no idea that most people in the world felt those connections deeply. History – America’s history, the world’s history – would slip in and out of my consciousness with no resonance whatsoever.

Racism, antisemitism and prejudice, however – those things, on some unconscious level, I must have known. They were expressed in the fear of Asbury Park, which was black; in the resentment of the towns of Marlboro and Deal, which were known as Jewish; in the way Hispanics seemed exotic. Much of the Jersey Shore was segregated as if it were still the 1950s, and so prejudice was expressed through fear of anything outside Wall, anything outside the tiny white world in which we lived. If there was something that saved us from being outwardly racist, it was that in small towns such as Wall, especially for girls, it was important to be nice, or good – this pressure tempered tendencies toward overt cruelty when we were young.

I was lucky that I had a mother who nourished my early-onset book addiction, an older brother with mysteriously acquired progressive politics, and a father who spent his evenings studying obscure golf antiques, lost in the pleasures of the past. In these days of the 1%, I am nostalgic for Wall’s middle-class modesty and its sea-salt Jersey Shore air. But as a teenager, I knew that the only thing that could rescue me from the Wall of fear was a good college.

I ended up at the University of Pennsylvania. The lack of interest in the wider world that I had known in Wall found another expression there, although at Penn the children were wealthy, highly educated and apolitical. During orientation, the business school students were told that they were “the smartest people in the country”, or so I had heard. (Donald Trump Jr was there then, too.) In the late 1990s, everyone at Penn wanted to be an investment banker, and many would go on to help bring down the world economy a decade later. But they were more educated than I was; in American literature class, they had even heard of William Faulkner.

When my best friend from Wall revealed one night that she hadn’t heard of John McEnroe or Jerry Garcia, some boys on the dormitory hall called us ignorant, and white trash, and chastised us for not reading magazines. We were hurt, and surprised; white trash was something we said about other people at the Jersey Shore. My boyfriend from Wall accused me of going to Penn solely to find a boyfriend who drove a Ferrari, and the boys at Penn made fun of the Camaros we drove in high school. Class in America was not something we understood in any structural or intellectual way; class was a constellation of a million little materialistic cultural signifiers, and the insult, loss or acquisition of any of them could transform one’s future entirely.

In the end, I chose to pursue the new life Penn offered me. The kids I met had parents who were doctors or academics; many of them had already even been to Europe! Penn, for all its superficiality, felt one step closer to a larger world.

Still, I cannot remember any of us being conscious of foreign events during my four years of college. There were wars in Eritrea, Nepal, Afghanistan, Kosovo, East Timor, Kashmir. US embassies in Nairobi and Dar es Salaam were bombed. Panama, Nicaragua (I couldn’t keep Latin American countries straight), Osama bin Laden, Clinton bombing Iraq – nope.

I knew “Saddam Hussein”, which had the same evil resonance as “communism”. I remember the movie Wag the Dog, a satire in which American politicians start a fake war with foreign “terrorists” to distract the electorate during a domestic scandal – which at the time was what many accused Clinton of doing when he ordered a missile strike on Afghanistan during the Monica Lewinsky affair. I never thought about Afghanistan. What country was in Wag the Dog? Albania. There was a typical American callousness in our reaction to the country they chose for the movie, an indifference that said, Some bumblefuck country, it doesn’t matter which one they choose.

I was a child of the 90s, the decade when, according to America’s foremost intellectuals, “history” had ended, the US was triumphant, the cold war won by a landslide. The historian David Schmitz has written that, by that time, the idea that America won because of “its values and steadfast adherence to the promotion of liberalism and democracy” was dominating “op-ed pages, popular magazines and the bestseller lists”. These ideas were the ambient noise, the elevator music of my most formative years.

But for me there was also an intervention – a chance experience in the basement of Penn’s library. I came across a line in a book in which a historian argued that, long ago, during the slavery era, black people and white people had defined their identities in opposition to each other. The revelation to me was not that black people had conceived of their identities in response to ours, but that our white identities had been composed in conscious objection to theirs. I’d had no idea that we had ever had to define our identities at all, because to me, white Americans were born fully formed, completely detached from any sort of complicated past. Even now, I can remember that shiver of recognition that only comes when you learn something that expands, just a tiny bit, your sense of reality. What made me angry was that this revelation was something about who I was. How much more did I not know about myself?         

It was because of this text that I picked up the books of James Baldwin, who gave me the sense of meeting someone who knew me better, and with a far more sophisticated critical arsenal than I had myself. There was this line:

But I have always been struck, in America, by an emotional poverty so bottomless, and a terror of human life, of human touch, so deep, that virtually no American appears able to achieve any viable, organic connection between his public stance and his private life.

And this one:

All of the western nations have been caught in a lie, the lie of their pretended humanism; this means that their history has no moral justification, and that the west has no moral authority.

And this one:

White Americans are probably the sickest and certainly the most dangerous people, of any colour, to be found in the world today.

I know why this came as a shock to me then, at the age of 22, and it wasn’t necessarily because he said I was sick, though that was part of it. It was because he kept calling me that thing: “white American”. In my reaction I justified his accusation. I knew I was white, and I knew I was American, but it was not what I understood to be my identity. For me, self-definition was about gender, personality, religion, education, dreams. I only thought about finding myself, becoming myself, discovering myself – and this, I hadn’t known, was the most white American thing of all.

I still did not think about my place in the larger world, or that perhaps an entire history – the history of white Americans – had something to do with who I was. My lack of consciousness allowed me to believe I was innocent, or that white American was not an identity like Muslim or Turk.

Of this indifference, Baldwin wrote: “White children, in the main, and whether they are rich or poor, grow up with a grasp of reality so feeble that they can very accurately be described as deluded.”

Young white Americans of course go through pain, insecurity and heartache. But it is very, very rare that young white Americans come across someone who tells them in harsh, unforgiving terms that they might be merely the easy winners of an ugly game, and indeed that because of their ignorance and misused power, they might be the losers within a greater moral universe.

In 2007, after I had worked for six years as a journalist in New York, I won a writing fellowship that would send me to Turkey for two years. I had applied for it on a whim. No part of me expected to win the thing. Even as my friends wished me congratulations, I detected a look of concern on their faces, as if I was crazy to leave all this, as if 29 was a little too late to be finding myself. I had never even been to Turkey before.

In the weeks before my departure, I spent hours explaining Turkey’s international relevance to my bored loved ones, no doubt deploying the cliche that Istanbul was the bridge between east and west. I told everyone that I chose Turkey because I wanted to learn about the Islamic world. The secret reason I wanted to go was that Baldwin had lived in Istanbul in the 1960s, on and off, for almost a decade. I had seen a documentary about Baldwin that said he felt more comfortable as a black, gay man in Istanbul than in Paris or New York.

When I heard that, it made so little sense to me, sitting in my Brooklyn apartment, that a space opened in the universe. I couldn’t believe that New York could be more illiberal than a place such as Turkey, because I couldn’t conceive of how prejudiced New York and Paris had been in that era; and because I thought that as you went east, life degraded into the past, the opposite of progress. The idea of Baldwin in Turkey somehow placed America’s race problem, and America itself, in a mysterious and tantalising international context. I took a chance that Istanbul might be the place where the secret workings of history would be revealed.

In Turkey and elsewhere, in fact, I would feel an almost physical sensation of intellectual and emotional discomfort, while trying to grasp a reality of which I had no historical or cultural understanding. I would go, as a journalist, to write a story about Turkey or Greece or Egypt or Afghanistan, and inevitably someone would tell me some part of our shared history – theirs with America – of which I knew nothing. If I didn’t know this history, then what kind of story did I plan to tell?

My learning process abroad was threefold: I was learning about foreign countries; I was learning about America’s role in the world; and I was also slowly understanding my own psychology, temperament and prejudices. No matter how well I knew the predatory aspects of capitalism, I still perceived Turkey’s and Greece’s economic advances as progress, a kind of maturation. No matter how deeply I understood the US’s manipulation of Egypt for its own foreign-policy aims, I had never considered – and could not grasp – how American policies really affected the lives of individual Egyptians, beyond engendering resentment and anti-Americanism. No matter how much I believed that no American was well-equipped for nation-building, I thought I could see good intentions on the part of the Americans in Afghanistan. I would never have admitted it, or thought to say it, but looking back, I know that deep in my consciousness I thought that America was at the end of some evolutionary spectrum of civilisation, and everyone else was trying to catch up.

American exceptionalism did not only define the US as a special nation among lesser nations; it also demanded that all Americans believe they, too, were somehow superior to others. How could I, as an American, understand a foreign people, when unconsciously I did not extend the most basic faith to other people that I extended to myself? This was a limitation that was beyond racism, beyond prejudice and beyond ignorance. This was a kind of nationalism so insidious that I had not known to call it nationalism; this was a self-delusion so complete that I could not see where it began and ended, could not root it out, could not destroy it.

In my first few months in Istanbul, I lived a formless kind of existence, days dissolving into the nights. I had no office to go to, no job to keep, and I was 30 years old, an age at which people either choose to grow up or remain stuck in the exploratory, idle phase of late-late youth. Starting all over again in a foreign country – making friends, learning a new language, trying to find your way through a city – meant almost certainly choosing the latter. I spent many nights out until the wee hours – such as the evening I drank beer with a young Turkish man named Emre, who had attended college with a friend of mine from the US.

A friend had told me that Emre was one of the most brilliant people he had ever met. As the evening passed, I was gaining a lot from his analysis of Turkish politics, especially when I asked him whether he voted for Erdoğan’s Justice and Development party (AKP), and he spat back, outraged, “Did you vote for George W Bush?” Until that point I had not realised the two might be equivalent.

Then, three beers in, Emre mentioned that the US had planned the September 11 attacks. I had heard this before. Conspiracy theories were common in Turkey; for example, when the military claimed that the PKK, the Kurdish militant group, had attacked a police station, some Turks believed the military itself had done it; they believed it even in cases where Turkish civilians had died. In other words, the idea was that rightwing forces, such as the military, bombed neutral targets, or even rightwing targets, so they could then blame it on the leftwing groups, such as the PKK. To Turks, bombing one’s own country seemed like a real possibility.

“Come on, you don’t believe that,” I said.

“Why not?” he snapped. “I do.”

“But it’s a conspiracy theory.”

He laughed. “Americans always dismiss these things as conspiracy theories. It’s the rest of the world who have had to deal with your conspiracies.”

I ignored him. “I guess I have faith in American journalism,” I said. “Someone else would have figured this out if it were true.”

He smiled. “I’m sorry, there’s no way they didn’t have something to do with it. And now this war?” he said, referring to the war in Iraq. “It’s impossible that the United States couldn’t stop such a thing, and impossible that the Muslims could pull it off.”

Some weeks later, a bomb went off in the Istanbul neighborhood of Güngören. A second bomb exploded out of a garbage bin nearby after 10pm, killing 17 people and injuring 150. No one knew who did it. All that week, Turks debated: was it al-Qaida? The PKK? The DHKP/C, a radical leftist group? Or maybe: the deep state?                   

The deep state – a system of mafia-like paramilitary organisations operating outside of the law, sometimes at the behest of the official military – was a whole other story. Turks explained that the deep state had been formed during the cold war as a way of countering communism, and then mutated into a force for destroying all threats to the Turkish state. The power that some Turks attributed to this entity sometimes strained credulity. But the point was that Turks had been living for years with the idea that some secret force controlled the fate of their nation.

In fact, elements of the deep state were rumoured to have had ties to the CIA during the cold war, and though that too smacked of a conspiracy theory, this was the reality that Turkish people lived in. The sheer number of international interventions the US launched in those decades is astonishing, especially those during years when American power was considered comparatively innocent. There were the successful assassinations: Patrice Lumumba, prime minister of the Democratic Republic of Congo, in 1961; General Rafael Trujillo of the Dominican Republic, also in 1961; Ngo Dinh Diem, president of South Vietnam, in 1963. There were the unsuccessful assassinations: Castro, Castro, and Castro. There were the much hoped-for assassinations: Nasser, Nasser, Nasser. And, of course, US-sponsored, -supported or -staged regime changes: Iran, Guatemala, Iraq, Congo, Syria, Dominican Republic, South Vietnam, Indonesia, Brazil, Chile, Bolivia, Uruguay and Argentina. The Americans trained or supported secret police forces everywhere from Cambodia to Colombia, the Philippines to Peru, Iran to Vietnam. Many Turks believed that the US at least encouraged the 1971 and 1980 military coups in Turkey, though I could find little about these events in any conventional histories anywhere.

But what I could see was that the effects of such meddling were comparable to those of September 11 – just as huge, life-changing and disruptive to the country and to people’s lives. Perhaps Emre did not believe that September 11 was a straightforward affair of evidence and proof because his experience – his reality – taught him that very rarely were any of these surreally monumental events easily explainable. I did not think Emre’s theory about the attacks was plausible. But I began to wonder whether there was much difference between a foreigner’s paranoia that the Americans planned September 11 and the Americans’ paranoia that the whole world should pay for September 11 with an endless global war on terror.

The next time a Turk told me she believed the US had bombed itself on September 11 (I heard this with some regularity; this time it was from a young student at Istanbul’s Boğaziçi University), I repeated my claim about believing in the integrity of American journalism. She replied, a bit sheepishly, “Well, right, we can’t trust our journalism. We can’t take that for granted.”

The words “take that for granted” gave me pause. Having lived in Turkey for more than a year, witnessing how nationalistic propaganda had inspired people’s views of the world and of themselves, I wondered from where the belief in our objectivity and rigour in journalism came. Why would Americans be objective and everyone else subjective?

I thought that because Turkey had poorly functioning institutions – they didn’t have a reliable justice system, as compared to an American system I believed to be functional – it often felt as if there was no truth. Turks were always sceptical of official histories, and blithely dismissive of the government’s line. But was it rather that the Turks, with their beautiful scepticism, were actually just less nationalistic than me?

American exceptionalism had declared my country unique in the world, the one truly free and modern country, and instead of ever considering that that exceptionalism was no different from any other country’s nationalistic propaganda, I had internalised this belief. Wasn’t that indeed what successful propaganda was supposed to do? I had not questioned the institution of American journalism outside of the standards it set for itself – which, after all, was the only way I would discern its flaws and prejudices; instead, I accepted those standards as the best standards any country could possibly have.

By the end of my first year abroad, I read US newspapers differently. I could see how alienating they were to foreigners, the way articles spoke always from a position of American power, treating foreign countries as if they were America’s misbehaving children. I listened to my compatriots with critical ears: the way our discussion of foreign policy had become infused since September 11 with these officious, official words, bureaucratic corporate military language: collateral damage, imminent threat, freedom, freedom, freedom.

Even so, I was conscious that if I had long ago succumbed to the pathology of American nationalism, I wouldn’t know it – even if I understood the history of injustice in America, even if I was furious about the invasion of Iraq. I was a white American. I still had this fundamental faith in my country in a way that suddenly, in comparison to the Turks, made me feel immature and naive.

I came to notice that a community of activists and intellectuals in Turkey – the liberal ones – were indeed questioning what “Turkishness” meant in new ways. Many of them had been brainwashed in their schools about their own history; about Atatürk, Turkey’s first president; about the supposed evil of the Armenians and the Kurds and the Arabs; about the fragility of their borders and the rapaciousness of all outsiders; and about the historic and eternal goodness of the Turkish republic.

“It is different in the United States,” I once said, not entirely realising what I was saying until the words came out. I had never been called upon to explain this. “We are told it is the greatest country on earth. The thing is, we will never reconsider that narrative the way you are doing just now, because to us, that isn’t propaganda, that is truth. And to us, that isn’t nationalism, it’s patriotism. And the thing is, we will never question any of it because at the same time, all we are being told is how free-thinking we are, that we are free. So we don’t know there is anything wrong in believing our country is the greatest on earth. The whole thing sort of convinces you that a collective consciousness in the world came to that very conclusion.”

“Wow,” a friend once replied. “How strange. That is a very quiet kind of fascism, isn’t it?                 

It was a quiet kind of fascism that would mean I would always see Turkey as beneath the country I came from, and also that would mean I believed my uniquely benevolent country to have uniquely benevolent intentions towards the peoples of the world.

During that night of conspiracy theories, Emre had alleged, as foreigners often did, that I was a spy. The information that I was collecting as a journalist, Emre said, was really being used for something else. As an American emissary in the wider world, writing about foreigners, governments, economies partaking in some larger system and scheme of things, I was an agent somehow. Emre lived in the American world as a foreigner, as someone less powerful, as someone for whom one newspaper article could mean war, or one misplaced opinion could mean an intervention by the International Monetary Fund. My attitude, my prejudice, my lack of generosity could be entirely false, inaccurate or damaging, but would be taken for truth by the newspapers and magazines I wrote for, thus shaping perceptions of Turkey for ever.

Years later, an American journalist told me he loved working for a major newspaper because the White House read it, because he could “influence policy”. Emre had told me how likely it was I would screw this up. He was saying to me: first, spy, do no harm.

Adapted from Notes on a Foreign Country: An American Abroad in a Post-American World by Suzy Hansen, which will be published by Farrar, Straus and Giroux on 15 August

https://www.theguardian.com/us-news/2017/aug/08/unlearning-the-myth-of-american-innocence?CMP=share_btn_fb

@catcomaprada @evaannapaula @sissyhiyah

[lakbimajobs-blog]

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[deniscollins]

A Simple Way to Improve a Billion Lives: Eyeglasses

Experts estimate 1 billion to 2.5 billion people worldwide need eyeglasses but don’t get eye exams or glasses, which can cost just $1.50, due to poverty conditions and lack of eye doctors. Experts say a significant number of India’s roughly 200,000 traffic deaths each year are tied to poor vision. If you were an executive for an eye industry association, what would you do, if anything, in response to this? Why? What are the ethics underlying your decisions?

Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up.

Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school.

“Sometimes I don’t see a motorbike until it’s almost in my face,” he said.

As his grades flagged, so did his dreams of becoming a pilot. “You can’t fly a plane if you’re blind,” he noted glumly.

The fix for Shivam’s declining vision, it turns out, was remarkably simple.

He needed glasses.

More than a billion people around the world need eyeglasses but don’t have them, researchers say, an affliction long overlooked on lists of public health priorities. Some estimates put that figure closer to 2.5 billion people. They include thousands of nearsighted Nigerian truck drivers who strain to see pedestrians darting across the road and middle-aged coffee farmers in Bolivia whose inability to see objects up close makes it hard to spot ripe beans for harvest.

Then there are the tens of millions of children like Shivam across the world whose families cannot afford an eye exam or the prescription eyeglasses that would help them excel in school.

“Many of these kids are classified as poor learners or just dumb and therefore don’t progress at school,” said Kovin Naidoo, global director of Our Children’s Vision, an organization that provides free or inexpensive eyeglasses across Africa. “That just adds another hurdle to countries struggling to break the cycle of poverty.”

In an era when millions of people still perish from preventable or treatable illness, many major donors devote their largess to combating killers like AIDS, malaria and tuberculosis. In 2015, only $37 million was spent on delivering eyeglasses to people in the developing world, less than one percent of resources devoted to global health issues, according to EYElliance, a nonprofit group trying to raise money and bring attention to the problem of uncorrected vision.

So far, the group’s own fund-raising has yielded only a few million dollars, according to its organizers.  It has enlisted Ellen Johnson Sirleaf, the former Liberian president, Elaine L. Chao, the transportation secretary for the United States and Paul Polman, the chief executive of Unilever, among others, in an attempt to catapult the issue onto global development wish lists. They contend that an investment in improving sight would pay off. The World Health Organization has estimated the problem costs the global economy more than $200 billion annually in lost productivity.

“Lack of access to eye care prevents billions of people around the world from achieving their potential, and is a major barrier to economic and human progress,” said Madeleine K. Albright, the former  secretary of state who is also involved in the group.

Hubert Sagnieres, the chief executive of Essilor, a French eyeglass company and a partner in the fund-raising campaign, said he often confronts ambivalence when pitching the cause to big-name philanthropists.

In an interview, he recalled a recent conversation with Bill Gates, whose foundation has spent tens of billions of dollars battling infectious diseases in the developing world. He said he reminded Mr. Gates of his own childhood nearsightedness, noting that without glasses, he might have faltered in school and perhaps never gone on to start Microsoft. Mr. Gates, he said, politely demurred, saying he had other priorities. A spokeswoman for the Gates Foundation declined to comment.

The initiative’s backers point out that responding to the world’s vision crisis does not require the invention of new drugs or solving nettlesome issues like distributing refrigerated vaccines in countries with poor infrastructure. Factories in Thailand, China and the Philippines can manufacture so-called readers for less than 50 cents a pair; prescription glasses that correct nearsightedness can be produced for $1.50.

But money alone won’t easily solve systemic challenges faced by countries like Uganda, which has just 45 eye doctors for a nation of 41 million. In rural India, glasses are seen as a sign of infirmity, and in many places, a hindrance for young women seeking to get married. Until last year, Liberia did not have a single eye clinic.

“People in rural areas have never even seen a child wearing glasses,” said Ms. Sirleaf, who was president of Liberia from 2006 to this year. “Drivers don’t even know they have a deficiency. They just drive the best they can.”

On a recent afternoon, hundreds of children in powder-blue uniforms giddily jostled one another in the dusty courtyard of a high school in Panipat, two hours north of New Delhi. The students, all from poor families, were having their eyesight checked by VisionSpring, a nonprofit group started by Jordan Kassalow, a New York optometrist who helped set up EYElliance, that works with local governments to distribute subsidized eyeglasses in Asia and Africa.

For most, it was the first time anyone had checked their eyesight. The students were both excited and terrified. Roughly 12 percent were flagged as having weak vision and sent to an adjacent classroom where workers using refractor lenses conducted more tests.

Shivam, the boy who dreamed of being a pilot, walked away with a pair of purple-framed spectacles donated by Warby Parker, the American eyewear company, which also paid for the screenings.

“Everything is so clear,” Shivam exclaimed as he looked with wonder around the classroom.

Anshu Taneja, VisonSpring’s India director, said that providing that first pair of glasses is pivotal; people who have experienced the benefits of corrected vision will often buy a second pair if their prescription changes or they lose the glasses they have come to depend on.

Ratan Singh, 45, a sharecropper who recently got his first pair of reading glasses, said he could not imagine living without them now. Standing in a field of ripening wheat, he said his inability to see tiny pests on the stalks of his crop had led to decreasing yields. He sheepishly recalled the time he sprayed the wrong insecticide because he couldn’t read the label. “I was always asking other people to help me read but I was becoming a burden,” he said.

Last month, after he accidentally broke his glasses, Mr. Singh, who supports his wife and six daughters, did not hesitate to fork out the 60 rupees, roughly 90 cents, for a new pair.

Most adults over 50 need reading glasses — more than a billion people in the developing world, according to the International Agency for the Prevention of Blindness — though the vast majority simply accept their creeping disability.

That’s what happened to D. Periyanayakam, 56, a power company employee whose job requires him to read electrical meters. His failing eyesight also made it hard to drive or respond to text messages from customers and co-workers.

“I figured it was a only matter of time before they suspended me,” he said during a visit to a mobile eye clinic run by Aravind Eye Hospital, a nonprofit institution that screened his vision and told him he would soon need cataract surgery.

Mr. Periyanayakam returned to work that day with a $2 pair of glasses. He was among 400 people who showed up at a daylong clinic in a high school run by ophthalmologists, lens grinders and vision screeners.

Aravind dispenses 600,000 pairs of glasses each year in India and has expanded its efforts to Nepal, Bangladesh and countries in Africa through local partners.

The hospital trains its own vision screeners, most of them young women; a separate program trains primary schoolteachers to test their students’ sight using eye charts.

Then there is the matter of road safety. Surveys show that a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.

Experts say a significant number of India’s roughly 200,000 traffic deathseach year are tied to poor vision. In a country with a huge number of drivers, among them nine million truckers, the government agencies that administer licenses are ill-equipped to deal with the problem of declining vision, critics say.

Sightsavers, a British nonprofit that has been treating cataract-related blindness in India since the 1960s, has spent the past two years trying to get glasses to commercial drivers. It operates mobile eye-screening campsat truck stops and tollbooths in 16 cities. A driver who has his eyes examined at a clinic in north India can pick up his glasses 10 days later at a clinic in the far south.

“These men are always on the move and they are pressed for time, so we try to make it as easy as possible for them,” said Ameen, a Sightsaver employee who uses a single name.

On a recent morning, dozens of drivers, many wearing flip-flops and oil-stained trousers, lined up in front of an eye chart taped to the wall of a trucking company in the town of Chapraula. Asked why they had waited so long to have their vision checked, some shrugged. Others said they were too busy. A few cited fears they would be fired if an employer discovered that their vision was flawed.

About half the men, it turned out, needed glasses. They included Jagdish Prasad, 55, a father of nine with a deeply lined face who had never had his eyes tested.

“I haven’t had an accident in 35 years,” Mr. Prasad exclaimed — but then reluctantly admitted that he has lately been squinting to see whether a traffic light had changed.

Then he gestured to the cavalcade of honking vehicles behind him and told a story. Four days earlier, he said, a mentally ill man had been lying on the edge of the road, forcing drivers to swerve to avoid him. One of those vehicles, a truck not unlike his own, tried to avoid the man but ended up killing two students who were crossing the road on their way to school. The next day, the mentally ill man was also struck and killed, Mr. Prasad said.

He paused and then considered the piece of paper in his hand. It contained the prescription for his first pair of glasses. Mr. Prasad hesitated and then gently placed it in his pocket.

[cleopatrarps]

A Simple Way to Improve a Billion Lives: Eyeglasses

PANIPAT, India — Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up.

Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school.

“Sometimes I don’t see a motorbike until it’s almost in my face,” he said.

As his grades flagged, so did his dreams of becoming a pilot. “You can’t fly a plane if you’re blind,” he noted glumly.

The fix for Shivam’s declining vision, it turns out, was remarkably simple.

He needed glasses.

More than a billion people around the world need eyeglasses but don’t have them, researchers say, an affliction long overlooked on lists of public health priorities. Some estimates put that figure closer to 2.5 billion people. They include thousands of nearsighted Nigerian truck drivers who strain to see pedestrians darting across the road and middle-aged coffee farmers in Bolivia whose inability to see objects up close makes it hard to spot ripe beans for harvest.

Then there the tens of millions of children like Shivam across the world whose families cannot afford an eye exam or the prescription eyeglasses that would help them excel in school.

“Many of these kids are classified as poor learners or just dumb and therefore don’t progress at school,” said Kovin Naidoo, global director of Our Children’s Vision, an organization that provides free or inexpensive eyeglasses across Africa. “That just adds another hurdle to countries struggling to break the cycle of poverty.”

In an era when millions of people still perish from preventable or treatable illness, many major donors devote their largess to combating killers like AIDS, malaria and tuberculosis. In 2015, only $37 million was spent on delivering eyeglasses to people in the developing world, less than one percent of resources devoted to global health issues, according to EYElliance, a nonprofit group trying to raise money and bring attention to the problem of uncorrected vision.

So far, the group’s own fund-raising has yielded only a few million dollars, according to its organizers. It has enlisted Ellen Johnson Sirleaf, the former Liberian president, Elaine L. Chao, the transportation secretary for the United States and Paul Polman, the chief executive of Unilever, among others, in an attempt to catapult the issue onto global development wish lists. They contend that an investment in improving sight would pay off. The World Health Organization has estimated the problem costs the global economy more than $200 billion annually in lost productivity.

“Lack of access to eye care prevents billions of people around the world from achieving their potential, and is a major barrier to economic and human progress,” said Madeleine K. Albright, the former secretary of state who is also involved in the group.

Hubert Sagnieres, the chief executive of Essilor, a French eyeglass company and a partner in the fund-raising campaign, said he often confronts ambivalence when pitching the cause to big-name philanthropists.

In an interview, he recalled a recent conversation with Bill Gates, whose foundation has spent tens of billions of dollars battling infectious diseases in the developing world. He said he reminded Mr. Gates of his own childhood nearsightedness, noting that without glasses, he might have faltered in school and perhaps never gone on to start Microsoft. Mr. Gates, he said, politely demurred, saying he had other priorities. A spokeswoman for the Gates Foundation declined to comment.

The initiative’s backers point out that responding to the world’s vision crisis does not require the invention of new drugs or solving nettlesome issues like distributing refrigerated vaccines in countries with poor infrastructure. Factories in Thailand, China and the Philippines can manufacture so-called readers for less than 50 cents a pair; prescription glasses that correct nearsightedness can be produced for $1.50.

But money alone won’t easily solve systemic challenges faced by countries like Uganda, which has just 45 eye doctors for a nation of 41 million. In rural India, glasses are seen as a sign of infirmity, and in many places, a hindrance for young women seeking to get married. Until last year, Liberia did not have a single eye clinic.

“People in rural areas have never even seen a child wearing glasses,” said Ms. Sirleaf, who was president of Liberia from 2006 to this year. “Drivers don’t even know they have a deficiency. They just drive the best they can.”

On a recent afternoon, hundreds of children in powder-blue uniforms giddily jostled one another in the dusty courtyard of a high school in Panipat, two hours north of New Delhi. The students, all from poor families, were having their eyesight checked by VisionSpring, a nonprofit group started by Jordan Kassalow, a New York optometrist who helped set up EYElliance, that works with local governments to distribute subsidized eyeglasses in Asia and Africa.

For most, it was the first time anyone had checked their eyesight. The students were both excited and terrified. Roughly 12 percent were flagged as having weak vision and sent to an adjacent classroom where workers using refractor lenses conducted more tests.

Shivam, the boy who dreamed of being a pilot, walked away with a pair of purple-framed spectacles donated by Warby Parker, the American eyewear company, which also paid for the screenings.

“Everything is so clear,” Shivam exclaimed as he looked with wonder around the classroom.

Anshu Taneja, VisonSpring’s India director, said that providing that first pair of glasses is pivotal; people who have experienced the benefits of corrected vision will often buy a second pair if their prescription changes or they lose the glasses they have come to depend on.

Ratan Singh, 45, a sharecropper who recently got his first pair of reading glasses, said he could not imagine living without them now. Standing in a field of ripening wheat, he said his inability to see tiny pests on the stalks of his crop had led to decreasing yields. He sheepishly recalled the time he sprayed the wrong insecticide because he couldn’t read the label. “I was always asking other people to help me read but I was becoming a burden,” he said.

Last month, after he accidentally broke his glasses, Mr. Singh, who supports his wife and six daughters, did not hesitate to fork out the 60 rupees, roughly 90 cents, for a new pair.

Most adults over 50 need reading glasses — more than a billion people in the developing world, according to the International Agency for the Prevention of Blindness — though the vast majority simply accept their creeping disability.

That’s what happened to D. Periyanayakam, 56, a power company employee whose job requires him to read electrical meters. His failing eyesight also made it hard to drive or respond to text messages from customers and co-workers.

“I figured it was a only matter of time before they suspended me,” he said during a visit to a mobile eye clinic run by Aravind Eye Hospital, a nonprofit institution that screened his vision and told him he would soon need cataract surgery.

Mr. Periyanayakam returned to work that day with a $2 pair of glasses. He was among 400 people who showed up at a daylong clinic in a high school run by ophthalmologists, lens grinders and vision screeners.

Aravind dispenses 600,000 pairs of glasses each year in India and has expanded its efforts to Nepal, Bangladesh and countries in Africa through local partners.

The hospital trains its own vision screeners, most of them young women; a separate program trains primary schoolteachers to test their students’ sight using eye charts.

Then there is the matter of road safety. Surveys show that a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.

Experts say a significant number of India’s roughly 200,000 traffic deaths each year are tied to poor vision. In a country with a huge number of drivers, among them nine million truckers, the government agencies that administer licenses are ill-equipped to deal with the problem of declining vision, critics say.

Sightsavers, a British nonprofit that has been treating cataract-related blindness in India since the 1960s, has spent the past two years trying to get glasses to commercial drivers. It operates mobile eye-screening camps at truck stops and tollbooths in 16 cities. A driver who has his eyes examined at a clinic in north India can pick up his glasses 10 days later at a clinic in the far south.

“These men are always on the move and they are pressed for time, so we try to make it as easy as possible for them,” said Ameen, a Sightsaver employee who uses a single name.

On a recent morning, dozens of drivers, many wearing flip-flops and oil-stained trousers, lined up in front of an eye chart taped to the wall of a trucking company in the town of Chapraula. Asked why they had waited so long to have their vision checked, some shrugged. Others said they were too busy. A few cited fears they would be fired if an employer discovered that their vision was flawed.

About half the men, it turned out, needed glasses. They included Jagdish Prasad, 55, a father of nine with a deeply lined face who had never had his eyes tested.

“I haven’t had an accident in 35 years,” Mr. Prasad exclaimed — but then reluctantly admitted that he has lately been squinting to see whether a traffic light had changed.

Then he gestured to the cavalcade of honking vehicles behind him and told a story. Four days earlier, he said, a mentally ill man had been lying on the edge of the road, forcing drivers to swerve to avoid him. One of those vehicles, a truck not unlike his own, tried to avoid the man but ended up killing two students who were crossing the road on their way to school. The next day, the mentally ill man was also struck and killed, Mr. Prasad said.

He paused and then considered the piece of paper in his hand. It contained the prescription for his first pair of glasses. Mr. Prasad hesitated and then gently placed it in his pocket.

The post A Simple Way to Improve a Billion Lives: Eyeglasses appeared first on World The News.

from World The News https://ift.tt/2KGOO7Q via News of World

[dragnews]

A Simple Way to Improve a Billion Lives: Eyeglasses

PANIPAT, India — Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up.

Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school.

“Sometimes I don’t see a motorbike until it’s almost in my face,” he said.

As his grades flagged, so did his dreams of becoming a pilot. “You can’t fly a plane if you’re blind,” he noted glumly.

The fix for Shivam’s declining vision, it turns out, was remarkably simple.

He needed glasses.

More than a billion people around the world need eyeglasses but don’t have them, researchers say, an affliction long overlooked on lists of public health priorities. Some estimates put that figure closer to 2.5 billion people. They include thousands of nearsighted Nigerian truck drivers who strain to see pedestrians darting across the road and middle-aged coffee farmers in Bolivia whose inability to see objects up close makes it hard to spot ripe beans for harvest.

Then there the tens of millions of children like Shivam across the world whose families cannot afford an eye exam or the prescription eyeglasses that would help them excel in school.

“Many of these kids are classified as poor learners or just dumb and therefore don’t progress at school,” said Kovin Naidoo, global director of Our Children’s Vision, an organization that provides free or inexpensive eyeglasses across Africa. “That just adds another hurdle to countries struggling to break the cycle of poverty.”

In an era when millions of people still perish from preventable or treatable illness, many major donors devote their largess to combating killers like AIDS, malaria and tuberculosis. In 2015, only $37 million was spent on delivering eyeglasses to people in the developing world, less than one percent of resources devoted to global health issues, according to EYElliance, a nonprofit group trying to raise money and bring attention to the problem of uncorrected vision.

So far, the group’s own fund-raising has yielded only a few million dollars, according to its organizers. It has enlisted Ellen Johnson Sirleaf, the former Liberian president, Elaine L. Chao, the transportation secretary for the United States and Paul Polman, the chief executive of Unilever, among others, in an attempt to catapult the issue onto global development wish lists. They contend that an investment in improving sight would pay off. The World Health Organization has estimated the problem costs the global economy more than $200 billion annually in lost productivity.

“Lack of access to eye care prevents billions of people around the world from achieving their potential, and is a major barrier to economic and human progress,” said Madeleine K. Albright, the former secretary of state who is also involved in the group.

Hubert Sagnieres, the chief executive of Essilor, a French eyeglass company and a partner in the fund-raising campaign, said he often confronts ambivalence when pitching the cause to big-name philanthropists.

In an interview, he recalled a recent conversation with Bill Gates, whose foundation has spent tens of billions of dollars battling infectious diseases in the developing world. He said he reminded Mr. Gates of his own childhood nearsightedness, noting that without glasses, he might have faltered in school and perhaps never gone on to start Microsoft. Mr. Gates, he said, politely demurred, saying he had other priorities. A spokeswoman for the Gates Foundation declined to comment.

The initiative’s backers point out that responding to the world’s vision crisis does not require the invention of new drugs or solving nettlesome issues like distributing refrigerated vaccines in countries with poor infrastructure. Factories in Thailand, China and the Philippines can manufacture so-called readers for less than 50 cents a pair; prescription glasses that correct nearsightedness can be produced for $1.50.

But money alone won’t easily solve systemic challenges faced by countries like Uganda, which has just 45 eye doctors for a nation of 41 million. In rural India, glasses are seen as a sign of infirmity, and in many places, a hindrance for young women seeking to get married. Until last year, Liberia did not have a single eye clinic.

“People in rural areas have never even seen a child wearing glasses,” said Ms. Sirleaf, who was president of Liberia from 2006 to this year. “Drivers don’t even know they have a deficiency. They just drive the best they can.”

On a recent afternoon, hundreds of children in powder-blue uniforms giddily jostled one another in the dusty courtyard of a high school in Panipat, two hours north of New Delhi. The students, all from poor families, were having their eyesight checked by VisionSpring, a nonprofit group started by Jordan Kassalow, a New York optometrist who helped set up EYElliance, that works with local governments to distribute subsidized eyeglasses in Asia and Africa.

For most, it was the first time anyone had checked their eyesight. The students were both excited and terrified. Roughly 12 percent were flagged as having weak vision and sent to an adjacent classroom where workers using refractor lenses conducted more tests.

Shivam, the boy who dreamed of being a pilot, walked away with a pair of purple-framed spectacles donated by Warby Parker, the American eyewear company, which also paid for the screenings.

“Everything is so clear,” Shivam exclaimed as he looked with wonder around the classroom.

Anshu Taneja, VisonSpring’s India director, said that providing that first pair of glasses is pivotal; people who have experienced the benefits of corrected vision will often buy a second pair if their prescription changes or they lose the glasses they have come to depend on.

Ratan Singh, 45, a sharecropper who recently got his first pair of reading glasses, said he could not imagine living without them now. Standing in a field of ripening wheat, he said his inability to see tiny pests on the stalks of his crop had led to decreasing yields. He sheepishly recalled the time he sprayed the wrong insecticide because he couldn’t read the label. “I was always asking other people to help me read but I was becoming a burden,” he said.

Last month, after he accidentally broke his glasses, Mr. Singh, who supports his wife and six daughters, did not hesitate to fork out the 60 rupees, roughly 90 cents, for a new pair.

Most adults over 50 need reading glasses — more than a billion people in the developing world, according to the International Agency for the Prevention of Blindness — though the vast majority simply accept their creeping disability.

That’s what happened to D. Periyanayakam, 56, a power company employee whose job requires him to read electrical meters. His failing eyesight also made it hard to drive or respond to text messages from customers and co-workers.

“I figured it was a only matter of time before they suspended me,” he said during a visit to a mobile eye clinic run by Aravind Eye Hospital, a nonprofit institution that screened his vision and told him he would soon need cataract surgery.

Mr. Periyanayakam returned to work that day with a $2 pair of glasses. He was among 400 people who showed up at a daylong clinic in a high school run by ophthalmologists, lens grinders and vision screeners.

Aravind dispenses 600,000 pairs of glasses each year in India and has expanded its efforts to Nepal, Bangladesh and countries in Africa through local partners.

The hospital trains its own vision screeners, most of them young women; a separate program trains primary schoolteachers to test their students’ sight using eye charts.

Then there is the matter of road safety. Surveys show that a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.

Experts say a significant number of India’s roughly 200,000 traffic deaths each year are tied to poor vision. In a country with a huge number of drivers, among them nine million truckers, the government agencies that administer licenses are ill-equipped to deal with the problem of declining vision, critics say.

Sightsavers, a British nonprofit that has been treating cataract-related blindness in India since the 1960s, has spent the past two years trying to get glasses to commercial drivers. It operates mobile eye-screening camps at truck stops and tollbooths in 16 cities. A driver who has his eyes examined at a clinic in north India can pick up his glasses 10 days later at a clinic in the far south.

“These men are always on the move and they are pressed for time, so we try to make it as easy as possible for them,” said Ameen, a Sightsaver employee who uses a single name.

On a recent morning, dozens of drivers, many wearing flip-flops and oil-stained trousers, lined up in front of an eye chart taped to the wall of a trucking company in the town of Chapraula. Asked why they had waited so long to have their vision checked, some shrugged. Others said they were too busy. A few cited fears they would be fired if an employer discovered that their vision was flawed.

About half the men, it turned out, needed glasses. They included Jagdish Prasad, 55, a father of nine with a deeply lined face who had never had his eyes tested.

“I haven’t had an accident in 35 years,” Mr. Prasad exclaimed — but then reluctantly admitted that he has lately been squinting to see whether a traffic light had changed.

Then he gestured to the cavalcade of honking vehicles behind him and told a story. Four days earlier, he said, a mentally ill man had been lying on the edge of the road, forcing drivers to swerve to avoid him. One of those vehicles, a truck not unlike his own, tried to avoid the man but ended up killing two students who were crossing the road on their way to school. The next day, the mentally ill man was also struck and killed, Mr. Prasad said.

He paused and then considered the piece of paper in his hand. It contained the prescription for his first pair of glasses. Mr. Prasad hesitated and then gently placed it in his pocket.

The post A Simple Way to Improve a Billion Lives: Eyeglasses appeared first on World The News.

from World The News https://ift.tt/2KGOO7Q via Today News

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[party-hard-or-die]

A Simple Way to Improve a Billion Lives: Eyeglasses

PANIPAT, India — Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up.

Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school.

“Sometimes I don’t see a motorbike until it’s almost in my face,” he said.

As his grades flagged, so did his dreams of becoming a pilot. “You can’t fly a plane if you’re blind,” he noted glumly.

The fix for Shivam’s declining vision, it turns out, was remarkably simple.

He needed glasses.

More than a billion people around the world need eyeglasses but don’t have them, researchers say, an affliction long overlooked on lists of public health priorities. Some estimates put that figure closer to 2.5 billion people. They include thousands of nearsighted Nigerian truck drivers who strain to see pedestrians darting across the road and middle-aged coffee farmers in Bolivia whose inability to see objects up close makes it hard to spot ripe beans for harvest.

Then there the tens of millions of children like Shivam across the world whose families cannot afford an eye exam or the prescription eyeglasses that would help them excel in school.

“Many of these kids are classified as poor learners or just dumb and therefore don’t progress at school,” said Kovin Naidoo, global director of Our Children’s Vision, an organization that provides free or inexpensive eyeglasses across Africa. “That just adds another hurdle to countries struggling to break the cycle of poverty.”

In an era when millions of people still perish from preventable or treatable illness, many major donors devote their largess to combating killers like AIDS, malaria and tuberculosis. In 2015, only $37 million was spent on delivering eyeglasses to people in the developing world, less than one percent of resources devoted to global health issues, according to EYElliance, a nonprofit group trying to raise money and bring attention to the problem of uncorrected vision.

So far, the group’s own fund-raising has yielded only a few million dollars, according to its organizers. It has enlisted Ellen Johnson Sirleaf, the former Liberian president, Elaine L. Chao, the transportation secretary for the United States and Paul Polman, the chief executive of Unilever, among others, in an attempt to catapult the issue onto global development wish lists. They contend that an investment in improving sight would pay off. The World Health Organization has estimated the problem costs the global economy more than $200 billion annually in lost productivity.

“Lack of access to eye care prevents billions of people around the world from achieving their potential, and is a major barrier to economic and human progress,” said Madeleine K. Albright, the former secretary of state who is also involved in the group.

Hubert Sagnieres, the chief executive of Essilor, a French eyeglass company and a partner in the fund-raising campaign, said he often confronts ambivalence when pitching the cause to big-name philanthropists.

In an interview, he recalled a recent conversation with Bill Gates, whose foundation has spent tens of billions of dollars battling infectious diseases in the developing world. He said he reminded Mr. Gates of his own childhood nearsightedness, noting that without glasses, he might have faltered in school and perhaps never gone on to start Microsoft. Mr. Gates, he said, politely demurred, saying he had other priorities. A spokeswoman for the Gates Foundation declined to comment.

The initiative’s backers point out that responding to the world’s vision crisis does not require the invention of new drugs or solving nettlesome issues like distributing refrigerated vaccines in countries with poor infrastructure. Factories in Thailand, China and the Philippines can manufacture so-called readers for less than 50 cents a pair; prescription glasses that correct nearsightedness can be produced for $1.50.

But money alone won’t easily solve systemic challenges faced by countries like Uganda, which has just 45 eye doctors for a nation of 41 million. In rural India, glasses are seen as a sign of infirmity, and in many places, a hindrance for young women seeking to get married. Until last year, Liberia did not have a single eye clinic.

“People in rural areas have never even seen a child wearing glasses,” said Ms. Sirleaf, who was president of Liberia from 2006 to this year. “Drivers don’t even know they have a deficiency. They just drive the best they can.”

On a recent afternoon, hundreds of children in powder-blue uniforms giddily jostled one another in the dusty courtyard of a high school in Panipat, two hours north of New Delhi. The students, all from poor families, were having their eyesight checked by VisionSpring, a nonprofit group started by Jordan Kassalow, a New York optometrist who helped set up EYElliance, that works with local governments to distribute subsidized eyeglasses in Asia and Africa.

For most, it was the first time anyone had checked their eyesight. The students were both excited and terrified. Roughly 12 percent were flagged as having weak vision and sent to an adjacent classroom where workers using refractor lenses conducted more tests.

Shivam, the boy who dreamed of being a pilot, walked away with a pair of purple-framed spectacles donated by Warby Parker, the American eyewear company, which also paid for the screenings.

“Everything is so clear,” Shivam exclaimed as he looked with wonder around the classroom.

Anshu Taneja, VisonSpring’s India director, said that providing that first pair of glasses is pivotal; people who have experienced the benefits of corrected vision will often buy a second pair if their prescription changes or they lose the glasses they have come to depend on.

Ratan Singh, 45, a sharecropper who recently got his first pair of reading glasses, said he could not imagine living without them now. Standing in a field of ripening wheat, he said his inability to see tiny pests on the stalks of his crop had led to decreasing yields. He sheepishly recalled the time he sprayed the wrong insecticide because he couldn’t read the label. “I was always asking other people to help me read but I was becoming a burden,” he said.

Last month, after he accidentally broke his glasses, Mr. Singh, who supports his wife and six daughters, did not hesitate to fork out the 60 rupees, roughly 90 cents, for a new pair.

Most adults over 50 need reading glasses — more than a billion people in the developing world, according to the International Agency for the Prevention of Blindness — though the vast majority simply accept their creeping disability.

That’s what happened to D. Periyanayakam, 56, a power company employee whose job requires him to read electrical meters. His failing eyesight also made it hard to drive or respond to text messages from customers and co-workers.

“I figured it was a only matter of time before they suspended me,” he said during a visit to a mobile eye clinic run by Aravind Eye Hospital, a nonprofit institution that screened his vision and told him he would soon need cataract surgery.

Mr. Periyanayakam returned to work that day with a $2 pair of glasses. He was among 400 people who showed up at a daylong clinic in a high school run by ophthalmologists, lens grinders and vision screeners.

Aravind dispenses 600,000 pairs of glasses each year in India and has expanded its efforts to Nepal, Bangladesh and countries in Africa through local partners.

The hospital trains its own vision screeners, most of them young women; a separate program trains primary schoolteachers to test their students’ sight using eye charts.

Then there is the matter of road safety. Surveys show that a worrisome number of drivers on the road in developing countries have uncorrected vision. Traffic fatality rates are far higher in low-income countries; in Africa, for example, the rate is nearly triple that of Europe, according to the W.H.O.

Experts say a significant number of India’s roughly 200,000 traffic deaths each year are tied to poor vision. In a country with a huge number of drivers, among them nine million truckers, the government agencies that administer licenses are ill-equipped to deal with the problem of declining vision, critics say.

Sightsavers, a British nonprofit that has been treating cataract-related blindness in India since the 1960s, has spent the past two years trying to get glasses to commercial drivers. It operates mobile eye-screening camps at truck stops and tollbooths in 16 cities. A driver who has his eyes examined at a clinic in north India can pick up his glasses 10 days later at a clinic in the far south.

“These men are always on the move and they are pressed for time, so we try to make it as easy as possible for them,” said Ameen, a Sightsaver employee who uses a single name.

On a recent morning, dozens of drivers, many wearing flip-flops and oil-stained trousers, lined up in front of an eye chart taped to the wall of a trucking company in the town of Chapraula. Asked why they had waited so long to have their vision checked, some shrugged. Others said they were too busy. A few cited fears they would be fired if an employer discovered that their vision was flawed.

About half the men, it turned out, needed glasses. They included Jagdish Prasad, 55, a father of nine with a deeply lined face who had never had his eyes tested.

“I haven’t had an accident in 35 years,” Mr. Prasad exclaimed — but then reluctantly admitted that he has lately been squinting to see whether a traffic light had changed.

Then he gestured to the cavalcade of honking vehicles behind him and told a story. Four days earlier, he said, a mentally ill man had been lying on the edge of the road, forcing drivers to swerve to avoid him. One of those vehicles, a truck not unlike his own, tried to avoid the man but ended up killing two students who were crossing the road on their way to school. The next day, the mentally ill man was also struck and killed, Mr. Prasad said.

He paused and then considered the piece of paper in his hand. It contained the prescription for his first pair of glasses. Mr. Prasad hesitated and then gently placed it in his pocket.

The post A Simple Way to Improve a Billion Lives: Eyeglasses appeared first on World The News.

from World The News https://ift.tt/2KGOO7Q via Breaking News

[optometrist0]

Vision Care Optometry

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[deniscollins]

The Night the Oxygen Ran Out in an Indian Hospital

What would you do if you were a vendor who supplied liquid oxygen to a government hospital in India that you had repeatedly warned many times about the lack of payment of a $100,00 bill that was causing the supplier to not meet its bills: (1) pay a 2-5 percent bribe to a government official to pay the vendor, (2) cut off the supply of oxygen and risk deaths, (3) something else (if so, what?)? Why? What are the ethics underlying your decision?

It was around 6 a.m. last Friday, said Mohamed Jahid — the father of a very sick little girl being treated at a government hospital — when the oxygen stopped. The situation was desperate, but the parents of children in the intensive care unit did not panic, because they had no idea what was going on.

Most were villagers like Mr. Jahid, who said they all thought it was normal procedure when the nurses unhooked the ventilators that had been helping keep their children alive, handed out small plastic hand-operated resuscitators and quickly showed the parents how to use them.

With his daughter gasping for air, Mr. Jahid got right to work.

“I pumped and pumped,” he said. He looked around the ward. All the parents were pumping and pumping. Unbeknown to them, the hospital’s supplies of oxygen had been steadily dwindling, after the supplier cut off shipments of liquid oxygen for lack of payment. On Friday, despite repeated warnings from the supplier and hospital technicians, the oxygen ran out.

By the time the flow was stabilized, more than 60 children had died. Many were sick with Japanese encephalitis and other tropical diseases and may have died from other causes, but doctors admitted that the oxygen interruption is likely to have claimed at least several lives.

The children’s deaths have become a national outrage, headlining front pages of all the major newspapers and marring celebrations this week of India’s 70th anniversary of independence.

The government hospital, part of the larger Baba Raghav Das Medical College in Gorakhpur, was considered the area’s best, a beacon to millions of people. It is now a symbol of India’s swamped, mismanaged and often corrupt public health care system. As this episode underscored, the system is so enormous and has so many people moving through it that mistakes are often not corrected until many lives are lost.

The medical college is a monument to that sense of scale. It is a hulking, sprawling network of buildings with nearly 1,000 beds and 10-foot-wide corridors a city block long. With such a deluge of patients, some coming from hundreds of miles away, doctors sometimes work 36-hour double shifts with just a six-hour break, and children are crammed two or three to a bed. Families are camped out everywhere, their bedrolls, blankets, water jugs and round steel food tins clogging the hallways.

The case has cast a glare on the government of Prime Minister Narendra Modi, in no small part because Gorakhpur is the home turf of one of Mr. Modi’s most contentious allies, Yogi Adityanath. A divisive politician and Hindu ascetic, Adityanath recently became chief minister of India’s most populous state, Uttar Pradesh, which, at 200 million, has more people than all but a handful of the world’s nations.

The state government’s initial response to the oxygen fiasco was to imply that it was perfectly normal for 10 children to die every day at the Gorakhpur hospital, especially at this time of year, the rainy season, when swarms of mosquitoes spread deadly Japanese encephalitis, a virus that causes brain swelling and seizures.

That explanation was widely criticized as the height of insensitivity. “Who have we become?” asked Pratap Bhanu Mehta, a leading commentator, in a recent column. “In our republic poor children are fated to die.”

The government response continues to be confused. Adityanath’s administration is adamant that the oxygen problem was not responsible for any deaths, even though no autopsies were performed. At the same time, it has suspended the head of the medical college and called for a full investigation.

Lying just south of the India-Nepal border, Gorakhpur is very lush, especially now, during the monsoon. Some parts of it are beautiful, with dripping banyan trees, brightly painted houses and new shops. There’s even a Domino’s pizza place. But in other areas, stagnant water covers the roads and garbage is stuffed into every nook and cranny — between houses, along riverbanks, heaped up in vacant lots. Entire neighborhoods seem to be sinking under piles of their own waste.

The town is surrounded by wet green rice fields that during the rainy season are infested with mosquitoes.

Brahamdev Yadav, a rice farmer, had never heard of Japanese encephalitis. But by putting his hand to the foreheads of his newborn twins, he could tell they were sick.

He checked them into the hospital on Aug. 3, around the same time that the hospital’s oxygen supplier was issuing increasingly urgent pleas for payment. In a string of letters to the medical college, the Indian news media reported, the supplier insisted it had its own bills to cover and could not keep delivering liquid oxygen for the hospital’s central oxygen system unless a $100,000 bill was settled.

In India, public officials often squeeze their vendors for “commissions.” It is widely acknowledged that even after public contracts are awarded, vendors have to grovel for payment, and that the best way to lubricate the bureaucracy is to give the officials in charge a 2 to 5 percent cut. When asked whom they blamed for the tragedy, several parents of children who died in the oxygen shortage said simply, “corruption.”

The head of the medical college, R. K. Mishra, who has resigned, was already under suspicion for misusing public money, Indian news outlets reported. In this same part of India, millions of dollars have vanished in other public health corruption scandals.

The medical college clearly needs all the funds it can get. While a new Japanese encephalitis wing is state of the art, with its plate glass windows and beeping machines, other parts of the hospital are in chaotic disrepair. Giant holes have been punched in the walls, the wide corridors reek of urine, many lights have burned out and water drips from the ceiling, pooling on the floor.

The hospital is “overburdened 10 times,” said Dr. K. P. Kushwaha, the former head of the medical college.

Doctors said that many Indian hospitals are like this, often with deadly consequences. In 2011, 16 new mothers died at one crowded hospital in Jodhpur before it was discovered that many intravenous fluid bags were contaminated with bacteria. That same year, 22 babies died at another hospital over a four-day period, though the cause remains unclear.

On Thursday night, Mr. Jahid arrived at the medical college with his 5-year-old daughter burning with fever and struggling to breathe. This was just hours after the Gorakhpur Newsline, a website featuring local news, published an article warning that the hospital’s oxygen supply was about to run out.

Mr. Jahid, a jewelry salesman, had not seen that report. Like most others with children at the hospital, he had passed through several smaller facilities before getting there.

“They told me, ‘Take her to the medical college, where there are good doctors and machines, and she’ll be O.K.,’” he recalled. He said the oxygen cut out five times on Friday.

Around this time, Mr. Yadav’s newborn twins died. Both of them had been on ventilators. They were 10 days old, and did not even have names. “I thought about killing myself,” Mr. Yadav said.

As news of the children’s deaths spread, the hospital scrambled to make a partial payment. Liquid oxygen was delivered on Saturday morning and hospital officials insist there was only a two-hour gap between 11:30 p.m. Thursday and 1:30 a.m. Friday without a central oxygen supply.

They say they brought in cylinders of compressed oxygen during the shortage and kept the oxygen flowing to crucial areas, like the intensive care unit. But several parents disputed that, saying the oxygen flow had not been restored until Friday evening, when journalists with video cameras showed up.

Several pediatricians interviewed at the hospital said it would be difficult to pinpoint a cause for each of the more than 60 child deaths last week, but that the oxygen cutoff by itself claimed at least two or three lives.

Mr. Jahid is haunted by thoughts about what he could have done differently. Sitting at home, holding a picture of his daughter, Khushi, he said he had squeezed the manual resuscitator as best he could.

“She was so affectionate,” said her grandfather, Ilahi. “She would bring me tea, she would bring me food, she would bring me water.”

He gazed into the alleyway in front of the family home, seeming to see her out there again, walking toward him, and said softly, “She was like my hand.”