Global Need for Ophthalmology and Otolaryngology

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Overshadowed by the toll taken by HIV/AIDS, malaria, and other communicable diseases, rates of death and disability stemming from ophthalmic and ENT conditions continue to rise. Most cases of preventable blindness and treatable deafness occur in the developing world and most go untreated, needlessly incapacitating millions of children and adults. The developing world accounts for 80% of the 360 million people worldwide with disabling hearing loss and 90% of the 345 million people who are visually impaired or blind. Additionally, by 2030, the developing world will account for 70% of all newly diagnosed cancers, including tobacco-related cancers, Burkitt’s lymphoma, and Kaposi’s sarcoma, with most occurring in the head and neck region. Tragically, the fatality rate for those diagnosed in low-income countries is 75%, 30% greater than for those in high-income countries. ENT surgeons and ophthalmologists in the developing world often face a widened disease spectrum, where environmental conditions including pollution; unsafe drinking water; bacterial, fungal, and viral infections, and higher numbers of individuals living with HIV and TB result in numerous uncommon ENT and ophthalmic manifestations.

There is a disparity and inequity in the availability of care to the most vulnerable members of our global community compounded by pervasive poverty. In Sub-Saharan Africa, as in most developing countries, only half of the countries have ENT training programs; with only 496 otolaryngologists serving a population of 950 million (0.5/million), the majority of patients do not have access to even the most basic ENT surgical interventions. There is a similar shortfall of training for ophthalmologists, with fewer than 1,000 ophthalmologists (1/million) in the region. Comparatively, in the United States, there are approximately 63 ophthalmologists and 31 otolaryngologists for every million people. The healthcare worker shortage impacts all aspects of specialty care - from trained anesthesiologists and ICU nurses to audiologists and speech therapists. The gap between supply and demand will continue to widen as average lifespans lengthen, increasing the disease burden that cannot be addressed by the number of residents and staff currently in training. Lack of compensation, resources, and opportunities for professional development lead many of those who are able to find training to locate outside of the area of biggest disease burden, further exacerbating the shortage.

These staggering statistics, coupled with the lack of resources available, demonstrate the very real need for increased access to subspecialty care in the developing world.

Page updated: May 31, 2013