Aid agencies promoting the donation of used spectacles to help the visually impaired in developing nations are being short-sighted in their approach, an Australian study shows.
Study author Dr David Wilson, of the International Centre for Eyecare Education in Sydney, says recycled spectacle programs are almost twice as expensive as providing new ready-made glasses, and such schemes should be ditched.
His view is based on research that shows only 7 per cent of donated spectacles are useable and the cost of delivery to recipients is twice the cost of providing new ready-made glasses.
The study, published in the journal Optometry and Vision Science, compares the cost of providing donated spectacles with new ready-made glasses to one of the estimated 829 million people in developing countries with vision problems.
Wilson says recycled spectacle programs involve many hidden costs: the glasses must first be brought to a central repository; manually checked - with those passing the initial screening then measured on a focimeter (lensometer); cleaned; sorted; labeled; shipped; and stored before they can be used in a refractive error program.
For the study two batches of donated glasses were examined by the researchers - one was a box delivered to the Solomon Islands and another was sent by the donor organisation to the ICEE.
Wilson says many donated glasses were cracked or broken and obviously unuseable while others were in very poor condition.
Of 106 spectacles in the Solomons batch only seven pairs were useable, while the ICEE box contained 169 spectacles with just 11 passing inspection.
However, he says all of the "useable" spectacles had minor damage with the cost of delivery of a pair of recycled spectacles found to average US$20.49.
By contrast the cost of delivering a pair of ready-made spectacles where only a brief quality check is carried out is US$11.28. If a full focimeter check were carried out it would add a further US$1.95 to the cost of each pair.
Appearance and self-esteem
Wilson says recycled spectacle programs focus solely on correcting refractive error correction and do not sufficiently consider the appearance of the spectacles and the self-esteem of the wearer.
"This may result in lower levels of use than expected, as people may refuse to wear spectacles which they believe make them look different or unappealing," he says.
However ready-made spectacles - similar to ones that can be bought in newsagents and service stations in Australia - were often hard to distinguish from custom-made glasses.
"Ready-made glasses are quite fashionable and you are not sending people out looking like Dame Edna and Groucho Marx," he says.
Wilson says among other problems the study highlighted was the fact donated spectacles were sent to a facility in the developing country without any professional support.
"One of the batches we examined was transported to the Solomon Islands and then was meant to be sorted over there - but [the people] over there didn't know what to do with them so they were just put in a cupboard," Wilson says.
He says importantly donation of spectacles does not develop a sustainable industry in countries and communities being serviced.
The ICEE had run a number of training programs in Sri Lanka, Papua New Guinea and the Solomons to train staff locally to establish locally run vision centres where ready-made glasses were dispensed.
"We would rather encourage the donation of money to help set up sustainable ongoing centres rather than encourage the fly-in cargo cult style of aid," he says.