Poverty, Visual Loss and Destitution in Onitsha, Nigeria

Abstract

Background: Visual loss is a major public health problem. About 90% of people who are blind live in low income countries, where increasing poverty perpetuates destitution. Poverty can be a cause and consequence of visual loss, and poor individuals have less access to eye care services. Objectives: To determine the relationship between poverty and visual loss among destitute. Materials and Methods: This was a cross-sectional study conducted among destitute in Onitsha, Nigeria between June and July 2011. Destitute clusters were randomly selected and interviewed. Information sought included socio-demographic variables, duration of destitution and estimation of monthly income in relation to needs. Ocular examination included estimation of presenting visual acuity, refraction, anterior and posterior segment evaluation. A focus-group discussion was also conducted. Data obtained was analyzed using SPSS, version 16. Results: One hundred and sixty-eight destitute comprising 93 males (55.4%) and 75 females (44.6%) were studied and the age range was 11-78 years with a mean age of 38.2±21.0 years. One hundred and twenty-nine (76.8%) did not have formal education, none was employed and 158 (94.0%) participants earned less than one United States dollar per day. All the blind destitute and those with severe visual impairment had very low daily income. Cataract (37.5%), glaucoma (17.2%) corneal disease (15.7%) and conjunctival disease (11.0%) were the common causes of visual loss. Conclusion: Poverty and visual loss are common among destitute in Nigeria. While each reinforces the other in a vicious cycle, there may be other reasons why people beg on the street.