Yemen
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Summary» Data-Table» Relevant-Organizations» Case-Studies» Sources»Yemen is a Middle Eastern nation located between Oman and Saudi Arabia along the Gulf of Aden, the Arabian Sea, and the Red Sea.[5] As of 2010, the country is home to 22,858,238 [5] residents and over 1% of the population is blind.[6] The most common types of curable blindness include cataracts[1] [4], glaucoma [1] [4], trauma [1] [4], trachoma [11], and onchocerciasis.[9]
There has not been a national blindness study conducted in Yemen, therefore most of the data on blindness comes from hospital based studies.[1] Two such studies published in 2008 [1] and 2010 [4] suggest that blindness is prevalent from childhood through adulthood. A study published in 2008 about patients from the Ibn Al-Haitham Eye Centre in Sana’a found that of the 3845 adults studied, 7.7% were uniocularly blind and 11.2% were binocularly blind.[1] The 2010 study was a retrospective review of patient records at an ophthalmic clinic in Sana’a. Of the 1104 patients under the age of 16 studied, 10.4% were found to be unilaterally blind and 4.1% bilaterally blind.[4]
Cataracts and glaucoma, often issues in adults, were found to be major causes of blindness in Yemeni children. It was hypothesized that high rates of consanguineous marriages may increase the prevalence of these types of disorders.[4]
Misconceptions about treatment and eye care in Yemen are cited as barriers to eliminating blindness. For example, the practice of ‘couching’ a cataract by dislodging it with a sharp object is still widespread in rural areas of the nation.[8] Also, because there is no screening program for glaucoma, patients often seek medical care when the disease has already progressed significantly.[1] Age related macular degeneration is the most common cause of blindness in western nations, but ranks lower on the list in Yemen. This difference is possibly due to lower life expectancy in Yemen as well as a higher level of illiteracy in older generations that do not notice their vision has changed.[1]
‘Couching’ as a treatment for cataracts is still widespread in Yemen, mainly in poor and rural areas where access to medical care is very limited. The practice involves dislodging the cataract into the vitreous cavity of the eye. This is done with a pointed object and can be ineffective and dangerous. Complications from the procedure can include uveitis (inflammation of the middle layer of the eye), glaucoma, and endophthalmitis (inflammation of the intraocular cavity). Satisfaction levels post-surgery are usually low.[8]
A study from 2008 reported that since 2002, 65 eye camps have taken place in Yemen’s rural provinces. The aim of the camps is to provide large scale relief to areas of the country with shortages of ophthalmic facilities and medical professionals. These camps help reduce the backlog of people waiting for cataract treatment. The authors of the study note that the camps will continue until there are a sufficient number of eye hospitals in Yemen. The patients receiving services are often poor and they receive free surgery, medicine and glasses.[3]
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Number of Blind |
Based on population estimates [5], greater than 228,000 (1%) of residents of Yemen are blind. [6] |
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Number of Curable Blind |
Information unavailable |
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Prevalence of Curable Blind |
The WHO estimates that greater than 1% of the population of Yemen is blind and less than 1% has low vision.[6] There has not been a national blindness study in Yemen. Most of the data on blindness comes from smaller studies focusing on sections of the country.[1] 2008 study of 3845 adults over 17 years: 7.7% uniocularly blind 11.2% binocularly blind [1] 2010 study of 1104 children under 16 years: 10.4% unilaterally blind 4.1% bilaterally blind [4] |
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Most Common Types of Curable Blindness |
Uniocular/Unilateral Blindness: Cataract (adults – 21.3%), (children – 34.8%) Trauma (adults – 20.3%), (children – 19.1%) Corneal opacity (adults – 11.5%), (children – 10.5%) Amblyopia (adults – 10.8%), (children – 10.4%) Glaucoma (adults – 6.8%) [1] [4] Binocular/Bilateral Blindness: Cataract (adults – 46.3%), (children – 20%) Glaucoma (adults – 10.4%), (children – 17.8%) Diabetic retinopathy (adults – 8.6%) Age related macular degeneration (adults – 8.1%) Corneal opacity (adults – 6.3%), (children – 13.3%) Retinal disorders (children – 13.3%) [1] [4] The Carter Center assisted Yemen in the control of Trachoma from 1998-2003.[11] Onchocerciasis is endemic in Yemen.[9] |
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Age Range of Affected Population |
Childhood through adulthood [1] [4] |
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Gender Breakdown of Affected Population |
A hospital based study of blindness in Sana’a included more boys than girls. Of the 1104 children studied, 588 were male and 516 were female. 167 males reported blindness or low vision compared to 150 females.[4] The authors hypothesized: Boys may be at higher risk of blinding conditions. Blind girls may have a higher mortality rate than blind boys. Parents of blind boys may be more willing to seek care than parents of blind girls.[4] |
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Racial/Ethnic Breakdown of Affected Population |
Information unavailable |
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Income Range of Affected Population |
Information unavailable |
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City/Rural Breakdown of Affected Population |
Information unavailable |
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Single/Married Breakdown of Population |
Information unavailable |
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Cases of family history/genetic factors |
Congenital cataracts and glaucoma are major causes of childhood blindness in Yemen. Another main cause of bilateral blindness noted in the study was hereditary retinal dystrophies. The authors suggest this may be due to the high rate of consanguineous marriages in Yemen.[4] |
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Causes of Blindness |
Cataracts, glaucoma, retinal disorders, corneal opacities, trauma, diabetic retinopathy, trachoma, onchocerciasis.[1] [4] [9] [13] The Carter Center reports that based on surveys conducted between 1996 and 1999, trachoma is the 3rd leading cause of blindness in Yemen and approximately 12% of all children under age 5 are infected.[11] |
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Awareness of curable blindness/different types of treatment |
The Carter Center worked in Yemen from 1998 to 2003 to provide health education aimed at preventing trachoma. This included better hygiene, improvements in sanitation, antibiotic distribution, and surgery. The Carter Center cites lack of funding, lack of making blindness a health priority, and low health coverage as complications in controlling the disease.[11] Ways to Control River Blindness/Onchocerciasis: Insecticide (expensive and short term) Slowing fast moving rivers (expensive and impractical) Wearing protective garments (impractical because of high temperatures) Surgery to kill adult worms (must have access to surgical site) Pharmaceuticals (must be given regularly and widely) [10] |
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Percent of individuals with access to clean water |
Urban: Use of improved drinking water sources [7] 75% in 2005 72% in 2008 Use of improved sanitation facilities [7] 89% in 2005 94% in 2008 Rural: Use of improved drinking water sources [7] 58% in 2005 57% in 2008 Use of improved sanitation facilities [7] 29% in 2005 33% in 2008 |
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Level of government intervention |
According to Vision2020, Yemen signed the Global Initiative for the Elimination of Avoidable Blindness and had a national committee and plan in place by the December 2006 deadline.[2] |
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Amount of economic burden/economic productivity |
Information unavailable |
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Level of access to eye doctors per 1000 individuals |
65 eye camps took place between 2002 and 2008, providing free surgery, medicine, and glasses to poor Yemenis in rural provinces. The camps provide large scale relief to areas lacking medical facilities and personnel.[3] |
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Success of eye surgeries |
Cataract Surgical Rate – 650 [2] *(CSR is the number of cataract operations performed per million population per year based on information from the World Health Organization and the International Agency for the Prevention of Blindness) The results of surgery in children to relieve congenital cataracts are often poor because surgical techniques on children require experience and expensive equipment or treatment and postoperative care. The authors of one study suggest that these outcomes would be improved if all such surgeries were conducted in tertiary eye facilities.[4] ‘Couching’ as a treatment for cataracts is still wide spread in Yemen and leads to satisfaction levels as low as 18%.[8] |
1. Al-Akily, Saleh A., and Mahfouth A. Bamashmus. "Causes of Blindness among Adult Yemenis: A Hospital-based Study." Middle East African Journal of Ophthalmology 15.1 (2008): 3-6. Web. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848797/>.
2. Bamashmus, M. A., and A. O. Al-Barrag. "Eye Camps in Yemen." Medical Science Monitor 14.11 (2008): 41-45. Web. <http://www.ncbi.nlm.nih.gov/pubmed/18971880>.
3. Bamashmus, M. A., and S. A. Al-Akily. "Profile of Childhood Blindness and Low Vision in Yemen: a Hospital-based Study." Eastern Mediterranean Health Journal 16.4 (2010). Web. <http://www.emro.who.int/publications/emhj/1604/article14.htm>.
4. McGrath, Dermot. "‘Couching’ for Cataracts Remains a Persistent Problem in Yemen." EuroTimes (2005). Web. <http://www.escrs.org/Publications/Eurotimes/05September/pdf/couching.pdf>.
1. Al-Akily, Saleh A., and Mahfouth A. Bamashmus. "Causes of Blindness among Adult Yemenis: A Hospital-based Study." Middle East African Journal of Ophthalmology 15.1 (2008): 3-6. Web. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2848797/>.
2. "ANNEX V. Implementation of Vision 2020 Objectives by WHO Region at December 2006." World Health Organization. Web. 22 Sept. 2010. <http://www.who.int/blindness/Pages%20from%20Vision2020%20-report.pdf>.
3. Bamashmus, M. A., and A. O. Al-Barrag. "Eye Camps in Yemen." Medical Science Monitor 14.11 (2008): 41-45. Web. <http://www.ncbi.nlm.nih.gov/pubmed/18971880>.
4. Bamashmus, M. A., and S. A. Al-Akily. "Profile of Childhood Blindness and Low Vision in Yemen: a Hospital-based Study." Eastern Mediterranean Health Journal 16.4 (2010). Web. <http://www.emro.who.int/publications/emhj/1604/article14.htm>.
5. "CIA – The World Factbook — Yemen." Welcome to the CIA Web Site. 19 Aug. 2010. Web. 22 Sept. 2010. <https://www.cia.gov/library/publications/the-world-factbook/geos/ym.html>.
6. "Global Blindness Map." Map. WHO | Data and Maps. World Health Organization. Web. 22 Sept. 2010. <http://www.who.int/blindness/data_maps/en/>.
7. "Joint Monitoring Programme for Water Supply and Sanitation, Improved Drinking-Water Sources – Yemen" (2010). WHO/UNICEF, Mar. 2010. Web. <http://wssinfo.org/datamining/introduction.html>.
8. McGrath, Dermot. "‘Couching’ for Cataracts Remains a Persistent Problem in Yemen." EuroTimes (2005). Web. <http://www.escrs.org/Publications/Eurotimes/05September/pdf/couching.pdf>.
9. "Onchocerciasis." VISION 2020: The Right to Sight. World Health Organization, 15 July 2010. Web. 22 Sept. 2010. <http://www.vision2020.org/main.cfm?type=WIBONCHOC>.
10. River blindness – Sightsavers." Sightsavers International – International Charity. Web. 22 Sept. 2010. <http://www.sightsavers.org/learn_more/causes_of_blindness/river_blindness/default.html>.
11. "Yemen." The Carter Center: Advancing Human Rights and Alleviating Suffering. Web. 22 Sept. 2010. <http://www.cartercenter.org/countries/yemen.html>.
