MADURAI, India: Black ticks on their foreheads marking the eye to be operated on, dozens of patients in green overalls wait in line, beneficiaries of a pioneering Indian model that is restoring sight to millions.
With a highly efficient assembly line model inspired by McDonald's, the network of hospitals of the Aravind Eye Care System performs around 500,000 surgeries a year -- many for free.
More than a quarter of the world's population, some 2.2 billion people, suffer from vision impairment. Of which one billion cases could have been prevented or have been left unaddressed, according to the World Vision Report by the World Health Organization.
There are an estimated 10 million blind people in India, with a further 50 million suffering from some form of visual impairment. Cataracts -- clouding of the eye lens -- is the main cause.
"The bulk of this blindness is not necessary because a lot of it is due to cataract which can be easily set right through a simple surgery," said Thulasiraj Ravilla, one of the founding members of Aravind.
The hospital was set up by doctor Govindappa Venkataswamy who was inspired by McDonald's ex-CEO Roy Kroc and learned about the fast-food chain's economies of scale during a visit to the Hamburger University in Chicago.
"If McDonald's can do it for hamburgers, why can't we do it for eye care?" he famously said.
Aravind started as an 11-bed facility in 1976 in Madurai, a city in the southern state of Tamil Nadu but has expanded to care centres and community clinics across India.
The model has been so successful it has been the subject of numerous studies including by Harvard Business School.
But it is the outreach camps which have been the cornerstone of its no-frills high-volume work -- nearly 70 percent of India's population lives in rural areas.
"It is the access that is the main concern, so we are taking the treatment to people rather than waiting for them to come for us," Ravilla told AFP.
The free eye camps are a boon for those like Venkatachalam Rajangam who received care close to home.
Rajangam said he had to stop working because he was unable to see the money customers at his provisions store gave him, and also stumbled on the stairs or when out after dark.
The 64-year-old found out about a camp next to his village in Kadukarai, some 240 kilometres (150 miles) from Madurai, where doctors screened his eyes and detected a cataract in the left one.
Rajangam was taken in a bus with some 100 others to a shelter run by the hospital, which also provides basic meals and mats to sleep on free of charge, and underwent a procedure to remove the cataract.
"I thought the operation would be for an hour but within 15 minutes everything was over. But it didn't feel rushed. The procedure was done properly," Rajangam said after the bandage roll covering his eye was removed.
"I didn't have to spend even a penny... God has created eyes, but they are the ones who restored my eyesight," he gushed, clasping his hands in gratitude.
Aravind eye surgeon Aruna Pai said the doctors receive rigorous training to make sure they can perform surgeries quickly.
The complication rate is less than two per 10,000 at Aravind compared to Britain or the United States where it ranges from 4-8 per 10,000, according to the hospital.
"We have wet labs where we are taught to operate on goats' eyeballs. This helps us to sharpen our skills," said Pai, who performs some 100 surgeries in a day.
Aravind said it does not take charity money but instead uses the revenue generated from paying customers to help cover the cost of those who need free treatment.
It reduces costs further by manufacturing lenses for cataract treatment at its own facility called Aurolab.
Aurolab currently produces more than 2.5 million of these lenses a year at a sixth of the cost of those previously imported from the US, the hospital said.
Rajib Dasgupta, a community health expert based in New Delhi, lauded the clinics: "The Aravind model has emerged as an important one in blindness prevention."
But he warned that India still needed to look at root causes -- including diet, hygiene, and sanitation -- that could help avoid preventable blindness.
Dasgupta warned: "The communicable causes of blindness due to infectious conditions still exist and remain significant challenges."
McSurgery: An Indian hospital restoring eyesight to millions
https://arab.news/j84ee
McSurgery: An Indian hospital restoring eyesight to millions
- There are an estimated 10 million blind people in India, with a further 50 million suffering from some form of visual impairment
Macron offers first glimpse of post-fire Notre Dame
- France is to offer the world a first look inside the restored Notre Dame cathedral in Paris on Friday
Eight days ahead of the December 7 reopening of the cathedral, President Emmanuel Macron will conduct an inspection, broadcast live on television, which will provide the first official insight into how the 850-year-old edifice now looks inside.
Notre Dame will welcome back visitors and worshippers over the December 7-8 weekend after a sometimes challenging restoration to return to its former glory the great Paris cathedral badly damaged by the April 19, 2019 fire.
Macron at the time set the ambitious goal to rebuild Notre Dame within five years and make it “even more beautiful” than before, a target that the French authorities say has been met.
Some 250 companies and hundreds of experts were mobilized for a restoration costing hundreds of millions of euros in what was dubbed the “building site of the century.”
All 2,000 people who contributed to the work have been invited to Friday’s event, of whom at least 1,300 are expected to attend.
“This final site visit is an opportunity to thank them in particular — from wood craftsmen to those of metal and stone, from scaffolders to roofers, from bell makers to art restorers, from gilders to masons and sculptors, from carpenters to organ builders, from architects, archaeologists, engineers and planners to logistical or administrative functions,” stated Macron ahead of the visit.
Accompanied by his wife Brigitte, Macron is expected from 0930 GMT to inspect the key areas of the cathedral including the nave, choir and chapel and discuss the restoration in person with the workers.
The restoration cost a total of nearly 700 million euros (more than $750 million at today’s rate).
It was financed from the 846 million euros in donations that poured in from 150 countries in an unprecedented surge of solidarity.
The 19th-century gothic spire has now been resurrected with an exact copy of the original, the stained windows have regained their color, the walls shining after fire stains cleaned and a restored organ ready to thunder out again.
Unseen to visitors is a new mechanism to protect against any future fires, a discreet system of pipes ready to release millions of water droplets in case of a new disaster.
Notre Dame, which welcomed 12 million visitors in 2017, expects to receive an even higher figure of “14 to 15 million” after the reopening, according to the church authorities.
French ministers have also floated the idea of charging tourists an entrance fee to the site but the Paris diocese has said free admission was an important principle to maintain.
Archbishop of Paris Laurent Ulrich told AFP last month that Macron will on Saturday, December 7 give an address inside Notre Dame to mark the reopening.
It is extremely unusual for a political leader to be allowed to address the faithful inside a Catholic religious building. France is by its constitution a secular country with a strict division between church and state.
World leaders are expected to join but the guest list has yet to be unveiled.
The next day, Sunday December 8, will see the first mass and consecration of the new altar, he added.
Macron in December said he had invited Pope Francis to the reopening of the cathedral but the head of the Catholic church announced in September, to the surprise of some observers, that he would not be coming.
Instead, the pontiff is on the subsequent weekend making a landmark visit to the French island of Corsica.
The French Catholic church has in recent years been rocked by a succession of sexual abuse allegations against clerics, including most recently the monk known as Abbe Pierre who became a household name for his aid to the destitute.
Over five years on, the investigation into what caused the fire is ongoing, with initial findings backing an accidental cause such as a short circuit, a welder’s torch or a cigarette.
UN talks struggle for breakthrough on plastics treaty as deadline looms
- South Korea is hosting delegates from about 175 countries at the fifth and final meeting of the UN Intergovernmental Negotiating Committee
- Nations which produce petrochemicals, such as Saudi Arabia, oppose efforts to cap plastic production
BUSAN, South Korea: The chairman of talks aiming for an international treaty to rein in pollution from plastics issued a document on Friday outlining measures that could furnish the basis of a pact, in an attempt to spur discussions as a Dec. 1 deadline approaches.
South Korea is hosting delegates from about 175 countries at the fifth and final meeting of the UN Intergovernmental Negotiating Committee (INC-5) to agree globally binding rules on plastics, but this week's talks had moved at glacial pace.
The document, issued by committee chair Luis Vayas Valdivieso and viewed by Reuters, featured ideas such as a global list of plastic products to be managed and a financial mechanism to help fund developing countries act on the treaty.
"The high and rapidly increasing levels of plastic pollution ... represent a serious environmental and human health problem," the document said.
It mentioned, but did not confirm, some of the most divisive tasks, such as whether the treaty will set a global target to cut output of primary plastic polymers or skip it altogether, and left undecided how rich nations would contribute to a fund.
"A global target to reduce plastic production is in (the document)," said Graham Forbes, who led the Greenpeace delegation to the talks.
"Keeping this in the final treaty text must be a redline for any country serious about ending plastic pollution."
The International Council of Chemical Associations (ICCA) representing makers of plastic, backs governments' efforts to finalise the deal, said its spokesperson, Stewart Harris, adding that the body wanted to hasten a circular economy for plastics.
Nations which produce petrochemicals, such as Saudi Arabia, oppose efforts to cap plastic production, despite the protests of low- and middle-income nations that bear the brunt of plastic pollution.
While supporting an international treaty, the petrochemical industry has also been vocal in urging governments to avoid setting mandatory plastic production caps in favour of efforts to reduce plastic waste, such as recycling.
The chairman's move came after several participants had expressed frustration at the slow pace of the talks, amid disagreements over procedure, multiple proposals and some efforts to return to ground covered in the past.
International court to begin hearings that may shape global climate litigation
- Court to give opinion on legal obligations around climate
- ICJ opinion is non-binding but likely to influence litigation
While the advisory opinions of the International Court of Justice’s (ICJ) are non-binding, they are legally and politically significant. Experts say the ICJ’s eventual opinion on climate change will likely be cited in climate change-driven lawsuits in courts from Europe to Latin America and beyond.
The hearings begin a week after developing nations denounced as woefully inadequate an agreement reached at the COP29 summit for countries to provide $300 billion in annual climate finance by 2035 to help poorer nations cope with climate change.
Ralph Regenvanu, Vanuatu’s special envoy for climate change and the environment, said it was imperative fossil fuels be phased out and more money provided to poorer nations bearing the brunt of climate change, such as his Pacific island nation.
“We’re not seeing that in the outcome of the COPs,” Regenvanu told Reuters.
“We are hoping (the ICJ) can provide a new avenue to break through the inertia we experience when trying to talk about climate justice,” he added.
Fiji’s Attorney General Graham Leung called the hearings a historic opportunity for small island developing states in their quest for climate change justice.
CLIMATE LITIGATION
Climate litigation is on the rise.
Earlier this year, Europe’s top human rights court ruled that the Swiss government had violated the rights of its citizens by failing to do enough to combat climate change. But it also rejected two other cases, pointing to the complexities of the growing wave of climate litigation.
Vanuatu, one of the small developing nations that pushed for an ICJ advisory opinion, says it disproportionately suffers the effects of climate change as a result of increasingly intense storms and rising sea levels.
Vanuatu will be the first of 98 countries and twelve international organizations to present arguments to the ICJ, also known as the World Court. It is the United Nations’ highest court for resolving international disputes between states and can be tasked by the UN General Assembly to give advisory opinions.
In 2023, the assembly asked it for a formal opinion on questions including the legal obligations of states to protect the climate system and whether large states that contribute to greenhouse gas emissions may be liable for damages, in particular to small island nations.
“As COP29 failed to provide a clear direction for climate justice and ambition, any developments from the ICJ will now only become more weighty,” said Lea Main-Klingst, a lawyer with ClientEarth.
Aside from small island states and numerous Western and developing countries, the court will also hear from the world’s top two emitters of greenhouse gases, the United States and China. Oil producer group OPEC will also give its views.
The hearings will start at 10 a.m. (0900 GMT) local time on Monday and run until Dec. 13. The court’s opinion will be delivered in 2025.
Top UN court to open unprecedented climate hearings next week
- Representatives from more than 100 countries, organizations will make submissions before the International Court of Justice
- Activists hope the legal opinion from the ICJ judges will have far-reaching consequences in the fight against climate change
THE HAGUE: The world’s top court will next week start unprecedented hearings aimed at finding a “legal blueprint” for how countries should protect the environment from damaging greenhouse gases — and what the consequences are if they do not.
From Monday, lawyers and representatives from more than 100 countries and organizations will make submissions before the International Court of Justice in The Hague — the highest number ever.
Activists hope the legal opinion from the ICJ judges will have far-reaching consequences in the fight against climate change.
But others fear the UN-backed request for a non-binding advisory opinion will have limited impact — and it could take the UN’s top court months, or even years, to deliver.
The hearings at the Peace Palace come days after a bitterly negotiated climate deal at the COP29 summit in Azerbaijan, which said developed countries must provide at least $300 billion a year by 2035 for climate finance.
Poorer countries have slammed the pledge from wealthy polluters as insultingly low and the final deal failed to mention a global pledge to move away from planet-heating fossil fuels.
The UN General Assembly last year adopted a resolution in which it referred two key questions to the ICJ judges.
First, what obligations did states have under international law to protect the Earth’s climate system from greenhouse gas emissions?
Second, what are the legal consequences under these obligations, where states, “by their acts and omissions, have caused significant harm to the climate system and other parts of the environment?“
The second question was also linked to the legal responsibilities of states for harm caused to small, more vulnerable countries and their populations.
This applied especially to countries under threat from rising sea levels and harsher weather patterns in places like the Pacific Ocean.
“Climate change for us is not a distant threat,” said Vishal Prasad, director of the Pacific Islands Students Fighting Climate Change (PISFCC) group.
“It is reshaping our lives right now. Our islands are at risk. Our communities face disruptive change at a rate and scale that generations before us have not known,” Prasad told journalists a few days before the start of the hearings.
Launching a campaign in 2019 to bring the climate issue to the ICJ, Prasad’s group of 27 students spearheaded consensus among Pacific island nations including his own native Fiji, before it was taken to the UN.
Last year, the General Assembly unanimously adopted the resolution to ask the ICJ for an advisory opinion.
Joie Chowdhury, a senior lawyer at the US and Swiss-based Center for International Environmental Law, said climate advocates did not expect the ICJ’s opinion “to provide very specific answers.”
Instead, she predicted the court would provide “a legal blueprint in a way, on which more specific questions can be decided,” she said.
The judges’ opinion, which she expected sometime next year, “will inform climate litigation on domestic, national and international levels.”
“One of the questions that is really important, as all of the legal questions hinge on it, is what is the conduct that is unlawful,” said Chowdhury.
“That is very central to these proceedings,” she said.
Some of the world’s largest carbon polluters — including the world’s top three greenhouse gas emitters, China, the United States and India — will be among some 98 countries and 12 organizations and groups expected to make submissions.
On Monday, proceedings will open with a statement from Vanuatu and the Melanesian Spearhead Group which also represents the vulnerable island states of Fiji, Papua New Guinea and the Solomon Islands as well as Indonesia and East Timor.
At the end of the two-week hearings, organizations including the EU and the Organization of the Petroleum Exporting Countries are to give their statements.
“With this advisory opinion, we are not only here to talk about what we fear losing,” the PISFCC’s Prasad said.
“We’re here to talk about what we can protect and what we can build if we stand together,” he said.
Indonesian rescuers search for missing in buried cars and bus after landslide in Sumatra
- The death toll from one landslide on Wednesday on a hilly interprovince road rose to nine from seven
- Flash floods hit the provincial city of Medan on Friday although waters have receded in some areas
JAKARTA: Indonesian rescuers on Friday searched for survivors buried in three cars and bus at the base of a cliff after flash floods and landslides in North Sumatra province killed at least 29 people.
Torrential rain for the past week in the province has triggered flash floods and landslides in four different districts, Indonesia’s disaster agency has said.
The death toll from one landslide on Wednesday on a hilly interprovince road rose to nine from seven, Hadi Wahyudi, the spokesperson of North Sumatra police told Reuters on Friday.
At least five cars, one bus, and one truck were trapped at the base of a cliff following the landslide. On Friday, police and rescuers focused their search for missing people on three cars and one bus buried in mud.
“We still don’t know how many people who were still trapped,” Hadi said.
In other districts, landslides over the weekend killed 20 people and rescuers will keep searching for two missing people until Saturday.
Flash floods hit the provincial city of Medan on Friday although waters have receded in some areas, said Sariman Sitorus, spokesperson for the local search agency.
The floods forced a delay in votes for regional elections in some areas in Medan on Wednesday.
Extreme weather is expected in Indonesia toward the end of 2024, as the La Nina phenomenon increases rainfalls across the tropical archipelago, the country’s weather agency has warned.
