Sightsavers' Approach to Making Health Services Inclusive For

Sightsavers’ approach to making health services inclusive for everyone: text alternative May 2019 The film starts with a shot of the outside of a hospital, which then cuts to the inside of the building where three men are entering a waiting area. One of them uses a wheelchair and another man uses a crutch to walk. The Sightsavers logo is laid over the images. The footage cuts to a close-up of someone reading a braille wall sign. Voiceover: Our shared global vision, as laid out by the Sustainable Development Goals, is of a world where everyone has access to good quality healthcare. The footage shows a man trying on glasses. It cuts to a man standing in front of a building in India. Caption: Dr Sandeep Buttan, Sightsavers India. Dr Buttan: “To make that a reality, we need to identify and remove the barriers that prevent people accessing healthcare they need, particularly groups marginalised on grounds of gender or disability. That’s why, for the past three years, Sightsavers has been developing a systematic approach to make our eye health programmes more inclusive and accessible. We’ve been working closely with disabled people’s organisations to conduct accessibility audits and make adjustments to facilities.” A series of clips is shown: Dr Buttan walks and talks with a patient using a crutch. The exterior of Sewa Sadan Eye hospital is shown and Dr Buttan and the patient walk inside. A man using a wheelchair goes up a ramp to enter the building. A patient enters a consulting room where a vision and mission statement is shown on a sign on the wall. A patient has their eyes tested. An older woman with an eye patch is guided out of the doorway. Dr Buttan walks in the eye hospital with the man using the wheelchair and the patient using a crutch. All three enter in a consulting room, and then talk in a waiting area. Dr Buttan continues: “Our project here in Bhopal was a pilot. We are reviewing our progress, learning what works and what doesn’t, and applying our learnings across regions and continents.” More clips show: A group of people in a meeting; a female health professional writing a notepad; a woman sits at a computer with a Sightsavers poster on the wall behind; two female health professionals sit at a table talking; the exterior of a building. 1 Inclusive Health Video – Alternative Text | May 2019 Dr Buttan, wearing a Sightsavers t-shirt, sits at a desk and is on a Skype call. He says, “Hello Cristina. How are you?” The footage cuts to Cristina at her desk. Cristina says, “Hi Sandeep, I’m good thank you.” Dr Buttan, at his desk, says, “So how are things in Mozambique?” Footage plays of a van being followed along the streets of a town in Mozambique. It then cuts to Cristina who stands outside a building. She talks directly to camera. Caption: Cristina Abudo Pires from Sightsavers Mozambique. Cristina says, “Here in Mozambique, we are combining the lessons from Bhopal, with the insight of the local disability organisations, to design and implement our programme.” While she is speaking a series of clips play: Cristina talking to a man in a yellow shirt outside of the hospital. Cristina and another man talk and look at a laptop. An older woman is assisted up a kerb outside of the hospital. An older woman has her eyes checked by a health worker in a hospital room. Voiceover: The issue surrounding people with disabilities not accessing healthcare starts with lack of appropriate accessibility at health posts and even hospitals. Another series of clips: An older woman has her eyes checked; an eye operation takes place; a group of people including Cristina, discuss using a step at the entrance to a building. The man from the previous shot sits outside a hospital in Nampula and speaks directly to camera. Caption: Camilo Morreira from the Association of Youth Disabilities. He says, “On the other hand, it also has to do with attitudes, even from the health care staff.” A man stands outside a hospital and speaks directly to camera. Caption: Mucussirima F. Assane, Opthalmic Nurse. He says: “Yes, there are a lot of people who lack sensitivity. Patients struggle.” Footage shows the legs of a person in a waiting area and another person in a wheelchair. People stand in a hospital waiting area. A woman speaks to camera. Caption: Aurora Atunes, Optician. She says: “In other departments, such as the maternity ward, it’s very striking. Women with disabilities attend appointments and will 2 Inclusive Health Video – Alternative Text | May 2019 be told a lot of things like: ‘Why would you get pregnant in your situation?’ Their right to be a mother is denied because of their disabilities.” Footage shows a woman waiting outside a hospital in Mozambique. Voiceover: To combat this, we are training healthcare staff to understand the barriers to healthcare for people with disabilities and establish a more positive and supportive attitude to ensure health facilities like this are more welcoming spaces. More clips are shown: Mucussirima in a meeting. Cristina talks to Aurora. Aurora assists an older woman to walk. Mucussirima helps the woman into an eye exam. A busy waiting room is shown full of people and a line of women hold hands and walk through. Mucussirima talking to a patient. Doctors guide a patient down a corridor. Aurora and another woman help an older patient up a step at the hospital entrance. Camilo, Cristina, Aurora, the woman in the wheelchair and two others stand outside a health facility and discuss the accessibility of the area. Camilo says: “This could have a safety rail.” Cristina says: “Here it needs to have a handrail”. The group walks around the building. Camilo sits in the same spot outside the hospital. He says: “I think it is very important to involve people with disabilities in projects like this because ‘nothing about us, without us,’ that is our motto”. Footage shows hazards such as a broken pavement and upturned carpets. Uplifting music plays. A couple of clips: Cristina and a man talk while looking at a laptop. A close- up is shown of the laptop screen. A man sits in an office talking to the camera. Caption: Rosario Paulino, Civil Engineer. He speaks in Portuguese. The subtitles say: “The involvement of these associations really motivated me and was really beneficial to the project.” The footage cuts to the woman using a wheelchair. She talks to the group with Aurora and Camilo outside the hospital. Voiceover: Accessibility and training are important aspects of our programme. But here in Nampula we are doing much more. We are working in rural communities to reduce stigma and discrimination and to support people with disabilities and other marginalised groups to access healthcare services. We are organising targeted activities in many districts, to get to the people who are the most difficult to reach. 3 Inclusive Health Video – Alternative Text | May 2019 Clips play under the voiceover: A Sightsavers vehicle drives through a rural community in Mozambique. A large group of local people wait at a community clinic. Aurora conducts an eye exam on a woman. An exterior shot of a rural clinic is shown and people walk outside. The community members sit facing the camera. Aurora conducts an eye exam on an older woman. A health worker assists the woman to walk to the Sightsavers vehicle and climb in. A sped-up clip taken from the front of the vehicle shows it as it travels through the streets of a town in Mozambique. Voiceover: Aurora speaks Portuguese. The subtitles read: “Because of stigma, people think disabled people don’t have the same rights as someone without a disability. The preconceptions don’t always start with us in healthcare. Sometimes they start in the community with their own family.” This is set over footage of Aurora in a school classroom. She uses trial frames with a student and tests his eyesight with a ‘tumbling E’ chart. The voiceover continues. Subtitles read: ‘But we need evidence of what works. This is why we are disaggregating data by age, gender and disability, using the Washington Group Short Set of questions. We are working with our health partners to collect and analyse this data. And we are sharing the insights from the data with health facilities, and also local and national government staff to inform their planning”. More clips: A student with a physical disability walks. Aurora points to the ‘tumbling E’ chart. A female student wears trial glasses and reads the chart. Aurora talks to children and then writes a report in the classroom. Two health care professionals talk over some documents in a hospital. Another health care worker in a hospital corridor looks through a stack of documents. A health care worker at a desk adds data into a record book. A shot of a street in Mozambique is shown, followed by a clip of the national flag, the street again, and the sign for ‘Hospital Central Nampula’. A close-up shot shows hands working with a piece of equipment provided by Sightsavers. A healthcare professional examines an older woman’s eyes. A woman sits behind a desk. Caption: Dr Bainabo Sahal, Clinical Health Director. She says: “The approach that Sightsavers is taking with the ophthalmology department is in my opinion one of the best. It would be great to expand this approach to other health departments such as the maternal and child health department.” This plays over clips of the exterior of the Nampula hospital and the hospital sign listing departments.

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