Around 39 million people in the world are affected by blindness — 80% of which could be avoided if people had timely access to diagnosis and proper treatment. The problem is that in many developing countries, most eye care providers are in cities, while the majority of patients live in hard-to-reach rural areas. To bridge this gap, London-based opthalmologist Andrew Bastawrous created Peek — an app and adapter that turn a smartphone into a comprehensive, easy-to-use, accurate eye-exam tool. Peek makes eye tests affordable and easy to administer, bypassing the need for expensive, fragile equipment. (Watch his TED Talk, “Get your next eye exam on a smartphone.”)
Bastawrous developed and extensively road-tested Peek during a research expedition in Kenya, and has now launched an Indiegogo campaign to set up manufacturing process for the Peek Retina adapter, which allows health workers to peer into the eye and capture images for diagnosis. If successful, Peek will soon be rolled out worldwide with the help of eye NGOs. Here, he tells the TED Blog how his own childhood experiences with poverty, inequality and impaired vision led him to devote his life to restoring sight to the world.
How long has Peek been in development?
I’ve been working on it for around three years, and the team came together about two years ago. We’re now at the point where we’ve got a proven, tested prototype, and we want to make it available. We’ve had so much demand — over 4,000 eye organizations in 180 countries are asking to use it, and we want to make it available and keep the cost low. We evaluated options, and recently won the TED Mazda Rebels award. We’ve used the majority of that to fund set-up of the manufacturing pipeline to develop the adapter, and that takes us to about the halfway point.
You grew up in England. What made you want to practice in developing countries?
I was born in York, but my parents are both from Egypt, and I grew up between cultures. We spent most of our holidays in Egypt, and I always felt a little like I didn’t know where home was. When I visited Egypt, I witnessed things I didn’t see in the UK. My father’s a doctor, and he’d always visit the village where he grew up whenever we went back. He would be inundated with requests for medical attention.
It really inspired me, the way he never said no to anyone. Once a woman complained to him that she couldn’t have a child. My father, who is actually a bone doctor, did some general blood tests, and said, “Look, as far as I can see, everything’s okay.” When we went back the following year, she had a child with her — and everyone else in the region who couldn’t have babies started coming to see my dad to get it sorted out.
So I think seeing such things left me with a very deep sense of inequality. I also realized I’d had a very privileged upbringing. Within Egypt, my relatives are quite well off. But my grandma lived on the first floor, and the family that lived on the basement floor were effectively working for the apartment block. There was a kid there the same age as me, and every year we’d diverge more in terms of our opportunities. When we first met, we both just wanted to play football, but by the time we were 18, he’d had a kid, and his opportunities were very limited. Meanwhile, I had so many fantastic options for my university, career. It just seemed deeply unfair.
But why eye care?
I grew up very short-sighted. I was at the bottom of my class until I was about 12, when my mum dragged me kicking and screaming to the optician’s and insisted I get some glasses. Suddenly I could suddenly see everything perfectly — and I don’t think I’ve ever forgotten that moment. So I’ve always been struck with the power of being able to have sight returned, the impact it can have. After that, I started to do well at school, and was better at sport. I looked a bit more geeky, but I was doing better in a lot of other ways.
So it had always been in my mind at medical school to go into ophthalmology. I spent my summer holidays traveling, visiting people who were doing eye care in resource-poor settings, and just really fell in love with the possibilities. There are so many people who are unnecessarily blind. Had they been living in the UK, they would have never have gotten to the point where their vision problems were anything more than a nuisance. I knew this would be how I’d spend my life.
Untreated eye disease must be a problem in many developing countries. Why did you choose to focus on Kenya?
I’d worked in various countries short term, from Uganda, Sierra Leone and Madagascar to Peru and Belize. I then got the opportunity to work at the International Center for Eye Health on a PhD program. We were to do a large trial in Kenya, for which we’d be required to take lots of expensive equipment to 100 different locations to try and work out why people were going blind. I was excited because I knew this research would result in change, as opposed to only lead to papers and publications.
The most common causes of blindness are the same everywhere in the world — with cataract the top cause. In developing countries, blindness is an issue of access to healthcare, not usually a result of weird and wonderful tropical diseases, although there are certain infectious diseases that are more prevalent in Africa.
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