N. C. GRASSET XXXlV conditions, and was adapted for implementation in another country- Nepal. This introduction is written with the hope that it will contribute to giving confidence to governments and individuals who are starting a new public health programme or planning a nationwide sur- vey, and that it will encourage them to pursue their planning in the face of a variety of problems, most of which seem impossible or difficult to solve in a limited period of time. This volume yields thousands of facts, figures, and diagrams and gives detailed information, on the different phases of the survey. But few persons will be able to read between the lines ail that the planning, implementation, and write-up involved. The major obstacles included delays of all kinds, climatic exigencies, human and technical failures, immovable laws and regulations, difficult communications, and cumbersome bureaucracy; nevertheless, the survey was successfully completed on time and the majority of problems overcome. The initial obstacle, which was later encountered again during the different phases of the survey, and still later during the im- plementation of the programme, was the lack of vision of a number of persons experienced in public health or in the prevention and control of blindness, whose advice was sought. Some argued against carrying out the survey, believing that the choice of Nepal as the site for a major survey and programme in eye care could only lead to failure. They proposed other countries, with flatter terrain, long- standing basic health services, and better communications than those existing in Nepal. Others considered that a nationwide sur- vey was unnecessary-was a luxury in a developing country where, it was thought, all available funds should be put to better use in expanding much-needed programme activities. If a survey were to be conducted, suggestions for assuring its success were that it be con- ducted in only one or two regions of Nepal, where the prevalence was known to be high; that the detailed epidemiological study that was planned should be replaced by collecting only basic clinical data on a one-page formula; that a computer, helicopter, and slit lamps be proscribed, as these were considered too sophisticated or com- plicating the survey activities; and the recruitment of a specialist in survey methodology was indignantly queried. What were the reasons for initiating the programme in Nepal? First, at a WHO meeting on the prevention and control of blindness held in 1978 in New Delhi, which the writer attended as an observer, it was evident that of all the Asian countries, Nepal was the one that most needed to expand its eye-care activities and was the
