!"#$%&# xli were to be provided on a regular basis to all trainees at the zonal, district, health post, and ward/village level. As concerns the above-mentioned manpower, training of staff would result in the programme acquiring at least 15 new ophthal- mologists, 94 ophthalmic assistants, and 1 ophthalmologist trained in public health ophthalmology. In the 75 district hospitals, 60 district medical officers would annually take a two-week refresher course, while at the health post level, at least 1 auxiliary health worker in the 450 health posts would be trained in primary eye care, as well as several thousands of community health workers and other volunteers in the wards and villages. As regards the ophthalmic assistants, once their training in basic ophthalmology was completed, they would be sent to one of the eye centers and to eye camps to receive further training in sub- jects related to blinding conditions, such as nutrition and sanitation, and in more specialized domains corresponding to their individual skills: assisting the ophthalmologist in running the outpatient departments and in performing cataract surgery; organizing eye camps; training village health workers in eye care; repairing eye instruments; and carrying out mobile team activities mostly related to the detection, prevention, and treatment of xerophthalmia/ keratomalacia and trachoma, as well as assisting in surgery for trachomatous trichiasis/entropion at the village level. A group would be trained to work part-time in the administration of the eye centers and camps, which included the regular reporting of the eye cases examined and treated, keeping stores, and maintaining a detailed inventory of all supplies and equipment. Since it was known that a high percentage of the blindness in the country was due to cataract and that surgery for this blinding condition was taking up a major portion of the ophthalmologists' time, a programme was planned to greatly reduce the large backlog of cataracts by approximately 1987. By eliminating the backlog, not only would tens of thousands of blind patients have their sight restored but, with only the annual incidence of new cataracts re- quiring surgery, the 15 Nepalese ophthalmologists who were being trained in the interim would be able to cope on their own from 1988 onward, no longer having to depend in part on foreign specialized manpower. To achieve this objective, it was decided that while the 15 planned Nepalese ophthalmologists were being trained (from 1982 to 1987), several expatriate ophthalmologists-52 to 91 annual person- months-would work side by side with the Nepalese workers, either as volunteers or for a minimal salary, bringing their own instruments, when possible.
