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She is deeply interested in simplicity and creativity in solutions. That proved more than handy when Alefia Merchant developed a novel method of screening for eye disease in children under the age of five. In fact, it was this innovation that brought the 32-year-old the honour of being included in the list of MIT’s prestigious ‘India Technology Review 35’ list. Alefia developed this method in 2009-10 as part of her community paediatric opthalmology project at the Narayana Nethralaya Postgraduate Institute of Opthalmology, Bangalore. Alefia was the co-investigator of the project along with Dr Ashwin Mallipatna, a consultant paediatric eye surgeon at Narayana Nethralaya.
What was it that drove Alefia to do something about blindness? “I met Dr Ashwin Mallipatna during his fellowship at the Hospital for Sick Children in Toronto, Canada. At that time, I was a second year medical student at the University of Montreal in Canada. For many years, Ashwin had been toying with the idea of developing an organised paediatric eye screening programme that would allow the identification of children of all ages in Karnataka who were in need of eye care. At the moment, there is no such programme,” she explains, adding that a large majority of children never receive basic eye screening, forget adequate eye care.
Alefia’s method of screening involves a photo-red protocol, which uses a digital camera to elicit red reflexes. To obtain a red reflex, all layers of the eye through which light passes must be transparent and the surface of the retina must be normal. “Any significant change in the structure of the eye changes the optics of the reflected light and can alter the reflex seen in the photograph,” she says.
The protocol allows one to consistently elicit a standard, clinically-relevant red reflex in children and adults using a compact digital camera, and can be performed by rural health workers with a little initial training.
Field work in Karnataka
Alefia’s field work took her to Pavagada. Ever since, Bangalore has been like home for this researcher based in Montreal. She has even taught herself some Kannada, and “can’t imagine not finishing her meals with yoghurt and rice”.
The feedback for the method of screening, which is still in the research stage, has been great, she points out. “I think the communities in which we have done our screening near Bangalore have been very open to us. There is sometimes the issue of flashes, thought to harm a baby’s eyes or parents disliking the idea of photographing a baby girl, however, it was a very rare occurrence. For the most part, I think, villagers give medical doctors a lot of respect and have implicit trust in them.”
Alefia has mostly lived outside of India all her life, though her parents hail from Maharashtra. She went to high school in the US and then went to Montreal. With a Bachelor’s in Immunology at McGill University, and years of research in vaccine development, this young researcher suddenly shifted tracks and opted to be a graphic designer for a few years, to explore her creative side. In fact, Alefia has many interests, from rock climbing to dancing tango.
Who are the people who inspire her? “People who think out of the box have always inspired me,” she says.
She admires women like Naomi Klein and Arundhati Roy, women who speak out and are unafraid of criticism, and have the courage to “get out there and participate as citizens”.
“In my medical school, there are more women than there are men,” she adds, explaining that she has personally not felt any discrimination so far in her career in the sciences. Is there a glass ceiling, then, for women in science? “I don’t know. I think what is more relevant is that women be taken seriously and judged not by their gender but by their intelligence and their abilities.”
Miles to go
Alefia is certainly being taken seriously, but her work is hardly over. She wants to continue with community work. She dreams of coming back to India to continue work in the field of paediatric eye care in the community. “In order to improve health care, it is critical to involve the community,” she adds. With an estimated 1.4 million blind children in the world, and 90 per cent of them in developing countries, Alefia’s photo-red protocol, one hopes, will help them see better.