Andrew Bastawrous is the cofounder and CEO of Peek Vision. He is an ophthalmologist (eye surgeon), and Associate Professor in International Eye Health at the London School of Hygiene & Tropical Medicine. We spoke to him about his work, his inspiration, and the future of Peek Vision.
Tell us about yourself. Why have you chosen to devote your career to ending preventable blindness?
I grew up severely visually impaired, but my poor vision wasn’t detected until I was 12 years old. My life completely changed when I received glasses – it didn’t just improve my education, it changed my whole life. But it has always struck me that had I lived somewhere else, such a simple and life-changing thing like glasses might not have been available to me. That seemed deeply unfair, and motivated me to pursue a career in eye health.
Early in your career you left your job in the UK to move to Kenya with your wife and baby son to pursue your vision of curing preventable blindness – that must have been a huge decision. Why did you choose Kenya?
Some inspiring colleagues at the International Centre for Eye Health at London School of Hygiene & Tropical Medicine had worked in Kenya for many years and suggested a PhD study that might be of interest to me. It was difficult, unfunded and would require a major life change – but my wonderful wife was supportive, so we went for it. Kenya also interested me because it has a huge unmet need in eye care and also is a global hub of innovation and creativity. It provided the perfect opportunity.
And it was while you were in Kenya that you had the idea to found Peek Vision? Was there any particular event that inspired you?
Peek was inspired by a lot of things. First, by the doctors and healthcare workers I met in Kenya, working tirelessly to bring vision to their patients in hugely challenging places. Second, by my academic mentors and teachers, who motivated me to work in global health. And finally, by my family, who supported and encouraged me and still do. I feel lucky to be working in eye health at such an exciting moment, where thanks to centuries of research and practice most blindness and visual impairment is curable or preventable.
But I’m also deeply troubled that billions of people can’t see clearly. Many only need something as simple as a pair of glasses, or a cheap surgical procedure. Ultimately, it is this which inspired me to set up Peek – and it will continue to inspire me, until everyone has access to the eye health treatment and services they need.
How did the response of the communities you worked with in Kenya affect the development of the technology?
Something I’ve learned from my mentors and my own research is the importance of listening to the people who are affected by your work – in this case the visually impaired. Peek simply wouldn’t have worked if we hadn’t listened to the people who used our work and understood their needs.
An example is our app, Peek Acuity, which can be used in eye screening. We tested it in schools in Kenya. We found that although the eye testing itself worked well, there was no change in the number of children who went on to receive help for their eye problems. So we talked to the teachers, local health care workers and other people involved in screening. They pointed out that it is not the child or the teacher who decides whether to seek treatment. It is the parent who ultimately decides whether to send their child for treatment. And the healthcare system can be complicated to navigate.
Because of this feedback we changed our eye screening programme. After the app was used in schools, we provided personalised referral cards and SMS message reminders for parents. We also provide schools with regular updates on how many of their pupils had been treated. The result was three times more children being referred for treatment. We should never forget that social interaction is central to good personalised care. We have to create our devices and systems for communities. This takes much longer to design and launch than a simple device or app.
How do you train people to use the Peek technology, and how long does this take?
Peek Acuity, our basic vision check app takes less than five minutes to learn. The user can follow a tutorial within the app and repeat it if they need to. Our full software package, Peek Capture, collects information from people who have eye problems and sends them reminders to attend treatment. This takes a little longer to learn to use.
We run training workshops for Peek Capture whenever we start work in a new country. We also have ‘training the trainer’ workshops with our partners, so the knowledge can be shared widely.
The Peek technology helps you to reach people in hard-to reach rural areas. What work do you do to ensure that those people are then able to access treatment?
We do not begin a screening programme unless the people screened can be guaranteed access to treatment in the local area. To date, we’ve worked with a variety of incredible organisations such as CBM, Operation Eyesight Universal, the Botswana Optometrists Association, Combat Blindness International, and Standard Chartered Bank’s Seeing is Believing initiative (to name just a few). They have helped us to make sure that people receive treatment. However, in the long-term, we believe that governments need to work with us to ensure that the millions of people worldwide with avoidable blindness and vision loss receive the treatment they need. There have already been incredible steps towards this goal in locations such as Botswana and Rwanda, but there’s so much more to be done.
The Peek Acuity app and Peek Retina technology are example of mHealth innovations. What is mHealth, and how do you think it will transform healthcare in Africa in the next twenty years?
M-health stands for “mobile health” – it is a term used to describe the use of mobile phone technology to improve health care. M-health will play a large role in global healthcare, but I think we need to be cautious about some of the hype in this area. M-health platforms, apps and devices are advancing quickly in many areas of healthcare.
It’s great to see so much innovation in the field, but there is currently a lack of good evidence in many areas. That is why Peek has taken an “evidence first” approach from the start – we owe it to the people who use our eye tests and devices to ensure that our products deliver good results. We’re continually working to improve the evidence base for our products and systems. The insights we get from this help us to improve our products and better meet the needs of the people who use them.
Is there anything new that Peek is working on that you are particularly excited about?
At the end of 2018 we signed our first major agreement with an international NGO partner, CBM, a leading international disability charity. CBM work with some incredible organisations in low- and middle-income countries who run eye health services. By working together we will be able to reach many people who would otherwise not receive eye health services, so I’m enormously excited to see what we can do together.
If there was one message about eye health you wanted everyone to know, what would it be?
Most people who have eyesight problems or are blind don’t need to be. Proven, cost-effective treatments exist for the vast majority of the millions of people affected worldwide.
Many of our readers are aged 18-24. What would you say to a young person who has an idea for a business or healthcare innovation to improve health care in their community? What advice would you give them?
My advice is to remain focused on your “why” – if you understand “why” you want to pursue your idea, it will always help to guide you through the difficult decisions you will have to make.
WANT TO KNOW MORE?
Want to know more, or access this technology?
The Peek Acuity app can be downloaded from the Google play store:
The Peek Retina device can be purchased via their website:
You can get in touch with the Peek team by visiting their website (https://www.peekvision.org/) or email (email@example.com)
This article is part of Eye Health Week at Right for Education.
Photo caption: Laureate Andrew Bastawrous, CEO of Peek, in Kitale, Kenya, where he plans to set up a centre of excellence.
© Rolex Joan Bardeletti.