Community trust and culturally sensitive mobilisation enabling cataract surgery uptake among tribals in rural West Bengal: a case report

Abstract

Cataract remains the leading cause of avoidable blindness in India, particularly among elderly populations residing in rural and underserved settings. Despite availability of free surgical services, uptake of cataract surgery is often limited by fear, misinformation, and lack of trust in healthcare systems. This case report describes how culturally sensitive community engagement facilitated cataract surgery acceptance among a tribal older adult in rural West Bengal. An elderly Oraon tribal man from a tea garden community in Alipurduar district of West Bengal was identified with visually disabling cataract during outreach activities under the Netra Vasant Rural Eye Health Programme. Despite repeated counselling and multiple home visits by programme workers, he consistently refused surgery due to fear and hesitation. Conventional awareness approaches including posters, interpersonal communication, and repeated counselling failed to convince him. Subsequently, a respected local community leader from the same tribal background who spoke the Oraon dialect was engaged for counselling. Through culturally familiar communication and trust-based interaction, the patient agreed to undergo cataract surgery. The patient successfully underwent free cataract surgery at a partner hospital and received follow-up care through the programme. Following surgery, he experienced substantial improvement in vision and resumed independent mobility and daily activities. His positive experience also influenced community perceptions regarding cataract surgery. This case highlights the importance of culturally responsive community engagement and local trust networks in improving uptake of eye health services among underserved tribal populations. Integrating community champions into public health programmes may strengthen healthcare utilisation and reduce avoidable blindness in rural settings.