Leeds, Kartunet- One of the biggest obstacles to fulfilling the rights of visually impaired individuals in Indonesia is the chaotic data collection system and the broken link between medical diagnosis and social services. Many patients who lose their sight are left confused after leaving the hospital, unsure where to seek rehabilitation support or social assistance.
To address this structural problem, Indonesia could look to the good practices of the United Kingdom, which has long implemented the system of Certificate of Visual Impairment (CVI). This system has proven successful in efficiently bridging the medical world and social protection. So, what exactly is CVI, what are its procedures, and why is this system highly relevant for adoption in Indonesia?
What is CVI?
The Certificate of Visual Impairment (CVI) is an official document that certifies that an individual has a significant visual impairment or loss of sight. Previously, this document was known by its carbon paper format called BD8, but it has now been modernized into a more digitally integrated CVI.
The most important aspect of the CVI is that this certificate is issued based on the patient's level of visual acuity and field of vision (level of sight), not based on the type of disease. Whether the vision loss is caused by macular degeneration, glaucoma, central retinal vein occlusion, or injury, patients are entitled to a CVI as long as their level of vision meets the established threshold. In the UK, CVI divides visual impairment into two official categories: Sight Impaired (SI/weak vision) and Severely Sight Impaired (SSI/blind).
How to Obtain a CVI?
The procedure for obtaining a CVI is designed to be patient-centered and integrated with local government:
- Medical Examination: Patients are examined by an ophthalmologist (consultant ophthalmologist) at an eye hospital or clinic. This doctor has the authority to sign the CVI document based on the results of vision acuity tests.
- ECLO Support: During the process, patients are accompanied by an Eye Clinic Liaison Officer (ECLO). The ECLO provides emotional support, explains the benefits of the CVI, and assists with administrative matters to ensure patients are not confused.
- Document Distribution: Once signed, copies of the CVI will be given to the patient, the patient's general practitioner (GP), and most importantly, sent directly to the social services department at the local council (Local Government) where the patient resides. Anonymized data copies (without names) are also sent to a national database for epidemiological research purposes.
Benefits of Having a CVI
This certificate is not just a piece of diagnostic paper; it is a "passport" to access various rights and protections:
- Automatic Access to Social Services: As soon as the local council receives the CVI, the local sensory team will directly contact the patient to offer rehabilitation support, such as mobility orientation training, cane use, and home environment adjustments for safety.
- Legal Protection: CVI holders are legally protected by the Equalities Act. This document serves as valid proof when requesting reasonable accommodations in the workplace or educational institutions, without needing to argue with HR departments or universities. (Note: CVI ownership is confidential, and patients are not obliged to disclose it publicly, except for safety-related matters such as driving licenses).
- Financial Incentives and Concessions: CVI holders are entitled to various benefits, such as certain tax exemptions, independent living allowances, public transport discounts, and free postal services for materials for the visually impaired (Articles for the Blind).
Budget Efficiency and Research (Government Perspective)
From the government's perspective, implementing the CVI system actually brings extraordinary budget efficiency. In the UK, anonymized CVI data is collected centrally and analyzed by research institutions (such as Moorfields Eye Hospital). With this high-quality data, the government can map trends of the main causes of blindness in various regions.
Budget-wise, this makes the allocation of health and social protection funds highly precise. The government no longer has to "guess" where rehabilitation services are most needed or waste budget on misdirected aid programs. CVI ensures that state funds go directly to medically validated individuals.
Relevance and Urgency of CVI Implementation in Indonesia
The current situation in Indonesia urgently requires a system intervention like the CVI. There are several pressing reasons why this is relevant:
1. Untangling the Integrated Social Welfare Data (DTKS) Problem
Based on data from the National Team for the Acceleration of Poverty Reduction (TNP2K), approximately 94.5% of individuals with severe disabilities have not yet received social protection benefits. Data collection (such as SUPAS and SUSENAS) is still in the form of unsustainable surveys. If Indonesia had a CVI system directly connected between health facilities (BPJS Kesehatan) and the Ministry of Social Affairs, disability data would be updated in real-time. Visually impaired patients would no longer need to go through convoluted bureaucracy from neighborhood units (RT/RW) to sub-districts just to have their disability recognized to be included in the DTKS.
2. Ensuring Fulfillment of Formal Sector Employment Quotas
Law No. 8 of 2016 mandates employment quotas for people with disabilities (2% for government/state-owned enterprises, 1% for private companies). However, the recruitment process is often hampered by companies' lack of understanding of the diversity of disabilities. If a visually impaired applicant has an Indonesian CVI, companies will have a valid basis regarding the type of impairment the applicant has and what screen accommodations (such as a screen reader or workspace modifications) should be prepared by the Manpower Disability Service Unit (ULD Ketenagakerjaan).
3. Basis for National & Regional Action Plans
The government is currently required to develop Regional Disability Action Plans (RAD Disabilitas). CVI data can provide a solid foundation of precise figures and demographics for Bappenas and Bappeda to design inclusive budgeting—ranging from rehabilitation programs, the construction of sidewalks/guiding blocks infrastructure, to inclusive education services.
Conclusion
It is time for Indonesia to stop separating examination room diagnoses from social sphere interventions. Adopting a system like the Certificate of Visual Impairment (CVI) is not just a step to comply with human rights conventions, but a strategy for efficient, budget-appropriate state governance that fully humanizes visually impaired citizens.
References:
- Thomas Pocklington Trust YouTube Channel, "Eye Care and You: What is a CVI and how can it support you?"
- Macular Society YouTube Channel, "What is a Certificate of Visual Impairment and how can it help me?"
- Ministry of National Development Planning/Bappenas & AIPJ2 (2021). Monitoring the Fulfillment of Disability Rights.
- Central Executive Board of the Indonesian Blind Association / DPP Pertuni. Guidelines for Recruitment and Placement of Visually Impaired Workers.