Dear Editor,

Nigeria, a lower middle-income country in Sub-Saharan Africa, has faced ongoing economic challenges that have led to rising poverty and a high cost of living, with more than half of its population living below the poverty line.1 These issues have resulted in significant socioeconomic unrest and frequent protests, which have substantially disrupted daily life and access to essential services.2 The health care industry3, and especially the eye care industry, has been greatly impacted. This has drawn attention to a serious public health issue: the challenge of accessing eye care under an unstable economy and disruptions caused by events like protests. The aim of this letter is to offer a perspective on this issue based on observations of a typical protest and an instance of civil unrest in Nigeria.

In early August 2024, Nigeria witnessed the start of an 11-day nationwide protest aimed at addressing the rising cost of living.4 While the protests were intended to be peaceful, past experiences have shown that they often escalate into violence. Therefore, many individuals chose to stay home during that time to avoid potential danger. This precaution led to the closure of various businesses, including supermarkets, financial institutions, and some health care centres, to protect lives and property.5, 6

During the initial days of the protests, as an eye care professional, I observed that patient turnout for eye exams significantly decreased. The disruption in transportation due to blockades made it particularly challenging to reach work, highlighting the difficulties faced by individuals needing eye care who might struggle to access these services during such disruption. Many studies have found that limited access to eye care in Africa is often due to inadequate healthcare facilities, insufficient eye care resources, and financial constraints faced by individuals.7, 8 However, socio-economic factors, such as protests driven by public dissatisfaction with the economic conditions, are frequently overlooked. This led me to consider the impact of prolonged economic unrest on society, particularly regarding healthcare, which is crucial for overall well-being. Eye care, in particular, is a significant concern, especially in emergencies where immediate attention and treatment are essential.

Nigeria’s recent protests illustrate a public health concern that goes beyond conventional obstacles to healthcare access. The need to address the larger socioeconomic issues influencing access to health care has become increasingly necessary to maintain resilience and continuity of service even in the face of social and economic unrest. Social determinants of health, like poverty and shortages of eye care facilities and trained personnel, significantly influence the ability of individuals to access essential care.7, 9 These issues often originate from broader socioeconomic challenges, such as a failing economic system.10 In contrast, a more stable and thriving economy with lower poverty levels might prevent such barriers from arising, reducing the need for protests, thus signifying the necessity of addressing the root causes of socioeconomic problems. More so, the 2030 Agenda for Sustainable Development recognizes vision as a crucial component of overall health and the importance of visual health in achieving broader health goals.11 Therefore, government agencies must carefully assess the implications of socioeconomic factors that make eye care services inaccessible and unavailable. It is imperative that these problems be resolved to guarantee that eye health continues to be a top concern in larger plans for development and health.

Going forward, it is essential to address the detrimental impacts of socioeconomic instability on general and eye health care systems, and to offer solutions. This includes making eye health a key component of national health policies, and increasing the availability and accessibility eye health care providers, particularly in underserved rural communities of low-and middle-income nations.12 Notably, advancements in mobile health have the potential to allow eye care professionals to provide eye health services virtually for individuals who cannot access care in person.12, 13 Telemedicine has allowed people to receive eye care from the comfort and safety of their homes,14 and it was significantly used and proven effective during the COVID-19 pandemic.15 Although it may not be suitable for all eye conditions, a consultation with an eye care provider through telemedicine can serve as an essential first step in receiving comprehensive eye health services. This could be especially important in situations such as socioeconomic unrest, lack of mobility, and protests, as discussed in this letter.

No funding was received for the preparation of this manuscript.

The author declares no competing interests.

Ethics approval is not required for articles of this type.