Health and South Asia

The humanitarian initiatives of Project Prakash are creating a remarkable population of children across a wide age range who are just setting out on the enterprise of learning how to see. We have begun following the development of visual skills in these unique children to gain insights into fundamental questions regarding object learning and brain plasticity. This is a rare window into some of the most fundamental mysteries of how the brain learns to acquire meaning from the world.

On an applied note, as new eye treatments become available and existing treatments reach children who are currently blind, the basic question we have to confront is how to proceed with their integration into the sighted world. In this context, Project Prakash holds the potential to make a significant impact by directly assessing how extended visual deprivation influences children’s subsequent development of visual skills. This undertaking is a prerequisite to developing strategies to compensate for particular deficits.

Supported by the National Institutes of Health in Washington, DC, as well as private, science-oriented US foundations, the Prakash initiative has so far screened over 40,000 children; over 400 of them have been treated surgically and 1,400 nonsurgically. It has been tremendously gratifying to see the dramatic changes that treatment has brought about in the lives of these children. Simultaneously, the scientific data gathered have begun challenging some long-held dogmas in neuroscience about learning and brain plasticity. The findings reveal that the brain maintains significant ability to change even after many years of profound visual deprivation. In a matter of a few months after their sight surgeries, the Prakash children begin to be able to use vision for complex tasks like recognizing objects and moving independently. Recently, Project Prakash provided the answer to a famous question in philosophy. In An Essay Concerning Human Understanding, John Locke quotes William Molyneux as stating the problem in this way: If a blind adult is taught by his touch to distinguish between a cube and a sphere, can the same man distinguish between these shapes solely using his visual capabilities if his sight is restored? Called the “Molyneux Query,� this question had remained open for the past over three centuries until work with the newly sighted Prakash children finally resolved it. We believe that the findings thus far represent just the tip of the iceberg in terms of insights regarding brain function that working with the newly sighted can reveal.

Coverage of the humanitarian and scientific outcomes of Project Prakash in the popular press has had collateral benefits; it has raised awareness about the problem of childhood blindness among the public at large and also governmental policy makers. True to its name, the project has illuminated lives and also illuminated science.

The magnitude of the problem of childhood disabilities in India is daunting, and the challenge of unraveling brain mechanisms of learning is among the hardest in science. But we are encouraged that Project Prakash has begun to serve as a nucleus for bringing together the resources, expertise, and 90 Health and South Asia