The Vanuatu Prevention of Blindness Project

 

Ten years ago, prior to The Vanuatu Eye Care Project, basic primary eye care was not available outside Vila. Large numbers of people were severely visually handicapped for want of glasses. Many others had debilitating or blinding eye conditions that went undiagnosed and therefore untreated. Over the 10 years the program has been operating, considerable progress has been made toward reversing this situation, but much still remains to be done.

 

During initial visits, the optometrists diagnosed significant numbers of patients with diabetic retinopathy. Screening for diabetes and blood pressure problems was commenced and revealed that diabetes in many areas was in epidemic proportions and was going untreated. Village visits also attract large numbers of people who come for general medical needs, many of them serious and even life threatening. For them too, access to real medical services is extremely limited. Eye Care teams can provide some of what is required and arrange follow up treatment and surgery as necessary.

 

The Presbyterian Church of Vanuatu (PCV) became concerned about the situation and established a Prevention of Blindness Committee. This committee is the implementing body, responsible for local planning and management. Technical training and supply of equipment is provided by the Australian partners. Membership of the Committee includes the Director General of Health for Vanuatu, The Clerk of the Assembly of PCV, a representative of the Municipality of Vila (usually the Mayor), the manager of the Vila Clinic and Edging Laboratory with the chairperson being the Moderator of the Presbyterian Church of Vanuatu.  The composition of the committee ensures that all plans are in accord with national policy and coordinated with other such initiatives. The PCV Prevention of Blindness Committee has endorsed this proposal.  

 

The Vanuatu Eye Care Project, which has been operating for 10 years, has the specific charter:

·        To provide professional eye care where local services are inadequate or absent.

·        To train and equip local people to test eyes, prescribe, make and provide glasses at a locally affordable cost. To this end a basic clinic and edging laboratory has been established in Vila.

·        To diagnose eye health problems, set up appropriate surgical or medical follow up. This includes screening for diabetes and blood pressure problems. As there are only 3 islands out of the 83 that have resident doctors, teams are also regularly called upon to provide broader medical support and treatment.

·        To provide eye health and general health education, to develop preventive strategies.

 

An indication of the extent of the services provided over the past three years, based on an analysis of patient record cards, is included in the table below:

 

Services Provided (By our visiting teams)

2006

2007

2008

Number of Patients screened

1952

2149

3428

Glasses supplied

860 

1020

1550

Sunglasses provided

450

600

800

Custom made glasses made at edging laboratory

199

230

325

Patients referred for eye surgery

172

130

163

Blood Pressure checks

1050

1322

1820

Blood Sugar checks conducted

520

563

1210

Patients referred for non eye related treatment

200

213

120

Local staff involved – project staff

1

2

3

No. of  Locations visited

28

31

43

No of Islands visited

7

8

5

 

Many of these services have been provided by Australian eye and health care professionals including optometrists, ophthalmologists, doctors, nurses and volunteer support staff. Usually three teams of 6 to 8 specialists and staff provide these services each year. Each team includes two optometrists, one doctor, one nurse, one health educator and two support staff. Each team includes at least one Ni-Vanuatu eye care worker, eye care nurse, general nurse or aid post worker. The project pays their travel and living expenses and during their time with the teams they are given personal on the job training and mentoring. The program attempts to revisit remote locations every three to four years..

 

There are some other health related projects being carried out by other NGOs, but no other project addressing the same optometry and ophthalmology needs. While some surgical teams visit from Australia, America Japan and China and work through the Health Department, they only attend to a small number of the identified cases. 

International Centre for Eye Care Education (ICEE) operates in Vanuatu to educate local professional eye care workers and nurses. The Vanuatu Eye Care Project has established a positive relationship with ICEE so that they include key personnel associated with Vanuatu Eye Care Project in their activities.

There are many Rotary programs running in Vanuatu and The Vanuatu Eye Care Project has operated jointly with Rotary since 2001. This link opens many very valuable extensions, for instance, Rotary’s “Reaching Overseas with Medical Aid for Children” (ROMAC) has assisted providing major life saving surgery in Australia for one child in 2006.