Pacific eye surgery
3 August 2004
Only one in eight blind people accesses Pacific eye surgery
Only 12 per cent of the estimated 9000 people with seriously sight impairing cataracts in Fiji receive surgery to restore their vision. The situation is not much better in Samoa, where 15 per cent receive surgery and in Tonga it is 38 per cent. These statistics come from research undertaken last year and were reported at The Fred Hollows Foundation Pacific Eye Care Workshop in Vanuatu last month.
The research into blindness in Pacific countries was commissioned last year as part of The Fred Hollows Foundation’s Pacific Regional Program. Conducted by Ms Jacqui Ramke of the International Centre for Eyecare Education (ICEE), it was found that in the Suva area of Fiji alone there are 3841 people who have severe eyesight problems as a result of cataracts. Numbers in Samoa and Tonga are 1788 and 554 respectively.
“These statistics are alarming, but not really surprising. They mean that in the worst situations, only about one in 10 blind people actually has sight restored,” said Carmel Williams, manager of The Fred Hollows Foundation (NZ). “We have been told anecdotally by eye doctors and nurses that most blind people are not accessing the eye clinics which are all in the main cities. But it is important to get some idea of the numbers so we can design the eye programmes in the Pacific to get services out to where the people are. This research tells us we should be sending more health workers out to villages to screen people for cataracts and other eye sight problems, then helping these people get into the eye clinics.”
Cataracts are the leading cause of blindness in these countries, followed by the need for spectacles and then by complications of diabetes. Cataract blindness is easily reversed in a straightforward 20 minute surgical procedure which should leave most patients with very good vision.
Eye doctors from around the Pacific have formed a network, PacEYES, so they can support each other through delivery of services in each other’s countries, coordinating training opportunities and promoting the need to have better eye health facilities and trained staff.
As expertise has been increasing amongst Pacific eye doctors, they have started to provide surgical skills to other Pacific countries. Dr John Szetu, a Solomon Islander, has been managing the Fred Hollows Foundation Vanuatu program for the past four years. He travels back to the Solomons twice a year to provide surgical services to that country which has been without an eye doctor since the ethnic crisis in 2000. Eye doctors from Papua New Guinea also provide surgical services outside their own country, most recently to Nauru and the Solomon Islands. PacEYES plans over time to extend such services.
At the Vanuatu workshop Dr Szetu led the training of a different surgical technique for cataract surgery. Called small incision sutureless cataract surgery, the technique is beneficial for patients, as they recovery more quickly, and is cheaper to provide as sutures are an expensive component of traditional cataract surgery. One of the recommendations from the Pacific audit of blindness is that all eye surgeons, including those who visit from overseas countries to perform surgery, should be monitoring their surgical results. An outcome of the workshop is the commitment of PacEYES members to commence research in the region, and to standardize their reporting so that a more comprehensive pool of information about Pacific eye health is developed which will enable better planning of eye health services to meet the need for surgery and spectacles in Pacific countries.
The Fred Hollows Foundation (NZ) has been working in the Pacific since 1999, with programs covering Papua New Guinea, Vanuatu, Fiji, Samoa, Tonga and the Cook Islands. The workshop was funded in part by NZAID.
Pic caption: Dr John Szetu (centre) training Pacific eye doctors in surgical techniques at The Fred Hollows Foundation Pacific Workshop