Spectacles for Vanuatu Report
Spectacles for Vanuatu Report |
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The IdeaA request by a respected chief asking for spectacles because of his failing eyesight has led to a project in Vanuatu by our Rotary Club, Sale Central. The project required collecting and testing spectacles and sunglasses donated by the local communities of GippsIand, Victoria, for recycling to the locals in Vanuatu. The idea came to our club via Donald McRaild who was a speaker at our club meeting in December 1999. Donald and his wife Margaret were volunteer teachers in Vanuatu with the Presbyterian Church, having visited the Pacific nation several times. The History
The FutureThe eye care team will be meeting with John Szetu, an Ophthalmologist in Vanuatu, to set up a program of supervision of optometry students for the future programmes, which it is hoped will become self funding and self reliant. |
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How can you help? The Rotary Club of Sale Central is looking for donations or cheap suppliers of instruments and other equipment or services to assist in its ongoing project to provide eye care in Vanuatu. To see the equipment required or if you can assist with surplus or outdated equipment from your business, |
Vanuatu Eye Care ProjectClick Here for 2003-2004 report on Vanuatu Project 23 August - 20 September 2001 Prepared by optometrists May Ho and Genevieve NapperIntroduction - Vanuatu Eye Care Project Team 2001 This is the second year that this particular eye care team has visited Vanuatu. In 2000 the visit was supported by the Rotary Club of Sale Central, the Presbyterian Church of Vanuatu and the Health Department of Vanuatu. In 2001, additional supporting organisations were the Uniting Church of Australia and the International Centre for Eyecare Education (ICEE). This year the team worked as two separate groups: one group (optometrist Donald Beaumont, volunteers Don and Meg MacRaild, and PCV worker Richard Tatwin) was involved in service provision on Efate, Ambrym and Malo Islands. The other group, optometrists Genevieve Napper and May Ho, travelled with ophthalmologist Dr John Szetu and the Eye Nurse Practitioner trainees to Ambae island to assist with service provision and were later involved in training the nurses in basic optics and refraction at the Northern District Hospital, Luganville, Santo. Supporting organisations
Ophthalmologist, Fred Hollows Foundation Dr John Szetu (currently based at Northern District Hospital, Santo, Sanma Province) Eye Nurse trainees, Health Department of Vanuatu Colwyn Dingley (to be based at Northern District Hospital, Santo, Sanma Province) Marielea Alguet (to be based at Northern District Hospital, Santo, Sanma Province) Basil Aitip (to be based at Norsup Hospital, Malekula, Malampa Province) Annie Bong (to be based at Vila Central Hospital, Efate, Shefa Province) Mary Tabi (to be based at Lolowai Hospital, Ambae, Penama Province) Optometry volunteers Genevieve Napper (Victoria) S May Ho (Victoria) Donald Beaumont (Tasmania) PCV/Uniting Church volunteers Donald MacRaild (retired teacher) Margaret MacRaild (retired nurse) PCV worker Richard Tatwin (Youth Co-ordinator, PCV) BackgroundVanuatu is a group of 83 islands located in the South Pacific. It has
a population of approximately 190,000 and is divided into 6 provinces.
The capital, Port Vila, has a population around 20,000 people and the
second largest town, Luganville, has around 10,000 people. 95% of the
population are indigenous Ni-Vanuatu (made up of mostly Melanesians and
some Polynesians). Vanuatu gained independence on 30 July, 1980. The main
languages spoken are local island languages, Bislama (pidgin English),
English and French. Basic facilities and medical supplies are often limited.
Electricity, reticulated water supplies, transport, sewerage and means
of communication are not always available, even at health centres.
The Vanuatu National Eye Care Program includes several surgical tours to islands throughout the provinces undertaken by Dr Szetu and the nurses in training. The tour program for 2001 has included visits to the northern Banks Islands (Mota Lava and Gaua Islands), Efate (Vila Central Hospital), Ambae Island (Lolowai Hospital), Tanna Island (Lenakel Hospital) and Malekula Island (Norsup Hospital). Optometrists May Ho and Genevieve Napper participated in the Ambae Island Tour (27 August to 31 August) where they assisted in screening patients for surgery and provision of spectacles. A total of 330 patients were seen on this tour over a period of five days including approximately sixty cases of surgery: cataract (ECCE), pterygium, enucleation, vitrectomy, lacrimal drainage surgery, breaking synechia due to chronic uveitis and removal of intraocular foreign bodies, performed by Dr Szetu and the trainee Eye Nurse Practitioners. The island of Ambae had never before been visited by an eye surgery team and many patients who had been enduring both simple and complex eye problems for many years were able to receive surgical help from Dr Szetu. Surgical tours to islands not normally receiving eye care services are a much needed and much appreciated part of the program. The cost, time and hard work required for these tours are very worthwhile. During the Ambae tour there was a high demand with surgery continuing for 14 hours each day. Participation of the training optometrists in the surgical tour allowed Dr Szetu and the trainee Eye Nurse Practitioners to spend more time in surgery. In addition, more patients requiring refraction and glasses could be seen during the one week visit, the optometrists were able to get to know the rest of the team and their level of knowledge and scope of work, the optometrists were also able to assist in surgery as extra pairs of hands and as international airline ticket holders were able to assist with excess baggage difficulties (due to transportation of a portable operating microscope and surgical supplies). Some of the challenges faced by Dr Szetu include the Vanuatu Health Department having difficulty meeting the agreed funding for consumables including essential drugs for post-operative cataract patients, transport costs for surgical tours (for personnel and equipment) and equipment for regional eye clinics. Funding for ongoing support and in service refresher training courses for the Eye Nurse Practitioners when their training has been completed may need to be considered in the future. Refraction Training Refraction training was provided by optometrists, Genevieve Napper and May Ho, over a period of two weeks. The training was based on the refraction manual and inserts provided by ICEE and other materials. The training consisted of a combination of lectures, practical training and experience in service provision. The focus of the training was basic optics and spherical refraction using a trial frame and trial lens set, measurement of vision and visual acuity, refractive errors, accommodation and presbyopia. Issues involved in the prescription and selection of nearest appropriate spectacles from donated and readymade spectacle supplies were also covered. The trainee Eye Nurse Practitioners were able to learn spherical refraction reasonably easily. Together with the optometrists, the nurses performed spherical refractions on approximately 250 people and prescribed approximately 200 pairs of spectacles over the training period both at the Northern District Hospital and at four remote village locations on Santo. A range of patients presented including children, young adult students, adults from a range of traditional and professional backgrounds, and elderly patients including those with cataracts, pseudophakia and aphakia. Basic principles of retinoscopy and hand neutralisation were also outlined and the most experienced Eye Nurse Practitioner, Colwyn Dingley who is based at the Northern District Hospital, was taught cross cylinder refraction and retinoscopy in more detail. Colwyn will have ongoing access to a retinoscope and supervision by Dr Szetu for practising astigmatic refractions and may later be able to assist with training in refraction. Assessment and Course Evaluation At the conclusion of the training the students were given a multiple choice examination prepared by ICEE covering some of the topics taught over the training period. A practical skills assessment and course evaluation were also conducted. Feedback was provided to ICEE regarding the training manual to improve its suitability for use in Vanuatu particularly with respect to the type of language used. The nurses were also taught how to write spectacle prescriptions and were provided with sample eye examination record cards (from John Farmer's manual and optometry record cards for the service provision part this project). All the nurses commented on their course evaluation forms that follow up refresher courses and in-service training would be important in maintaining newly acquired skills and to learn new techniques (including retinoscopy and cylindrical refraction). Spectacle Supply Supply of affordable spectacles in Vanuatu is a major ongoing issue. Many people have limited access to money due to limited paid employment opportunities and a significant proportion of the population lives a subsistence lifestyle. During the 2001 visit, 500 vatu (AUD $6) was generally charged for both donated and readymade spectacles. A significant number of people were unable to pay this and spectacles were provided at a lower cost or given free of charge. In effect those who were able to pay were subsidising those unable to pay. Vanuatu has been receiving an ongoing supply of donated spectacles from the Rotary Clubs of Sale Central, New Zealand Rotary (district 9910) and the Uniting Church of Australia. It is hoped that this supply will continue and will be distributed via the Presbyterian Church of Vanuatu office in Vila. Although more labour intensive than readymade spectacles, donated spectacles have the advantage of being free of charge, greater range of frames sizes, styles and quality. In addition, donated spectacles include bifocal (which were very popular with teachers, nurses, etc) and aphakic prescriptions. Maintaining the current combination of readymades and donated glasses may be the most realistic option for Vanuatu in the current circumstances. A reliable and affordable supply of sunglasses is currently being investigated by Karen Scott-Hoy in conjunction with the Rotary Club of Port Vila. Prevention of Blindness Committee At the suggestion of Dr John Szetu, the previously existing Presbyterian Church of Vanuatu Eye Care Committee has been re-constituted to form the Prevention of Blindness Committee of Vanuatu. Membership of the committee will include representation from the Health Department `of Vanuatu, the Northern District Hospital Eye Clinic, Presbyterian Church members, representatives from all provinces, women and youth if possible. Membership of the committee is also open to any other interested parties/stakeholders. The role of the Prevention of Blindness Committee is envisaged to be assisting with co-ordination and support for eye care provision and blindness prevention in Vanuatu. A draft constitution for the committee is currently being discussed further with the Health Department. The Presbyterian Church of Vanuatu (PCV) is keen to support the development of the Vanuatu National Eye Care Program and is looking at the feasibility of establishing an optical supplies/edging laboratory in Port Vila. A Korean Christian Blind Mission organisation has submitted a proposal to PCV for an eye clinic/laboratory to be located near Vila Central Hospital. If funding for this building eventuates, it will be a very valuable resource for eye care in Vanuatu and will be ideally located close to the proposed Eye Clinic at Vila Central Hospital. Ongoing support for staff training, equipment, frame and lens supplies will need to be considered. Future directions for eye care in Vanuatu, 2002 The Vanuatu National Eyecare Project/Dr John Szetu/Fred Hollows Foundation plans to provide a second 9 month training program for an additional 3-5 nurses in 2002. A 2-3 week basic optics and refraction training course will again be required. Combining the refraction training with a surgical tour to a regional island hospital worked well in 2001 and is suggested for 2002 (most northern and remote island groups: Banks and Torres are the proposed locations). This tour is likely to commence sometime in June 2002. The scheduling and content of the visit will again be developed in close consultation with Dr Szetu. Annual refresher training for all Eye Nurse Practitioners will be of great assistance in ensuring the ongoing success of the program. Refresher training may be achieved by participation of 2001 Eye Nurse Practitioner trainees in visiting optometry/eye care programs/visits in 2002. This will require discussion between Dr Szetu, visiting optometry/eye care groups, PCV and the Prevention of Blindness Committee when preparing a schedule for 2002. General support for the establishment of regional (provincial) Eye Clinics throughout Vanuatu has to be considered. This support may be in the form of equipment, consumables and staff support (eg in-service training). Acknowledgements The airfares and expenses for this eyecare project were supported by the Rotary Club of Sale Central, International Centre for Eye care Education, Uniting Church of Australia/Presbyterian Church of Vanuatu and voluntary contributions by the personnel. The Vanuatu Health Department provided some accommodation, food and land transport. Equipment loans and donations were provided by the Christian Blind Mission International (2 secondhand trial sets), Designs for Vision, National Vision Research Institute, Optometrists Association of Australia. Donated spectacles were obtained via Christian Blind Mission International, the Uniting Church of Australia and private optometrists. Readymade spectacles were supplied at cost by the International Centre for Eyecare Education. Thank you to all members of the Rotary Club, Sale Central. We look forward to continuing working with you on this very worthwhile project. |
| Donations
Of Ophthalmic Equipment required by the Spectacles for Vanuatu Project |
We appeal to companies and individuals with redundant / outmoded or a surplus stock to support this very worthwhile project by donating the following equipment, or any other equipment that you might think that you might think we could find useful.
On a priority we require... A supply of cheap ready made spectacles or used spectacles. Ophthalmoscope/ retinoscope, slit lamp, edging machine and sundry small instruments. please contact the president of Sale Central Rotary Club on +61 3 5144-3892 or Email: salecentral@district9820.org |
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