Page 28 - IB April 2023

THE FRED HOLLOWS FOUNDATION NZ:

A HOLISTIC APPROACH TO EYE CARE

Pacific Island nations make up six of the top ten countries with the cost of accessibility for patients to come to a main hospital. So, we work
highest rate of diabetes globally, and diabetic retinopathy, a complication in collaboration with Ministries of Health on the prevention side and
of diabetes, is quickly becoming the most common cause of vision support services to better reach the community, particularly those living
impairment. far from urban centres,” she added.
Also known as diabetes eye disease, the condition can present in a The Foundation’s Diabetic Retinopathy Health Awareness training
variety of ways. “Almost everyone who has diabetes is at risk of developing and outreaches have been key in strengthening referral pathways from
diabetic retinopathy if not managed well. Some of the symptoms include the community/primary level to secondary/tertiary care.
blurry or patchy vision or sudden vision loss,” says Komal Ram, Pacific “If a patient with diabetes lives in a village setting, the first point of call
Programme Manager for The Fred Hollows Foundation NZ. will be the village health worker. We want to make sure that the village
Unfortunately, we are seeing many people in our region reach the health worker has basic information on what to do for a patient with
worst stages of diabetic retinopathy, which requires advanced treatments diabetes and where to refer them for an annual check-up or if they are
to prevent further sight loss. To address this irreversible condition, already having problems with their eyes.
The Fred Hollows Foundation NZ is supporting its Ministry of Health “We have a Diabetic Retinopathy Awareness Training Module for
partners in the Pacific by taking a “more integrated approach” which health workers. It was developed with our Pacific Ministry of Health
includes regular eye screening along with raising awareness of diabetic diabetic retinopathy coordinators and eye health clinicians through a
retinopathy amongst the primary and community health care sectors. training kit that we’ve put together and it’s been tested. For example,
In recent years, The Foundation conducted two qualitative studies on we train health and community workers on how to do a simple visual
patients’ perceptions of diabetes and diabetic retinopathy in Kiribati and acuity test.”
Vanuatu, and found that inhibiting issues include the cost of accessing The Foundation has also translated health promotion resources into
health services and the stigma attached, especially in rural and remote local languages.
settings. “We also understand that there is a big need for evidence-based
As described by one ni-Vanuatu respondent, “There are many people information, especially on eye health. In the Pacific, our partners
in Vanuatu who do not want to hear anything about diabetes from any currently don’t have that information to inform the direction of future
source. They are scared to go to the clinic or hospital for a medical check eye health programmes. This year we have embarked on a significant
because they are afraid they might have diabetes.” piece of work on the state-of-eye-health research across the Pacific, in
The studies show that “we cannot only work on eyes, we have to look partnership with the University of Auckland. This research programme
at diabetic retinopathy holistically and have a wider approach, and intends to develop the evidence that Pacific governments and decision-
work with all our diabetes and Non-Communicable-Disease (NCD) makers require to establish eye health plans and policies that will
stakeholders,” Ram said. strengthen and sustain their eye-health systems for the long term.”
“We’re very aware of the geographical spread of the Pacific and the

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