Country Snap Shot & Eyecare Profile
	Country Samoa Region Western Pacific Capital Apia Area (sq/km) 38,961 Geography Provinces/Districts 78 provinces, 22 districts *Population 2,944 *Population Below Poverty Line N/A *Infant Mortality/1000 births 26.85 *GDP Per Capita ($US) $5,600 Schools of Optometry 0 Optometrists NA Opticians NA Ophthalmologists NA Eye Health Workers 2 Optometrist Association No Vision 2020 Signatory  No Vision 2020 National Plan Yes National Eyecare Health Plan NA

Project Manager
Professor Brian Layland

Project Personnel

• To train a nurse trainer in Primary Eyecare.
• To conduct screening for diabetic eye disease as part of a multidisciplinary team.

Project Commencement
2004

Project Background/History
The Pacific islands nation of Samoa is located half way between Hawaii and New Zealand. It has a population of approximately 176,900 people, two thirds of whom are involved in the agricultural industry. 

Diseases such as diabetes and systemic hypertension have an increasing prevalence in Samoa due to changing lifestyles and diets. In a World Health Organisation report, it was estimated that over half the population is obese. Diabetic eye disease pose a great problem in countries like Samoa where there is limited capacity to manage the eye conditions. After cataracts, refractive error (the need for glasses) and diabetic retinopathy were the main contributors to vision impairment.

There is one local and one temporary ophthalmologist providing eye care for the people of Samoa. This is also supplemented by visits from a visiting Australian ophthalmologist.

Project Activities
In 2004, a nurse from Samoa participated in an ICEE conducted Train the Trainers’ workshop in Primary Eye Care (PEC) held in Cook Islands. The workshop provided prospective eye nurse trainers with the knowledge, skills and attitudes they need to train others, based on learner-centred, participatory training techniques.

On the completion of the training, the new trainers went on to tutor twenty nurses from seven islands throughout the Cook Islands, during a five day workshop. In this way, the new trainers were able to immediately apply the skills they had learnt, and to continue to learn from ICEE and each other as they delivered their first Primary Eye Care course.

The PEC course aims to equip health workers with the knowledge, skills and attitudes to identify and manage common eye problems. The course uses interactive tutorials and active learning techniques, as well as group work to enable health workers to take a case history, measure visual acuity and examine the anterior eye in order to identify common eye conditions. Guidelines for treatment or referral are included. Each nurse was given a copy of the Primary Eye Care Manual and additional materials and resources to consult during the training and to use as a reference after the course.

In 2005, ICEE participated in a project aimed at preventing diabetes complications by providing and developing local healthcare services in Samoa funded by the World Diabetes Foundation, Denmark. This project is in collaboration with the Ministry of Health, Samoa and the Australian and New Zealand Society of Nephrology. The team included endocrinologists, nurses and optometrists. It was found that 31% of the 243 patients with diabetes screened showed some degree of diabetic retinopathy.  They were referred to the ophthalmologists for further follow up and treatment. Most of the patients seen had either no or inadequate spectacles and were most appreciative of the affordable readymade spectacles, and 225 pairs were dispensed.

Project Achievements
Patients Screened: 243 patients (with diabetes)
Spectacles Dispensed: 225
Training: 1 Nurse Trainer in Primary Eye Care

Project Partners 2004
Ministry of Health, Samoa
Fred Hollows Foundation, New Zealand

Project Partners 2005 (Diabetes)
Ministry of Health, Samoa
The Australian Centre for Diabetes Strategies
Australian and New Zealand Society of Nephrology
World Diabetes Foundation, Denmark

Project Sponsors
World Diabetes Foundation, Denmark

	Personal Story
	ICEE volunteer optometrist, Tim McKinnon, was a member of the Samoan multidisciplinary diabetes complications screening team.  He had this to say of his experience, “In our eye care screening, 31% of the patients showed retinopathy and 39% were referred to ophthalmology. Given the language and cultural differences, some refractions took a little time but the happy faces we left made it worth while.”