Country Snap Shot & Eyecare Profile
	Country Vanuatu Region Western Pacific Capital Port-Vila Area 12,200 Geography 83 islands Provinces / Districts *Population 208,869 *Population Below Poverty Line NA% *Infant Mortality/1000 births 53.80 *GDP Per Capita ($US) $2,900 Schools of Optometry 0 Optometrists 2 Opticians 2 Ophthalmologists 1 Eye Health Workers 9 Optometrist Association No Vision 2020 Signatory  Yes Vision 2020 National Plan Yes National Eye Health Plan Yes

Project Manager
Dr Suit May Ho

Project Personnel
Tricia Keys, Jane Kierath

• To eliminate avoidable blindness due to refractive error by providing refraction training to eye nurse practitioners.
• To establish a sustainable supply of affordable spectacles in Vanuatu.
• To support the activities of the Vanuatu National Eye Care Program.

Project Commencement
2001

Project History / Background
Vanuatu is a nation of over 200,000 people living on 83 islands scattered over 450,000 square kilometres of Pacific Ocean. Over 75% of its population lives in rural communities. Infrastructure is poorly developed, and there are insufficient health facilities and trained health care professionals. Access to eye care is difficult.

Dr John Szetu, a Solomon Islands eye surgeon, who moved to Vanuatu in 2001, has been instrumental in setting up the Vanuatu National Eye Care Program. The backbone of this program is the training of local eye nurse practitioners, competent to provide good quality eye care to the communities in which they live. ICEE has been a significant contributor to the education of these nurses.

Project Activities
In 2001, ICEE supported basic refraction training for five nurses undertaking an eye nurse practitioner training program run by Dr Szetu. ICEE and Dr Szetu established an affordable readymade spectacles and sunglasses project, whereby income from spectacle sales is kept within a revolving fund so as to maintain the project overheads and repurchase any stock. This enabled the nurses to provide comprehensive refractive care when they returned to their district clinics.

In 2002, the work of the previously trained eye nurse practitioners were evaluated, and another refraction course for a further four eye nurse practitioners in training was then conducted.

In 2004, to help overcome the problem of insufficient eye care providers, ICEE was invited to train the existing nine eye nurse practitioners in the skills necessary to train general nurses to identify and manage common eye conditions. This would create a local ongoing educational capacity capable of training existing and new nurses. ICEE conducted a workshop in training techniques and skills. Initially, the eye nurse practitioners learnt about communication skills, how people learn and how to effectively teach knowledge, skills and attitude related to eye care. Then, opportunities were provided for the eye nurse practitioners to practice their new skills by teaching a group of general nurses.

These trained general nurses would be the first of many to be taught how to incorporate good primary eye care into their everyday work. Ultimately, it is envisaged that when a villager with an eye complaint presents to a rural health post anywhere in Vanuatu, that condition will be identified and treated or the person referred for more sophisticated medical investigation.

Furthermore, in the same year an additional four eye nurse practitioners were trained in basic refraction with the support of ICEE. Two of these nurses were from Cook Islands and Solomon Islands.

In 2005, ICEE participated in a project aimed at preventing diabetes complications by providing and developing local healthcare services in Vanuatu funded by the World Diabetes Foundation, Denmark. This project is in collaboration with the Ministry of Health, Vanuatu and the Australian and New Zealand Society of Nephrology. The team included endocrinologists, nurses and optometrists. It was found that 43.5% of the 200 patients with diabetes screened showed some degree of diabetic retinopathy.

Project Achievements
To date ICEE has contributed to the Vanuatu National Eye Care Program in the training of eleven eye nurse practitioners. There is at least one eye nurse practitioner in each of the six provinces of Vanuatu. Some of these nurses also participated in a Train the Trainers workshop to enable them to teach general nurses about eye care.

Today these eye nurse practitioners work independently, helping ease Vanuatu’s burden of blindness, poor vision and eye disease. However, with just one nurse per 20,000 people, there is still a great need unmet. ICEE continues to work with the Vanuatu National Eye Care Program to eliminate avoidable blindness in Vanuatu.

Project Partners 2001 - 2006
Vanuatu National Eye Care Program

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

Project Sponsors
Kosmac and Clemens Optometrists, Australia
World Diabetes Foundation, Denmark

	Personal Story
	Colwyn comes from the small island of Motalava in Torba Province, the northern-most part of Vanuatu. Working for the Vanuatu Health Department for almost 20 years, Colwyn has spent most of that time assisting in the operating theatre. Because of his advanced nursing skills, Colwyn was chosen to join the Solomon Islands ophthalmologist, Dr John Szetu, for eye care training in the neighbouring Solomon Islands. On his return to Vanuatu, Colwyn was appointed to Nurse In-Charge at the nation’s first eye clinic based n the Northern District Hospital of Santo. A further nine months of in service training with Dr Szetu in Vanuatu has seen Colwyn become the most skilled eye care nurse in Vanuatu. A lot has happened in a short space of time in the eye care program, and now there are two major eye clinics and 11 trained eye nurses based throughout the country. To harness the skills of the trained eye nurses and to continue delivering eye care services to Vanuatu’s population, ICEE has worked with Colwyn and his colleagues to develop the eye nurses’ teaching skills so that they can go on to train other general nurses in primary eye care. With the support of ICEE, Colwyn feels confident to continue his teaching and training of other nurses.