In the Western Pacific, north of Fiji lies a quaint and extremely remote island nation. Tuvalu boasts a population of approximately 11,000 people distributed across 9 beautiful islands. There are as few as 90 people on some island and approximately 5,000 on the main island of Funafuti. The only link between the outer islands and the main island is a boat service. The trip from the most distant islands can take up to 24 hours.
Eye care in such an area is a great challenge. There are no optometrists or ophthalmologists residing in Tuvalu. On the islands, nurses are the sole providers of eye health care.
On of the main causes of vision impairment in Tuvalu is refractive error, or the need for a pair of glasses to see clearly. Since 1996 the Pacific Island Project (PIP), organised by the Royal Australasian College of Surgeons (RACS), has been sending a small ophthalmological team to Tuvalu to provide cataract and other eye surgery. ICEE has worked alongside the surgical team to provide glasses to those in need and pre-screening of surgical patients.
ICEE has been working together with the Tuvalu Ministry of Health to develop a strategy for permanent provision of preventative and primary eye care services. In 2004, 2005 and 2006 ICEE conducted training courses for nurses from all over Tuvalu to provide primary eye care, children’s vision screening and reading glasses.
The training programme has been an outstanding success; to date there have been over 35 nurses who have received training. This year saw an added component built in with the programme with the first trainer course being conducted which will enable a local nurse to continue to provide training to other nurses.
On her recent return from the island ICEE Programme Manager, Dr Suit May Ho stated, “Training local people to provide eye care is the first step to creating a sustainable long term solution. Training an optometrist in Australia takes 5 years; we often get the nurses for a few weeks at a time. So there is still more work to be done”.
“Local people are so keen to attend workshops they will go to great lengths to attend – even when on maternity leave! I admire the commitment of the young mother to learn new skills, not only was the baby not a distraction, the mum went on to score amongst the highest marks in the class,” she Dr Ho.
Tuvalu is well on its way to establishing ongoing local primary eye care services and spectacle supplies. The impact of trained nurses to provide primary eye care and near vision spectacles services on the outer islands was well indicated by the decrease in the number of minor eye conditions and patients presented during 2004 and 2005.
ICEE is continuing to work with the Tuvalu Ministry of Health to provide support for local programmes to prevent and treat many of the leading causes of avoidable blindness and vision impairment. As well as the evaluation and follow up of eye care training, ongoing support for nurses in the delivery of eye care to their communities.
