Malo e Lelei! This year was my first VOSO trip and my first visit to the beautiful Kingdom of Tonga. The team spent the week solely on the main island of Tongatapu this year. Hywel Bowen and I provided optometric services in the team along with the support of the nurses of the Vaiola Hospital who were extremely helpful as assistants as well as interpreters. Mele Vuki, an optically trained nurse, was able to screen many of the straightforward presbyopes while we tackled some of the tougher cases. We examined plenty of diabetics, some with severe proliferative retinopathy. We also saw a few more “interesting” cases, such as the man who has not taken his prosthetic eye out to clean in 20 years!
One young boy of 11 years old had his second juvenile cataract operated on this year by the doctors of our team, Dr Andrew Riley and Dr John-Paul Blanc. They had a fantastic result with him achieving 6/9 vision each eye unaided. I refracted him and I was able to find him a pair of small progressive spectacles that he could use for school. He left clutching his spectacle case with a big smile on his face. With no local optometric specialists or facilities, either private or public, based in Tonga, we knew we’d made a real difference to this boy, who will not get a chance to see another clinician for 12 months.
My first VOSO trip was certainly very busy but it was also incredibly rewarding. I was very appreciative of all the work and planning that was put into our one week. I left Tonga with a new perspective on the islands and on eye care in general, and I know I will be back!
Although Samoa attracts many tourists to its paradise beaches, it remains on the United Nations list of least developed nations. Samoa has strong links with NZ and has been visited by VOSO at least once a year. This was my first opportunity to volunteer with VOSO, and hopefully not my last.
Geographically Samoa is comprised of two large volcanic islands, Upolo and Savai’i, and a few smaller islands. The situation for eye care is poor outside the capital of Apia, especially on Savai’i where there is only one resident GP for a population of 60,000 and no optometrist or ophthalmologist. Over the years the VOSO team led by John Tarbutt has been trying to shift the focus from cursory eye screenings to a more thorough eye examination.
For two weeks, John and I were ably assisted by the national hospital optometrist Erna Takazawa, and two local nurses. Most days we had two optometrists refracting while the third was on slit-lamp. The clinics were packed full of pathology. There were injuries aplenty from cricket balls, tree branches, nails and fishing hooks. The pain tolerance of the Samoans was immeasurable!
We identified those with advanced cataract, pterygia, and other pathology requiring surgery for the Pacific Eye Institute surgical team who were to follow a week behind us. I was staggered to hear that the Pacific Eye Institute (PEI) team reached a record-breaking outreach with 186 operations in 5 days!
I was impressed with the quality of the new and pre-loved spectacles we were able to prescribe. Even more impressed with John who somehow managed to fit a new slit lamp into his luggage! This slit-lamp was generously donated by Optimed to replace the broken one at the hospital. The fluorescein donated by John, was also most welcomed, as there was a fishhook emergency while we were at hospital and the only fluorescein they could find was a strip that expired in 2005.
It was certainly a different type of optometry than what we are used to in NZ – one can’t be too idealistic and one needs to be adaptable and prepared to compromise.
We achieved most objectives with regard to referrals to the PEI surgical team, diabetic screenings, refractions and spectacle dispensing. Where possible we provided mentoring to Erna and the eye nurses, including two trainees, importantly maintaining good VOSO and Samoa National Health Services relationships whilst also helping them towards self-sufficiency.
I could not have asked for a more prepared, hardworking, and enjoyable team to work with. Volunteering in Samoa was the perfect opportunity to put my newly acquired therapeutic knowledge to use. It allowed me the opportunity to experience a new culture beyond my normal travels. Ultimately though it was great to regain some perspective and to give something back. Faafetai lava (thank you very much).