Roadmap for quality eye health launched

HEALTH

JUST imagine living in a world where every other person you come across is completely blind.
What would happen if everyone suddenly turned blind? Would our world still be beautiful? Or would it be the darkest and the ugliest place to ever live in?
Eyesight is one of the most important senses because our eyes allow us to connect with our surroundings, keep us safe, and help us remain mentally sharp, sound and secured. Thus, 80 per cent of what we perceive as physical reality, comes through our sense of sight.
Our eyes are the physical gateway through which information from the environment is collected and sent to the brain for processing and interpretation. The eyes are our windows to the soul. They are vital in how we view the world around us.
Sight and vision are integral to our eyes, and are important because they bring beauty and understanding of the world to us.
But bad things do or can happen to our eyes. And, in the absence of timely detection, reduced or absent eyesight can have long-term personal and economic effects and consequences.
Vision impairment affects people of all ages, with the majority being over the age of 50. Young children with early onset of severe vision impairment can experience lower levels of educational achievement. And in adults, it often affects quality of life through lower productivity, decreased workforce participation, and high rates of depression.
Vision impairment and blindness impact people everywhere. In low and middle-income settings, the burden of vision impairment can be even greater due to fewer opportunities to accessing the most essential eye care services.
According to World Health Organisation (WHO), more than 2 billion people worldwide are currently living with vision impairment. Of these, at least 1 billion people are needlessly living with poor vision due to lack of access to eye care services. Many of these vision impairments are preventable or can be corrected.
Cataract and uncorrected refractive errors are estimated to be the leading causes of vision impairment. However, other causes for vision impairment cannot be ignored. Age-related macular degeneration, glaucoma, long-standing systemic conditions like diabetes causing diabetic retinopathy, infectious diseases of the eye, and trauma to the eye are all equally important causes for vision impairment, and that surely need addressing.
In the Pacific, Papua New Guinea has the highest rate of blindness, which is also among the highest globally.
Thus, the National Prevention of Blindness Committee (PBL) was established in 2012. Over the years, this team has played the leading role in eye care. And with support from non-governmental and faith-based organisations, both local and international, eye care services have been maintained across many parts of the country.
Through the leadership of the Department of Health and the National Prevention of Blindness Committee, it has been demonstrated that eye health is critical issue for the country, and must be addressed appropriately so to improve health and wellbeing.

The failure to act will subject women, men, and children, and especially the poorest communities in PNG to face unjustifiable hardships.
PNG is burdened with many challenges including the rugged geographical terrain, high financial costs, lack of adequate awareness of services, and the culturally-rooted belief in sorcery and other non-medical causes and solutions to eye health issues. In the midst of these, we have seen success in other areas of eye health.
Amongst the Pacific island countries, PNG has been leading in research and collaboration. It has also developed a National Eye Plan which identifies critical workforce and infrastructure needs. We also have strong partnerships between universities and health facilities which have enabled local eye care workforce training over the years.
A comprehensive strategic analysis of health and eye health sector in PNG was undertaken over a period of time. This included: (1) a review of the Government’s key policy on planning and strategic frameworks for health plans of key stakeholders; (2) a review of the scope, strength, and limitations of the existing national health services in PNG; (3) a review of existing eye care services in PNG and the extent to which they are integrated within the health system.
All these resulted in a summary map that expresses a comprehensive, integrated, and sustainable eye health service delivery.
From Sept 27 to 28, 2022, the National Prevention of Blindness Committee with the Department of Health, hosted the launch of the “Eyes Ahead: 2022 and Beyond”. All the activities of past years culminated to that day. The event took place at UPNG’s School of Medicine and Health Sciences, Taurama Campus.
The launching brought together participants from the Port Moresby General Hospital, provincial health authorities, Australian Department of Foreign Affairs and Trade, New Zealand Ministry of Foreign Affairs and Trade, WHO, the Fred Hollows Foundation (Australia and New Zealand), and the University of Papua New Guinea. Representatives of other important local and international development partners were also in attendance.
Eyes Ahead is a road map where all stakeholders are committed to establish a quality, accessible, and equitable eye care in Papua New Guinea. It thus lays the foundation for the development of a 20-year strategic plan that will guide critical investments into PNG’s eye health and care sector to strengthen health systems weakened by the Covid-19 pandemic and the resulting economic shock.
Hence, Eyes Ahead is yet another significant achievement in our nation’s eye health system strengthening journey.
This workable action plan identifies our key objectives such as, Centre for Eye Health, which require partnership, investments, and cooperation among stakeholders to achieve better outcomes for our people.
The Eyes Ahead report aims at strengthening PNG eye health systems by following strategic approaches: (1) enhancing policy, commitment, and political engagement; (2) developing a country-wide sustainable eye care workforce; (3) increasing access, quality, and coverage of eye health services; (4) Improving strategic and collective advancement of eye health sector management; and (5) building a centre for eye health that is locally driven, providing leadership and direction, workforce development, generating research, and leading innovation.
This plan thus, provides a recommended road map for the provision of a realistic, comprehensive, integrated, and sustainable eye services for the next 20-plus years. This has come about as a result of a review of the scope, strength, and limitations of the existing national health services and eye care services. The extent to which they are integrated within the health system has resulted in this summary map that will now accommodate for the provision of a comprehensive, integrated, and sustainable eye health service delivery in PNG.
This plan will see more coordinated collaboration across stakeholders to support National Prevention of Blindness Committee. The Government has made the commitment to fully support this plan. Through the National Department of Health, policies will be developed, with funding and human resource training to be mobilized and delivered through our international partners, especially, the non-government organisations.
That training for eye care specialists and for primary eye care will be continued and ramped up to meet current, including cataract surgery backlog and projected future needs. It has been envisioned that, by increasing the PNG eye care workforce, people experiencing unnecessary blindness due to cataracts, uncorrected refractive error, and a whole range of treatable conditions, can be treated in a timely manner.
With many contextual challenges to accessing eye health services, it is no surprise that Papua New Guinea has the highest rate of blindness in the region, which is also among the highest in the world. In the face of such negative drawbacks, we certainly have made some progress.
PNG now has the opportunity to build on the potential of new eye health professionals and training within new Centre for Eye Health. To that, the Provincial Health Authorities will play a pivotal role as advocacy to draw in more candidates. Together, with our partners, we have the potential to do far better.
Thus, with the Eyes Ahead strategic plan, the National Prevention of Blindness Committee, and with the support of all stakeholders, is focused on further driving eye health services in this country for better.
Papua New Guinea is now 47 years old. And for these many years of our progress, we as a people, could not have done it without our partners, both from within and abroad. They are the people who continue to make a difference by standing with us to date, despite our many differences. They are certainly a team of marvelous people doing marvelous things out there.
Source of information
Most of the information for this article has been gathered from presentations done at the launch of the Eyes Ahead: 2022 and Beyond meet at the School of Medicine and Health Sciences

• Gelinde Narekine works with the Division of Health Sciences at the UPNG School of Medicine and Health Sciences.