Vanuatu

The first Ni-Vanuatu (indigenous) eye doctor has been groomed to take over his country's national eye health program and he is already easing into the role of advocate and leader.

Graduating from the postgraduate diploma of ophthalmology in 2004 from the University of Papua New Guinea's School of Medicine, Dr Johnson Kasso studied under Dr John Szetu, who provided an excellent example in advocacy and leadership as he set up the Vanuatu national eye health program. Dr Kasso has now taken over the running of this program, which has trained and stationed nurses throughout the provinces of Vanuatu.

Dr Johnson Kasso found it challenging to be away from his family during his studies in Papua New Guinea and practical placement on outreach tours in remote Vanuatu. He spent much time on the tours, learning practical surgery skills from Dr Szetu.

"I've got two young boys; I would often worry about my children, wonder what they were doing," says Dr Kasso, his face lighting up at the thought of his four- and six-year-old sons and his wife, a gynaecologist at the Northern District Hospital in Santo.

One of the most rewarding parts of his job is watching a change in the behaviour of children who are finally prescribed and dispensed spectacles. "We see improvements in children who were finding it hard in school, with below-average grades. As soon as they have glasses, they improve their grades. Those who can read, it helps them. You can see their appreciation," he says.

"The most enjoyable part of the job is the joy of seeing patients seeing again.

"It's like a miracle - we give people a second chance to see and move around. It makes me happy to be an eye doctor. There is joy in seeing patients live a normal life, instead of being led around buy family members. We give them back life as it was before they went blind."

Dr Kasso has been instrumental in setting up the sustainable eye glass clinic, where low-income earners can be fitted for ready-made spectacles for about three dollars. The profits go back into training, purchasing more spectacles and distributing them throughout the vast archipelago, which consists of more than 80 islands scattered in 12,200 square kilometres of water.

On Johnson's agenda for future outreach tours are parts of the country that have not been screened for eye health problems for many years.

"Depending on the need, we plan to get to even more remote areas, like South-West Malekula, Paama and Erromango. But we must secure funding from the ministry of health to pay the nurses a travel allowance," he says.

Having received funding through the New Zealand Agency for International Development (NZAID) Small Projects Scheme for his diploma, Dr Kasso is keen to pursue his masters in ophthalmology after a year or so of practical work in his homeland.

"Possibly I could study by distance learning in 2007 or 2008, and maybe do my placement at the Pacific Eye Institute.

The problem is that while I am in Fiji, there is no one to run the clinic in Vanuatu. So it depends on what is best for everyone," he says, touching on a problem that all ministries grapple with.

Health bosses face two problems when doctors and nurses seek further training - finding someone to treat the patients while they are gone, and running the risk that graduates will not return to their old jobs. The Pacific Eye Institute is attempting to address these problems by developing some distance learning modules in its courses. It is also keeping training in the Pacific.

"Health ministries prefer the idea of training in the Pacific, because graduates are more likely to return home from other Pacific countries than they are from studies in New Zealand or Australia," says Carmel Williams, executive director of The Fred Hollows Foundation NZ.