The Foundation has trained two nurse aids for two of the three atolls, and plans to have a nurse aid graduate to send to the remaining atoll to provide primary eye care and health promotion services for Tokelau.

Overview

Tokelau comprises three atolls in the South Pacific Ocean, midway between Hawaii and New Zealand. The atolls are Atafu, Nukunonu, and Fakaofo. Between them they comprise a land area of just over 10km². Tokelau has no ports or harbours, and its isolation and lack of resources greatly limit economic development.

These limitations, combined with overcrowding, are contributing to emigration to New Zealand and Samoa. The Government of Tokelau is almost entirely dependent on subsidies from New Zealand, which also pay directly for the cost of medical and educational services in the country.

There is no data on the prevalence of blindness in Tokelau, however local health workers report that the prevalence of diabetes is 44 per cent of the population (2011 PacEYES Pacific Regional Eye Health Conference) which signals that diabetic eye disease is a leading issue. Tokelau has a high elderly population so cataract blindness is also of concern.

Each of the atolls of Tokelau has a small hospital with a doctor, four nurses and five nurse aids. There is no eye clinic but each hospital has an ophthalmoscope and visual acuity chart. There is no ophthalmologist, no eye care service, no eye nurses, and no diabetes eye care except when teams from New Zealand visit every four years or so. The last visit was in 2005.

The eye services that are provided are by referral to Samoa, where there are eye nurses but no ophthalmologist.

About the program

The Foundation has developed a strategy for small island nations, with Tokelau leading the way for other small island nations: Nauru, Niue, and Tuvalu.

The strategy is to train a small local eye health workforce to service the population. Two nurse aids, from two of the three atolls, have recently graduated from the Pacific Eye Institute with the Certificate in Eye Care.

These health workers hope to achieve recognition as vision technicians, establish space for eye care in the hospitals and provide accessible primary eye care services and health promotion for their communities. Prevention and education efforts are vital for a small, isolated country like Tokelau.

Patients from Tokelau are organised to access surgical service when the Pacific Eye Institute teams visit nearby Samoa.