COVID-19 update from The Fred Hollows Foundation NZ

While Vanuatu is lucky to not have had any active COVID-19 cases since April, the pandemic is still affecting our work here. Currently, Vanuatu only has one fully trained eye doctor, Dr Kasso, which means Outreaches are essential. However, travel restrictions mean Dr Kasso can't receive much-needed support from outside of Vanuatu.

Our team has had to rethink the way we normally work and find alternative solutions to help the over 700 patients waiting for treatment in Vanuatu. To manage this backlog, we decided to mobilise graduates around Vanuatu to the capital, Port Vila, to conduct an Outreach. The response was so great we even had a retired eye nurse re-register to help.

What was originally planned to be a two-week Outreach was soon extended as the patients started flowing in. Dr Kasso and his team were successfully able to treat a large number of patients before they returned to their home islands.

The New Zealand Government have announced that the country will move to Alert Level 4 after a new COVID-19 case was found in the community. Auckland and the Coromandel will remain at Level 4 for seven days, and the rest of New Zealand for three days.

In response, our office in Auckland will be closed. However, staff are working remotely to ensure the organisation's activity continues. While we are well equipped to work from home, this does have certain challenges, primarily with receiving and processing mail donations from our amazing supporters.

If you would like to continue to support us, we would encourage you to try giving through different methods, such as on our website donation form or online banking. Our team are available on the phone or via email to answer any of your questions and help you through this.

For more information on the Alert Levels, please visit the Government's COVID-19 website https://covid19.govt.nz/

In Fiji, our staff and students continue to support the Fiji Ministry of Health’s eye care services while finding new ways of working in challenging circumstances.

The team is working from home and will do so until it is safe to return to work in line with local health authority directives. Our eye doctors have moved to online consultations and providing remote support to eye care graduates and students based in local hospitals. We have also provided equipment and PPE to the emergency eye care departments in Fiji’s central division to ensure emergency eye surgery can continue throughout the lockdown.

Our students continue their studies online, though much of this is happening after hours. Many have been called on to assist their local health authorities with the country’s COVID-19 response.

Fiji Country Manager Kirti Prasad says the team is feeling the pressure as the outbreak continues. However, they remain committed to doing whatever they can to support clinical eye care staff and patients through the lockdown. They are coming up with ways to stay connected and supported.

“Teams hold weekly and daily catch-ups to ensure everyone feels connected, and staff are also using this time to undertake professional development courses online so they can use the time from home productively.”

“Right now, our priority is to ensure the safety and wellbeing of our staff, students and patients and support the Ministry of Health’s eye care and COVID-19 priorities in any way that we can.”

The operating theatre at the Pacific Eye Institute/CWM Eye Center (PEI) is currently being utilised by the Fiji Ministry of Health for general surgery. It will provide much-needed emergency capacity for Suva’s Colonial War Memorial Hospital, which has moved most services due to COVID-19 outbreaks.

“We’ve had three Fijians begin their lives in our theatre due to being born by caesarean,” says Kirti.

The team is also turning its attention to putting robust plans and Standard Operating Procedures to meet the increased demand after the outbreak has passed.

“We thought we had a large backlog to address after the events of 2020, but we know now we’ll have to go forward with everything we’ve got to help those who haven’t been able to access eye care over the last few weeks,” says Kirti.

The Fred Hollows Foundation NZ staff and supported students in Papua New Guinea are now on an emergency footing as COVID-19 cases continue to rise.

The Madang Eye Clinic, in line with local health authority directives, is now open for emergency treatment only with rostered clinical staff on call but remaining at home unless required. All Outreaches are on hold and support staff are working from home until further notice. Students at Divine Word University and the University of Papua New Guinea are studying online from their school residences with support from university academic staff and support staff at The Foundation.

The Fred Hollows Foundation NZ Medical Director, Dr John Szetu says doing everything possible to ensure the safety of staff and students remains The Foundation’s priority.

“Standard Operating Procedures developed last year have been deployed and all staff and students have been supported to follow them.”

“The procedures include protocols on best practice to manage transmission risk including hand hygiene, use of face masks and social distancing. If any symptoms are experienced our staff and students have been advised to immediately get tested and isolate at their current place of residence to minimise the risk of spreading the virus further.”

Dr Szetu says clinical and support staff continue to support and mentor Foundation-supported students and graduates so that study can continue safely where possible.

“It is important that we work together to beat COVID-19 now so, when this outbreak is over, we can quickly scale our clinics and Outreaches back up to continue our work ending avoidable blindness and vision impairment in Papua New Guinea.”

Despite the challenges presented by COVID-19, our teams continue to support patients across the Pacific with life-changing eye surgeries.

This week, the Auckland team resumed working remotely, as we moved to Alert Level 3. And, as news emerged of an outbreak in the Madang Province, Papua New Guinea, our team quickly reviewed and refreshed our COVID-19 Standard Operating Procedures to ensure staff, trainee eye care specialists and patients remain as safe as possible.

Our programmes director, Peter Raynes says balancing the ongoing need to treat preventable blindness with ensuring the health and safety of clinical eye care workers, trainee eye care specialists and patients is the primary focus for The Foundation this year.

“Our Pacific clinical teams have developed and practised standard operating procedures for safely managing a COVID-19 outbreak and, thanks to the generosity of our donors, our people are currently well-stocked with quality PPE and safety equipment.”

“We are closely watching how the recent outbreak develops, and we are committed to making the right decisions for our teams and our patients,” says Peter.

The New Zealand Government have announced a move to Alert Level 3 for the Auckland region after four members of the same family tested positive for COVID-19.

Auckland will move to alert level 3 from midday on the 12th August for three days - until midnight on Friday 14th August. The rest of New Zealand will move to Level 2 for the same period.

District Health Boards are planning to establish pop up clinics to help with testing, and current testing centres in Auckland will expand capacity over the coming days.

In response, our office in Auckland will be closed until the end of the week. However, our team are all working remotely to ensure the organisation's activity continues.

For more information on the Alert Levels, please visit the Government's COVID-19 website https://covid19.govt.nz/

As COVID-19 cases continue to rise throughout the globe, many places are experiencing a second wave of the virus. Papua New Guinea has identified a significant outbreak in Port Moresby, with 73 active cases and two deaths to date.

As a result, the PNG government has re-introduced restrictions and is seeking to increase testing nationwide. In Port Moresby, a 2-week lockdown has come into force, with all domestic travel suspended. Face masks are now compulsory in all public spaces across the capital.

Elsewhere, the University of Papua New Guinea has suspended tuition for the lockdown period, and Madang Provincial Hospital Eye Clinic has moved to emergency services only.

Unfortunately, the nationwide restrictions have meant that we are once again unable to carry out outreaches in PNG. In the meantime, our team are responding to the crisis by reinforcing safety procedures and working closing with our partners and other health organisations. We are continuing to consult with our partners at Madang Provincial Hospital and Divine Word University to determine next steps and formulate a plan to reopen when it is possible and safe to do so.

Things are slowly starting to return to normal in Fiji, but COVID-19 remains a genuine threat.

The State of Emergency lasted for three months and, during that time, our eye doctors and nurses were only able to treat emergency, sight-threatening conditions and do online training.

This meant that thousands of consultations and surgeries were not performed, resulting in a significant backlog for the eye care specialists in Fiji.

Our Mobile Eye Clinic, which does free eye checks, cataract surgery, diabetes treatment and more, was out of action for 11 weeks. That resulted in 3,850 lost consultations and 308 lost sight-saving surgeries.

During the period three Outreaches also had to be cancelled, leading to another 1,500 consultations and 300 sight-saving surgeries unable to be performed.

At the Pacific Eye Institute, our annual patient targets saw a dramatic reduction, meaning 8,800 fewer consultations will happen in 2020 and 900 fewer sight-saving surgeries. It was necessary to halt all practical training, with some of our students returning to their home countries throughout the Pacific. As long as border closures remain in place, they cannot return.

Finally, because of COVID-19, we were forced to cancel 20 Diabetes Eye Disease Outreaches, resulting in 1,000 lost consultations.

In total, the pandemic led to 13,000 patients not seen and 1,500 surgeries unable to be performed in Fiji.

As New Zealand moves into level one, restrictions are also easing in other Pacific countries. There have been no new cases detected for six weeks in the countries in which The Foundation operates. But many are dealing with the aftermath of the pandemic and Cyclone Harold.

The Foundation staff continue to manage operations across the region to ensure we are safeguarding staff, students, partners and communities; supporting partners; supporting strategic eye care priorities and proactively engaging with donors. While some students have deferred their studies, the majority are continuing and are now likely to complete the year.

Except for Solomon Islands, clinics are moving back to regular services and are preparing to meet significant backlogs of eye care cases. The Mobile Eye Clinic in Fiji aims to re-start operations from 12th June, and the team in Papua New Guinea are planning for in-country outreaches from August.

Although international borders remain closed for now, all countries are engaging in discussions for a ‘Trans-Tasman (and potentially Pacific) bubble’ without quarantine restrictions. The bubble will be particularly crucial for those countries that rely heavily on tourism, as it will be vital to ease the economic impacts following the pandemic. At this stage, the timeframe and countries that will be involved in the bubble are unknown.

Since going into lockdown in March, there has been some relaxation of orders in Papua New Guinea, but the official State of Emergency will remain in force for two months.

Thanks to the hard work of our team and our partners at Divine Word University, we have been able to continue teaching the Postgraduate Diploma in Eye Care students, by providing online lectures to students who were in lockdown in the dorms. Face-to-face teaching has since resumed, which I know is welcome news for students and instructors alike.

The PNG team continue to provide emergency services during the nationwide lockdown. Our partner, Madang Provincial Hospital, seconded some other members of the eye clinic staff to the hospital's COVID response team.

Unfortunately, the nationwide restrictions have meant that we are unable to carry out outreaches throughout PNG. In the meantime, we are working with our partners and other health organisations to make sure we are taking the right approach during this time and developing a plan to reopen for cataract and other eye care services when it is possible and safe to do so.

Cyclone Harold severely damaged areas of the Pacific. In this particular time when a country is in a state of emergency due to COVID-19 and already lacking resources in what they are trying to do in response to this, they now find themselves in a devastating position where they additionally have to deal with such a serious natural event, putting a severe burden on the country’s already limited financial resources. We are doing everything we can to help our Pacific neighbours get through this difficult time.

Over half of our graduates are working on the frontlines in their home. From our end, we are ensuring our eye doctors and nurses have resources available on how to respond to patients suspected of infection by distributing ‘COVID-19 Standard Operating Procedure’ manuals, and we have trained our staff in these procedures. For our eye care services, we are providing these on an emergency basis only, yet despite this we are seeing increasing numbers of patients in our clinics. We have provided Personal Protective Equipment which are worn by our staff to minimise risks to the their health and safety.

States of emergency have now been declared across all the countries we work in, resulting in our clinics moving to an emergency setting. This means only the most urgent, sight-threatening conditions are being treated. Our focus right now is ensuring the safety of our teams in these clinics, sourcing Personal Protective Equipment and preparing new operating procedures. Our senior clinicians have been working with their local Ministry of Health Departments to support their planning and preparation for COVID-19.

As you are aware, a large part of the work we do involves training eye specialists. Last week as countries moved into lockdown, universities closed and we worked to return students to their home countries. Many will be asked to help on the frontline should the pandemic take hold. But until that time we are providing online lessons for our students so that this has minimal disruption to their medical training. We will need them more than ever once this pandemic passes.

Thankfully, many of the countries we work in have few, or no, cases of COVID-19, and while they have been able to take preventative steps that will hopefully save many lives, it will not be easy. As you may be aware Cyclone Harold is weaving an incredibly destructive path through the Pacific, severely hampering COVID-19 preparedness and causing heartbreak to many.

As the COVID-19 pandemic continues throughout the globe, we are ensuring the safety of our Pacific neighbours is of utmost priority.

The reason we exist as an organisation is because the health systems in these countries are still developing. Someone who is left blind by cataracts, might not be able to access eye care services due to limited medical professionals, facilities, supplies and equipment.

It is the same when we look at testing and treatment for COVID-19 by our Pacific neighbours. Their healthcare systems will reach full capacity a lot sooner than ours in New Zealand.

Thanks to the generosity of our kiwi donors, we have trained 300 eye doctors and nurses who are back in their home countries, working within their local health systems and helping prepare as much as they can for the COVID-19 pandemic.

We are staying in constant communication with our Pacific teams and will help them in any way that we can.

It’s an uncertain time but we must look after each other and our communities. As Fred once said “I believe the basic attribute of mankind is to look after each other”.

Our office in Auckland is now closed. However, our team are all working remotely to ensure the day-to-day functions of the organisation are successfully fulfilled.

This new way of working does mean we have certain challenges, primarily with the mail donations we receive from our wonderful supporters, as we have limited capacity to receive and open mail.

With this in mind, we would like to encourage you to try different ways of giving via our website or online banking.

Website
Donate on our website. Using your debit or credit card This is the easiest, safest and most secure way to donate.

Online Banking
The Fred Hollows Foundation NZ is already loaded as a payee through online banking. If you are set up for internet banking, all you need to do is write our name in the payee box and our account details will appear. You will be asked to include your donor number which is on all correspondence you receive from us.

If you would still prefer to give a mail donation, we would like to assure you that we will be able to receive it, but that it will take longer to process it.

Where we can, we try to use e-receipts for our donors, however, we know that a lot of our supporters prefer to receive donation receipts through the post. As previously mentioned, we are working through these processes but please expect a longer delay in receiving your donation receipt in the post. We are working as hard as we can to get these to as soon as we can.

If you want to contact the team to confirm a recent donation and receive an electronic receipt through email via PDF then please email us at info@hollows.nz.

If you would like to move to receive e-receipts permanently then please let our team know at info@hollows.nz.