Tonga | The Fred Hollows Foundation NZ

Tonga

Patients waiting outside the clinic for post op assessment during The Foundation's surgical outreach to Tonga, in April 2017. Photo courtesy of James Ensing-Trussell.

Patients waiting outside the clinic for post op assessment during The Foundation's surgical outreach to Tonga, in April 2017. Photo courtesy of James Ensing-Trussell.

Tonga has a significant diabetes problem, of which 80 percent was undiagnosed in a survey undertaken in 2002.  One eye health worker was worried that her country was heading for a “blind population,” due to the poorly managed nature of the disease.

The Kingdom of Tonga consists of 169 low-lying coral and volcanic islands, of which 36 are inhabited. There are three main island groups - Tongatapu, on which the capital Nuku'alofa is situated, Vava'u, and Ha'apai.

A 1989 survey of blindness in Tonga estimated that the national prevalence of blindness was 0.56 per cent, with monocular blindness prevalence three times that. Cataract was responsible for 68.4 per cent of bilateral and 30.3 per cent of monocular blindness. Risk factors for cataract included age and (self-reported) diabetes. Most of the remaining visual impairment was caused by corneal opacity from infection or trauma, and diabetes.

Eye clinics at Vaiola Hospital in Nuku'alofa, and Prince Wellington Ngu Hospital in Vava'u, are staffed by four Foundation-trained eye nurses, one of whom - a health assistant - also trained at the Pacific Eye Institute in retinal laser treatment. This team works with the support and supervision of the country's lead ophthalmologist, Dr Paula Vivili.

Achievements 2013

  • Performed 829 eye screenings. 
  • Performed 268 sight-restoring surgeries during surgical outreach.
  • Planned an outreach for 2014. 

About our program

The Foundation has trained eight eye health nurses. They are well supported by otehr outreach teams and in country professionals. The Foundation's recent goals include providing service to outlying areas and equipping eye care facitlities. 

In the next few years, the main goal in Tonga would is to send doctors to the Pacific Eye Institute to gain a Diploma in Ophthalmology and Postgraduate Diploma in the Medical Management of Vitreoretinal and Diabetes Eye Care. Tonga has fulfilled its desired goal of four nurses with a Post Graduate Diploma in Eye Care, but would like two more eye health workers to complete the Post Graduate Certificate in Diabetes Eye Care.

Facts and figures

Eye health
Prevalence of blindness 0.7%
Number of eye doctors 0
Number of eye doctors needed 2
Number of eye nurses 4
Number of eye nurses needed 4
Number of diabetes eye nurses 4
Number of diabetes eye nurses needed by 2020 6
General health
Population 105,000
Urban population 23%
Life expectancy 71.5
Adult literacy rate 99%
Under-5 mortality rate (per 1,000 births) 13
Number of doctors (per 1,000 people) 5.63

Source: World Health Organization: Tonga, International Human Development Indicators: Tonga, UNDP.
NB: Number of eye nurses includes those trained by The Foundation currently working as eye nurses. Number of eye doctors includes all doctors with MMed.

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