Ishmeen Dhaliwal (right) with ophthalmic nurse in training Annie Rofeta at the Pacific Eye Institute in Fiji

One of the main reasons I chose to study optometry was a deep desire to help improve healthcare outcomes in local communities. So when Specsavers announced its annual outreach programme and the opportunity to assist with the Fred Hollows Foundation New Zealand’s work in Fiji, I was quick to put my hand up.

I spent just over a week in Fiji, helping to train nurses and health extension officers, studying a one-year postgraduate diploma in eyecare at the Pacific Eye Institute, to improve their refraction skills and assisting with community screening in Nadi. I met and worked with ophthalmic nurse students and patients from different backgrounds, which really highlighted the barriers to access in rural healthcare across the Pacific. Most of the nursing students had left their homes and families to train with the foundation and would eventually return to their communities – often as the sole eyecare provider in their region, both inside and outside Fiji.

On the community screening day, I joined The Fred Hollows Foundation NZ’s famous Mobile Eye Clinic which is based in Nadi. In one day, my colleague and I saw 40 patients each – the usual number for daily screenings, we were told. The Mobile Eye Clinic team visits different locations around Fiji throughout the year, hosting community screenings to enable people who are unable to travel to access eye exams. As well as screenings, the clinic also provides diabetes eye injections and some surgery, including more than 700 cataract surgeries a year.

Most of the patients I saw had never had their eyes checked before. As anticipated, there were many dense cataracts that needed surgery. One lady could not walk without assistance from her son due to being almost blind with bilateral white cataracts. A lot of the patients who were screened also had other health issues, such as high blood pressure and poorly controlled diabetes. Giving them prescription spectacles improved their vision but not to the extent it would have been, had the damage from diabetic or hypertensive retinopathy been avoided by earlier screening and management. However, due to the lack of healthcare resources in these rural communities and the genetic predisposition many had to these conditions, this will be tricky to overcome. Another patient, a six-year-old child had central scarring on his eyes due to vernal keratoconjunctivitis because of allergies. The extent of the damage meant his vision could only be improved partially with spectacle correction.

These cases really highlighted why The Fred Hollows Foundation NZ has a real focus on increasing the number of healthcare practitioners in these communities to increase awareness about eyecare, manage vision problems and protect people’s sight. Contributing to the community screening day was the highlight of my experience. It was satisfying being able to share my skills and knowledge and knowing that might translate to long-term, positive outcomes for many people. However, I did face some barriers, including language and lack of equipment, but it was great to be pushed out of my comfort zone. The experience also helped me improve my own skills in areas I would not have come across so readily in normal day-to-day practice.

The Foundation staff were helpful and welcoming, from checking in regularly during clinics to sharing meals at lunch. By working closely with them, I gained a far better understanding of Fijian culture and the local healthcare system, which motivated me to contribute as much as I possibly could. It was also my first time in Fiji, so I loved experiencing a new culture and applying my skills in a new environment. I would love to partner with The Foundation again in the future so I can continue learning as well as contributing more to these communities.

I am very thankful that Specsavers selected me to be a part of this outreach and would like to encourage more optometrists to apply for similar opportunities as it was very rewarding.

Specsavers and The Fred Hollows Foundation NZ

• Specsavers has supported The Fred Hollows Foundation NZ since 2009
• During this time, it has donated more than $1.1m to the Foundation, most of which was earmarked for the ongoing operational costs of the Mobile Eye Clinic
• Specsavers hosts several teams of optometrists on outreaches to experience and contribute to The Foundation’s work each year. To date, almost 60 optometrists have participated in the Pacific outreach work
• The majority of Specsavers’ outreach trips assist The Fred Hollows Foundation NZ’s training efforts at the Pacific Eye Institute in Fiji and the Divine World University in Papua New Guinea

Ishmeen Dhaliwal has been an optometrist at Specsavers Dunedin for the past three years. She is passionate about increasing awareness in rural communities about eyecare and mentoring graduate optometrists.