The Pacific is a unique geographical challenge when it comes to staffing a medical workforce. Vast distances of ocean are dotted with approximately 25,000 scattered islands of which 1,500 are inhabited by humans.  The populations of these islands range from a single village to several million on Papua New Guinea. Placing eye care specialists on every inhabited island is neither feasible nor practical so the challenge remains how best to staff this “Blue Continent”.

In 2002 The Fred Hollows Foundation NZ teamed up with Solomon Islands Ophthalmologist Dr. John Szetu to address a region wide shortage of eye care specialists. At the time there was six ophthalmologists working in the public service across the Pacific and even fewer speciality eye nurses to assist them.

In 2006 and 2007 two mid-level practitioner training programmes were developed. The Postgraduate Diploma in Eye Care at Fiji National University is shortly to graduate its fifteenth year of students and the Advanced Diploma in Eye Care at Divine Word University in Papua New Guinea is to graduate its twelfth year of students. Since 2006 across the Pacific 266 mid-level practitioners have been trained to specialise in eye care from 15 countries: Cook Islands, Federated States of Micronesia, Fiji, Kiribati, Marshall Islands, Nauru, Niue, Papua New Guinea, Samoa, Solomon Islands, Timor Leste, Tokelau, Tonga, Tuvalu and Vanuatu.

Approximately 82% of these mid-level practitioners remain working in eye care.


The speciality training of ophthalmologists in Papua New Guinea has been ongoing from the late 1970s.

A second training programme for ophthalmologists supported by the Fred Hollows Foundation NZ began in 2007 at Fiji National University with a one-year Postgraduate Diploma in Ophthalmology which leads into a three-year Master in Medicine (Ophthalmology). Since then 17 ophthalmologists have graduated from the Master level and 15 eye doctors have graduated with the Postgraduate Diploma level from the following 9 countries: Federated States of Micronesia, Fiji, Kiribati, Samoa, Solomon Islands, Timor Leste, Tonga, Vanuatu and Cook Islands (Postgraduate Diploma level only).

As at the end of 2020 all countries above, apart from the Cook Islands, have at least one resident ophthalmologist based in the capital hospital and a team of mid-level practitioners spread across the country. Larger countries like Fiji have several ophthalmologists based at three divisional hospitals.

Continued work

All eye care teams service not only their base hospitals, but also have extensive outreach programmes to tackle the enormous challenge of patient accessibility. Although growth of the eye care workforce has changed the eyecare landscape, there still remains isolated populations to treat, remote hospitals to staff, and young health professionals to train.

Every single person living across the 1500 islands surrounded by the immense Pacific Ocean either will need or already need access to eye care and The Fred Hollows Foundation NZ will continue our work until this is made possible.

Dr Carole Poloso

Dr Carole at the Pacific Eye Institute Funded by the Fred Hollows Foundation NZ . March 2019 in Suva Fiji
Images Copyright James Ensing-Trussell 2019

Dr Carole Poloso trained at the Pacific Eye Institute in Fiji before returning home to Solomon Islands, to practise as a qualified Ophthalmologist. This is what the job means to her:

“As an individual, it means that I can fulfil my personal goals and, in doing so, contribute to improving the basic health needs of all Solomon Islanders.

On a professional level, it means that if I can attain this level of education, then so can others. So hopefully I can be a role model to young women Solomon Islanders to continue to strive to achieve their personal best, not just for themselves but so they can contribute to bettering the Solomon Islands.

On a family level, it means that as a wife I can help my husband support our family and as a mother to three girls, show my children that women can do almost anything they aim to.

As a daughter of the Solomon Islands, it means that I can contribute to my country’s health through the knowledge and skills that I have gained in my training, and aim to do so in a kind manner to instil hope in all who pass through my clinic doors.”