26,066 pairs of glasses would go a long way to help fixing Indigenous eye health. Additionally, 39,292 annual eye examinations for diabetic retinopathy and 4,382 cataract surgeries would be needed. These are the findings by the University of Melbourne School of Population and Global Health in the current issue of the Australian Journal of Rural Health (AJRH).
The study was led by Dr Ya-seng Hsueh and Professor Hugh Taylor. They estimated the extent of the additional expenditure needed to overcome the eye health gap faced by Aboriginal and/or Torres Strait Islander peoples. If the funds cannot be found to provide for the examinations, surgeries and glasses then something is very wrong with Government decision-making and polices and it will make a mockery of the swathe of claims that Governments only need to know exactly what to spend funds on in order to address Indigenous disadvantage.
“Although Indigenous Australian children have better vision than non-Indigenous children, the rate of blindness of Indigenous Australians aged 40 and above is six times higher than for non-Indigenous Australians,” said Professor Taylor.
“Moreover, 94 per cent of this vision loss is either preventable or treatable.”
The Fred Hollows Foundation works around the clock to do what it can to improve eye health in remote communities, with for instance cataract and retinal surgeries and in its work with trachoma. Governments could fully fund such organisations to end all unmet need. During the 1960s and 1970s the late Dr Archie Kalokerinos argued with Governments for funds and programs to end glaucoma among remote Aboriginal peoples. He was effectively ostracised. It has long been argued that we have moved away from this racism by neglect, but have we?
40 years later, Professor Taylor reminds me of Dr Kalokerinos when he urges Governments to pay attention. Hopefully his study and recommendations do not fall on deaf ears.
“We know that 35 per cent of Indigenous Australian adults report that they have never had an eye examination, compared with just 8.9 per cent of the generation population. There are an estimated 3,300 Indigenous adults who are blind and another 15,000 with low vision.”
“Four conditions – cataract, refractive error, diabetic retinopathy and trachoma – cause the vast majority of vision loss in Indigenous Australians.”
There is however some specific funding for trachoma, because of its very high incidence in Aboriginal and/or Torres Strait Islander communities, but not enough in order to eliminate unmet need but the other conditions do not have the equivalent proportion of specific funding that trachoma does.
The study developed a comprehensive costing model to estimate the current spending and additional funds required to close the gap for vision. The three major eye conditions that cause the majority of vision loss to Aboriginal and/or Torres Strait Islander peoples can be fully addressed with $45 million per annum. Currently only $17 million is being spent on these three conditions per annum.
Professor Taylor said if the ante was upped by the $28 million differential that it “is only a small fraction of the overall Australian health budget.”
Professor Taylor said existing services could be used to channel people and save on costs.
“There are Government programs to meet the challenges of the eye health gap, but many Indigenous Australians do not use them.”
“Accessing eye care is complex. There are multiple layers of service and multiple entry points to the eye services in the Australian health care system. Clinical pathways for treatment of eye conditions often involve multiple steps and appointments for appropriate treatment.”
The study considered the total workforce required for adequate eye care coordination. Dr Hsueh said that 8.3 full time personnel per 10,000 Aboriginal and/or Torres Strait Islander peoples would be required. He said that this cost $21.3 million annually but that this amount was part of the total $28 million differential.
“This would provide critical resources to make the eye gap effectively closed by assisting patients with ancillary tasks including transport, organising clinics and assisting with hospital attendances,” said Dr Hsueh.