Co-ordinated health delivery vital in Pacific, research shows

Transcript

The Fred Hollows Foundation which works to end avoidable blindness, says the work of two University of Auckland researchers will lead to a more co-ordinated approach to helping people with diabetes.

The students, from the School of Population and Health, Billy Wu and Mai Ling Gregory were investigating on behalf of the Hollows Foundation's Pacific Eye Institute.

The looked into what challenges affected service delivery for diabetics in the Suva area of Fiji.

They isolated a need for more integration of services and improved training and knowledge about diabetes and its impacts.

The Fred Hollows Foundation's executive director, Andrew Bell, told Don Wiseman the information will be valuable.

ANDREW BELL: It's really helpful to us, because, to just tell you a bit of the context, our knowledge of diabetes, it's sometimes referred to as the 'diabetic tsunami' because we're really just starting to understand this. New Zealand, Australia, round the world, diabetes and the impact it's going to have on public health systems, people are really starting to grapple with it. Back in 2010 we did research into eye health - what's called a rapid assessment of eye health - and we discovered then that 40% of Indo-Fijian males who are 40 years and older, have got diabetes through this process of eye health. So when you're looking at the eye and you find diabetic retinopathy, you've actually discovered advance diabetes. This is at the end stages of their diabetes, so it's very a very chronic health condition.

DON WISEMAN: These people would not be receiving treatment at that stage.

AB: No, they wouldn't even have known. So their diagnosis of diabetes was happening because they were having an eye test. That would not happen in New Zealand. You'd have your diabetes diagnosed because of the other symptoms that you were exhibiting. But in places like the Pacific and impoverished health systems, this was the outcome. So we're talking about Indo-Fijians, who traditionally are Hindu, traditionally vegetarian. Many people would think that diabetes is a result of poor eating. That's just not the case. We found that 40% of males 40 years and older had it. So that's dramatic. In New Zealand you're talking about a 5% incidence rate. So we discovered this dramatic incidence of diabetes. That's where this thing started. Now our latest research is showing that it could be as high as 25% across the whole population. That's huge. When a quarter of your population is suffering diabetes it's such a burden on the health care system. So we're sort of pushing this information back up the health system and saying, 'We're not going to be able to cope with the number of patients who require eye care if this goes untreated'. Because it's just going to be an avalanche of patients needing diabetic retinopathy treatment. So we're using this as a means of making the health system, making patients, making health care providers aware of diabetes so that we can start doing something about it in a comprehensive way, because really just as eye care professionals, we can't do the whole task alone. We need to get the others on board, as well.

DW: So just pointing again to improved co-ordination, improved education, things, of course that are being undertaken by a number of other groups around the Pacific.

AB: Yes, but not in an integrated way, as diabetes is not one of the things many people are doing things about. The World Diabetes Foundation is one of them. There are foundations here in New Zealand, foundations in the Pacific, but really under-resourced and struggling just with the sheer magnitude of the task at hand. And so we're all needing to work together to talk about the essential features of the public health system, which is access to patients, integration of treatment, meeting the demand and working on prevention. That's the only way you can manage a public health system.