Royal Australasian College of Surgeons (RACS) interview with Nefriana Buta Rade (Nefri), Sumbanese Eye Care Nurse
Sumba is an Indonesian island in the disadvantaged province of Nusa Tenggara Timur (NTT) that has limited local access to ophthalmology, optometry and
specialist eye care services. Eye disease and refractive error remain largely untreated in the province and many people continue to live with avoidable vision impairment.
The Royal Australasian College of Surgeons (RACS) managed Sumba Eye Program (the Program), founded by Ophthalmologist Dr Mark Ellis FRACS and Optometrists Peter Stewart and Peter Lewis, recruited two Sumbanese residents and has been supporting their training in eye health care and refraction since 2013. The Program, which has provided over 9,000 consultations and performed 1,400 life changing operations for the Sumbanese community since 2007, conducts biannual visits to the island to train and mentor the national eye care workers and provide specialist eye services for the population. With an initial focus on service provision, over time the Program has increased its focus on teaching and training of Indonesian health personnel in an effort to help establish a sustainable local infrastructure for eye care in Sumba. The eye care workers are employed by RACS partner organisation, the Sumba Foundation, a local non-government organisation.
During the Program visit to Sumba in August 2016, the RACS team sat down with one of the eye care workers, Nefriana Buta Rade or ‘Nefri’ as she is fondly known, to talk about her experience as an eye care nurse in Sumba.
What made you want to learn about eye care? What are your professional interests/passions?
My interest in eye care started years ago when I observed that an increasing number of people in Sumba do not have access to medical facilities and this includes eye care services. There were increasing numbers of locals with eye problems who are just not able to get help. This is due to the economic situation and living conditions in Sumba where most are from the rural villages and do not have a consistent source of income. They live on bare necessities and are not able to afford basic health checks or medical care. The lack of access to medical facilities is the root cause for the increasing eye problems in Sumba. I would estimate that close to 50 per cent of the population is affected by eye problems such as cataracts, which are most common.
You completed a training attachment at the John Fawcett Foundation in Bali with funding support from the RACS Sumba Eye Program over three years ago and have been working as an Eye Care Nurse with the Sumba Foundation since then. What has changed for you now that you are an experienced eye care nurse?
Before becoming involved with the Sumba Eye Program, I didn’t have any nursing training. Previously I worked in Public Health as an administrator. I feel blessed to have been given the opportunity to be trained as an eye care nurse, pursue a career in eye care and contribute to improving eye health care in my community. Since completing the training, I am able to diagnose and detect different eye problems in patients, report the different issues and provide interim solutions for some of the patients while waiting for specialist help. There is a sense of fulfilment being able to help the people of Sumba with their visual problems.
What is the most important contribution you can make as an experienced eye care nurse in Sumba?
Early detection of some of the major eye issues is important for patients during the early stages before the problem worsens. With the experience I gained over the years, this has allowed me to provide accurate clinical advice and refer them appropriately when the RACS Sumba Eye Program team visits to get the specialist help they need.
How has the Sumba Eye Program helped you over the last three years?
The Program has helped me a lot over the last three years. It is an ongoing learning experience but the Sumba Eye Program has helped my career development in health care for which I am really thankful. I can now confidently detect certain eye issues like retina problems or glaucoma, which previously I never thought of doing. The Program has certainly assisted me to become a more accomplished and experienced eye care nurse. I am able to put in practice what I have learnt and help my people access medical services especially in eye care.
Have you been involved in training your colleagues at the Sumba Foundation in eye care? What can you teach them from your experiences?
I am able to help my colleagues when they are doing preliminary eye checks on patients. I can confidently guide them to check the various conditions when doing the initial screening and help them to better understand the situation as well as providing an appropriate solution for the problem.
What is your vision for eye care and/or health care in Sumba?
There isn’t much I can do to change the living conditions of the people of Sumba. Most of them are farmers and this has been their livelihood and way of life for a long time. But I would like to see a fully functional eye clinic based in Sumba and a growing number of trained eye care nurses. This will help in facilitating the mobile eye screenings and reach out to more people in the various parts of Sumba. In time, I hope there will be a decrease in eye problems especially amongst children as they are the future generation of Sumba.
The Sumba Eye Program is supported by the Royal Australasian College of Surgeons, with funding kindly provided by Optometry Giving Sight, Rotary Clubs of Glenferrie and Kew, The Sumba Foundation, Kabo Lawyers, Watiga & Co., the Wilkinson Foundation and private donors.
This article appeared in RACS Surgical News, October 2016 issue