East Timor Eye Program evaluation

The East Timor Eye Program (ETEP) is one of the RACS Global Health Programs and is supported by the RACS Timor-Leste Country Office. It is situated in Hospital Guido Valdares Nacional (HNGV)—the national hospital in Dili. In 2021, this successful program was independently evaluated by the Nossal Institute for Global Health with the evaluation noting: ‘Perhaps the most impressive element of the approach, and a major contribution to efficiency, has been the extent of collaboration and partnership among those organizations and individuals engaged in supporting the eye health sector, including local and international NGOs, WHO, and international eye care professionals. This has resulted in a consistent and integrated approach to the development of eye care.’ Since its establishment in 2000, the ETEP has supported the Government of Timor- Leste and the HNGV to manage and develop eye care services focusing on cataracts, refractive error, and ocular trauma.

The ETEP delivers a wide-ranging set of in-country training activities in ophthalmology, optometry, eye care nursing and allied eye health specialties. It also facilitates capacity building of the national eye health workforce through education and clinical service delivery coupled with on-the-job mentoring and training. The context for eye care and health services in Timor-Leste has been evolving over the period of support provided through the various iterations of the eye care projects. The key aspects of that evolving context have been the development of eye care and health system strategies by the Ministry of Health (MoH) and the increasing capacity of the ministry to deliver health services, including eye care services. The current ETEP program for the period 2017 – 2023 sets out to achieve the reducing of preventable blindness in Timor-Leste. The program aims to help Timor-Leste build a sustainable and effective eye health system for the East Timorese people. The current focus of the ETEP is to:

• work with the National Eye Centre and

MoH to establish district clinics • focus on workforce planning and capacity building of the eye health workforcethrough formal education and participation in clinical services.

This includes scholarships for domestic postgraduate studies and overseas specialist training in ophthalmology • support the provision of general and sub-specialty eye health equipment and instruments, improvements to patient record management systems, and referral pathways including training for district GPs. In assessing the contribution of the ETEP, the evaluators have considered the longer trajectory of the program

in the context of the support and contribution of the previous programs. The ETEP has contributed to building the capacity to provide eye care at all three levels in Timor-Leste. This has been necessary, as the three levels of care are interdependent. The ETEP contribution has also evolved and developed, in line with the progressive development of Timor-Leste’s health system. The ETEP delivered a range of training activities in ophthalmology, optometry, eye care nursing and allied eye health specialties i.e. eye care technicians and a national ocularist. It also facilitated capacity building of the national eye health workforce through education and clinical service delivery coupled with onthe-job mentoring and training. A key element of the ETEP success and sustainability was to bring together the various international donors and individuals with technical expertise, and the key international organisations— notably the WHO office—in a coordinated program, rather than a series of potentially competing programs. The various iterations of the ETEP provided a coordinating framework that encouraged and enabled this cooperation. The East Timor Eye Program (ETEP) was founded by Australian ophthalmologist, Professor Nitin Verma, a Companion of the Royal Australasian College of Surgeons and President of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). Initially, the focus of the ETEP was to provide essential ophthalmic services in the post-independence era. Over the years, the scope of the program has expanded beyond service delivery and now focuses on training, capacity building and supporting the strengthening of health systems. To recognise and celebrate 20 years of great work, a limited-edition book East Timor Eye Program, celebrating 20 years was created. Full of firsthand stories of hardship and triumph, challenges, and successes it’s a must-have for your library. You can buy the book and support the Global Health’s work by logging into the website and visiting the RACS shop (http://store.surgeons.org/customer/ account/login/) If you would like more information about ETEP, or RACS Global Health initiatives please visit https://www. surgeons.org/about-racs/global-health

Limited-edition book East Timor Eye Program, celebrating 20 years released

Since 2000,the ETEP has: • supported the training of Timor-

Leste’s first three national ophthalmologists • trained nine East Timorese doctors in country with a postgraduate Diploma in Ophthalmology • trained eye specialist nurses, eye care workers, biomedical technicians, hospital administrators and community doctors in primary eye care

• equipped the Hospital Nacional

Guido Valadares Department of

Ophthalmology with a full range of sub-specialty ophthalmic equipment • established the national Prosthetics

Eye Lab and trained the first Esat

Timorese ocularist

• provided ongoing mentoring support to East Timorese eye health workers across the health system • played an integral advocacy role, which culminated in the launch of the

National Eye Health Strategy 20202050 by the Timor-Leste Ministry of

Health in September 2020.