KEY POINTS:
This month marks the 15th anniversary of the death of a celebrated Kiwi, Fred Hollows.
An eye surgeon and outspoken campaigner for social justice, he was recognised as Man of the Year in Australia, but went largely unacknowledged in his home country.
Mr Hollows spoke out for the right of all people to receive health care, and particularly care related to eyesight. He was a charismatic leader, and a foundation in his name was established to continue his fight.
Fifteen years on, in our Pacific neighbourhood from East Timor and Papua New Guinea to Polynesia, as many as 50,000 people remain blind for want of a cataract operation. Hundreds of thousands more simply need spectacles to restore their vision.
A cataract operation can be performed under local anaesthesia in about 20 minutes. A pair of prescription spectacles can cost as little as a few dollars. That these life-changing procedures are not available to so many Pacific Island people begs the question: why?
Here are some answers. Measures of health in the Pacific region paint a picture that would shock most New Zealanders. In New Zealand, the heartbreak of a child dying before his or her 5th birthday affects six families for every 1000 children born.
In PNG, 93 children out of 1000 die before they are 5. Port Moresby General Hospital has a room set aside for families to wail by the side of their dead child.
It is difficult to imagine a more harrowing sound. The room is never empty.
The tranquil images of islands and clear waters that entice Kiwi tourist dollars mask the health realities in the Pacific. In Fiji, childbirth kills 10 times as many women as in New Zealand, and 20 children in 1000 die before they turn 5.
Vanuatu loses 40 children per 1000 born, Solomon Islands 56 and Samoa 30. In all these countries, the average person lives 10 to 20 years less than the average Kiwi.
Within this short life span, they suffer greater disease and disability, including blindness.
Kiwis pride themselves on their sense of fair play and equal opportunity. But while the New Zealand Government can spend about $1600 a person each year on health, the PNG government spends about $25, East Timor $35, Fiji $85 and Vanuatu $50.
It's hard to run functional health systems on so little money, and it's even harder when their nurses and doctors migrate to developed countries.
New Zealand has one doctor for every 440 people and a nurse for every 130 people. PNG has one doctor for 22,000 people and one nurse per 2100.
Economic reforms throughout the 1990s in PNG (and other Pacific nations) saw the health budget cut repeatedly. Over a 10-year period, half the country's health centres closed.
The distance people had to travel to receive the most rudimentary health care doubled - leaving many people walking for four days to their nearest clinic, which likely had no drugs, bandages, or even a skilled health worker.
Salaries were often not paid, and many nurses understandably just walked off the job. Meanwhile, doctors were easily lured overseas, often to rural posts in Australia, where in comparison they received attractive salaries and conditions.
Although PNG has trained more than 445 doctors since 1973, just over half are at present working in the country.
Similarly, between 1987 and 2002, Fiji lost more local doctors than it trained, leaving the country of nearly one million people with only 271 doctors.
Again, many ended up in New Zealand and Australia. That this leaves so few doctors in the Pacific is an issue of social justice.
Ways to reduce this migration are being implemented by the Fred Hollows Foundation New Zealand in the Pacific. One way is training nurses and doctors in teams and in association with local universities, so that their degrees are recognised by employers and given increased status.
Another is improving working conditions with functioning equipment and efficient systems.
Regional networks are being built so eye-care personnel can support each other.
This is making a difference, and with more Pacific eye doctors and nurses now trained, many more Pacific people are having their sight restored.
Sir Edmund Hillary, until his death last month, was the patron of the Fred Hollows Foundation New Zealand. Sir Ed shared Mr Hollows' commitment to leave the world a better place.
Speaking at a Fred Hollows Foundation NZ dinner a couple of years ago, Sir Ed described his few minutes at the top of the world, where he studied the profile of an unconquered neighbouring peak, trying to identify a new route to its summit.
Sir Ed wasn't resting on his laurels, basking in glory. Both Sir Ed and Mr Hollows used their personal achievements and leadership to make the world a better place for others.
The New Zealand Government also has a responsibility to make sure its neighbours get a fair deal in all aspects of health.
These could include supporting moves to see that Pacific countries are compensated when their health workers are lured away to developed countries.
The Government could honour its international commitment to increase its aid budget to 0.7 per cent of gross domestic product.
Giving health initiatives a greater portion of the aid budget could make a positive step to changing people's lives for the better.
Let's follow a couple of remarkable Kiwis and refuse to turn a blind eye to tragedies so close to home.
* Carmel Williams is executive director of the Fred Hollows Foundation New Zealand, a non-government organisation aimed at eradicating avoidable blindness in developing countries. Visit its website, www.hollows.org.nz
