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Annual Report 2014

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At times, how we tell the story of eliminating avoidable blindness makes it sound all too easy. The cataract procedure takes 20 minutes and patient recovery takes 24 hours. The next day, a blind patient sees again. Our intention is not to diminish the dexterity with which the doctors and nurses perform the surgery nor take lightly the huge commitment they show to travel to out-of-the-way places to perform ‘the miracle’. Rather we are trying as best we can to allow our faithful supporters to actively

participate in the work that they so generously support.

As the number of graduates from our training programs increases each year, so we have been faced with another challenge. If they are to perform this delicate surgery in high volumes and within nascent eye health care systems, they will require specialist support to do so.

Our Workforce Support program is a unique feature of The Foundation’s Work, and in 2014 it went from strength to strength. No other eye care charity supports their eye doctors and nurses to continue their work in the years following their graduation. We help our staff advocate for funds and equipment, to remain resilient in the face of competing health care demands, and to stay abreast of new developments in eye care despite the resource limitations in their respective countries.

Without the generous support of our donors and professionals who often give their expertise at heavily discounted rates, we would never be able to provide the training required to grow our eye doctors and nurses into healthcare leaders. Thank you for helping to achieve Fred’s vision of a world where no-one is needlessly blind. I am proud to present to you, through this Annual Report, the progress we made in 2014.

Our ambition to rid the Pacific of avoidable blindness came closer to reality in 2014.

It was a milestone year for The Foundation, thanks to the dedicated support of our generous New Zealand donors, the New Zealand Ministry of Foreign Affairs and Trade and the Australian Department of Foreign Affairs and Trade.

We initiated three significant infrastructure developments, of which we’re very proud.

• The construction of a new theatre complex – largely financed by a generous bequest – in Madang, Papua New Guinea. This and a renovation of the existing clinic will have a significant impact on avoidable blindness in the country.

• The Pacific’s first mobile eye clinic in Fiji is a fantastic example of New Zealand innovation funded entirely by our public supporters. The clinic is now underway and seeing extraordinary numbers of patients.

• Our most ambitious development was made possible with the support of the New Zealand Aid Programme who committed NZD$4million for the construction of a Regional Eye Centre for Honiara, Solomon Islands.

During the year I stepped down as chair of The Foundation following a serious health scare. I am extremely grateful to Craig Fisher for taking over the role at short notice and I have every confidence The Foundation will strengthen under his leadership. My thanks to fellow trustees for their support and wise counsel; to the outstanding, high performance team under Andrew Bell’s leadership and finally to our growing family of generous donors without whom nothing would be possible.

It has been a great privilege to follow in Fred’s giant footsteps in his quest to beat the ogre of avoidable blindness.

Rob Fenwick CNZM ChairAndrew Bell Executive Director

Forewords

Photos: Michael Bradley

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1. Restore sight We perform thousands of sight-restoring surgeries and treatments every year at our clinics and through our surgical outreach program into underserved communities.

2. Train doctors and nurses Training local eye doctors and nurses is the only way to eliminate avoidable

blindness in a sustainable way. We provide specialist medical training to local doctors and nurses so they can take over the sight-restoring work carried out

by visiting surgical teams.

3. Build local eye care systemsOur graduates often return home to work in challenging and professionally

isolating environments. We provide ongoing logistical and technical support so they can deliver high quality eye care while continuing to improve their skills.

4. Ensure our approach is tested and effectiveWe aim to have the greatest possible impact on avoidable blindness with the resources we have. We are committed to ensuring our eye care programs are

locally appropriate and meet international best practice.

What we do

Vision

The Fred Hollows Foundation works for a world where no one

is needlessly blind.

Goal

To restore sight to the needlessly blind through the

provision of sight-saving surgeries and treatments, and by training local eye health specialists to deliver eye care services in their own communities.

Photo: Zoomfiji Photography

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Impact report

In 2014, we’re proud to have achieved the following results for the people of the Pacific, Papua New Guinea and Timor-Leste.

1,498Diabetes laser

treatment sessions

Restoring sight

Outreach

39 Outreaches across the Pacific, Papua New Guinea and

Timor-Leste

6,307 Sight-restoring surgeries

were performed

59,936 Patient consultations, with an eye care

worker who checked their eyes

12,279 Pairs of spectacles dispensed

Overcoming diabetic retinopathy

27Trained local eye care workers graduated; returning to their

communities to help more needlessly blind people see

Training

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Country highlights

Vanuatu398 surgeries and 23 diabetes laser sessions performed on 4 outreaches

Solomon Islands 57 surgeries performed on 1 outreach

1,046 surgeries performed by Pacific Eye Institute graduates

Fiji1,779 surgeries and 1,419 diabetes laser treatment sessions performed

4 training outreaches

19 students from across the Pacific region graduated from our Suva-based Pacific Eye Institute

Samoa265 eye surgeries performed on 2 outreaches

Papua New Guinea8 eye nurses graduated from our training program in Madang, in partnership with Divine Word University

992 sight-restoring surgeries performed

Timor-Leste1,160 sight-restoring surgeries performed

13 outreaches to rural locations

Tonga214 surgeries performed on 2 outreaches

Kiribati Dr Rabebe Tekeraoi is the first i-Kiribati eye doctor to graduate from the Pacific Eye Institute

298 surgeries and 44 diabetes laser treatment sessions were provided over 2 outreach visits

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Bibiane is a brave and determined woman from a remote village in Papua New Guinea. She’s unsure of her age, but remembers soldiers visiting her village during World War II. Cataracts in both her eyes meant that Bibiane was forced to leave her home village and go to live hours away with her daughter. She was no longer able to grow her own food, move around, or take care of herself, making her completely dependent on her family.

“I feel sorry for my family and grandchildren having to look

after me. My family do things like bringing me to the toilet and staying with me until I sleep. Before, when I could still see, it wasn’t like this. I think, what’s wrong with me?”

“When I tried to cook food on the fire, the food got burned, because I couldn’t see anymore. I couldn’t see the house, the road, nothing.”

When Bibiane found out about The Fred Hollows Foundation NZ clinic in Madang, she felt the first stirrings of hope that her sight could be restored.

“They told me ‘If you go to the doctor, they can clean your eyes so you can see again.’ So I dressed up in my best clothes and I went.”

The surgical team at the clinic was able to restore sight in both Bibiane’s eyes, and what a transformation! Bibiane returned home a different woman – able to look after herself again, contribute to her household and share the songs and stories of her village with her grandchildren. She was overjoyed.

“Now I can see clearly. I am thankful for the doctor and the work he did. I can cook, go to the river, bathe, go to the toilet. That’s what makes me happy.”

Bibiane’s story

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Photo: Vlad Sokhin

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Diabetes

Diabetic retinopathy (DR) affects approximately one-third of people with diabetes. The delicate retinal blood vessels multiply or weaken

and expand, leak or bleed, resulting in scarring in and about the retina (the ‘seeing’ layer of the eye). This results in the gradual and painless

loss of vision in one or both eyes. Sight loss through DR is irreversible but can be arrested and sight preserved with laser treatment.

1. IDF Diabetes Atlas 6th Edition Update 2013, International Diabetes Federation, available at: http://www.idf.org/sites/default/files/EN_6E_Atlas_Full_0.pdf.

Diabetes is one of the most challenging health problems of the 21st century.

Photo: ZoomFiji Photography

- Fiji -• 1,419 laser treatment sessions

were performed at our Suva-based diabetes clinic

• 3 successful diabetes-focused outreaches were completed

• Fortnightly eye screening outreaches took place in health centres around Suva detecting problems before they threaten to rob patients’ sight.

Complications due to diabetes are a major cause of disability, reduced quality of life, and death. Of the ten countries with the highest prevalence of diabetes in the world, seven are located within the Pacific.1 Approximately one-third of people with diabetes develop some degree of diabetes-related eye damage, or retinopathy, which can cause blindness.1 Throughout 2014, our team of specialist staff was involved in an extensive period of service delivery, situational analysis and planning, so we continue to expand the reach of our doctor and nurse training and services for patients with diabetic retinopathy. In 2015, our newly appointed Pacific Diabetic Retinopathy Coordinator will be driving activities in this area.

- Regional -• Diabetic retinopathy

specialist Dr Harris Ansari accompanied the Pacific outreach team working in Kiribati and Vanuatu.

- Solomon Islands -• Preparations for opening a new diabetes

clinic at the Regional Eye Centre in Honiara in 2015

• Training will be held in 2015 at the Regional Eye Centre in Honiara in partnership with the World Health Organisation and funded by the World Diabetes Foundation to strengthen the integration of eye care into diabetes programs

• Diabetes treatments will be provided on nationwide outreaches from 2015.

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Infrastructure

New operating theatre - Papua New Guinea -

This piece of infrastructure stands alongside a recently refurbished clinic in Madang, and is set to double the amount of people who can get their sight restored in the region. The operating theatre was designed and built by New Zealand specialists Timber Construction Solutions International (TCS) with concepts by Bossley Architects. The costs of building and materials for the new clinic were largely covered by a generous bequest. Our heartfelt thanks to TCS, Bossley Architects, Boyd Visuals and Optimed for their support in making this theatre a reality.

Mobile eye clinic - Fiji -

Designed, produced and funded by New Zealanders, the newly-launched mobile eye clinic is the first of its kind in the Pacific region: a state-of-the-art facility which travels to rural areas in Fiji, providing sight-saving services to blind people in need. The clinic is a one-stop-shop for free eye checks, cataract surgery, diabetes laser treatment and a range of other eye conditions.The clinic will help to eliminate an enormous hurdle in eye care: access to services. We’re taking it straight to our patients, going into remote communities where people won’t have to travel so far to get help. The clinic was designed and built in Hamilton by Action Motor Bodies.

Regional Eye Centre - Solomon Islands -

The Regional Eye Centre opens in 2015 and will allow thousands of people to receive quality eye care for decades to come. The Honiara-based Centre will provide free eye care services to Solomon Islanders, in addition to functioning as a regional facility where eye care professionals can come to gain specialist expertise. Staff will also be available to conduct outreach clinics in neighbouring Pacific countries.

The Centre represents a tripartite collaboration between the governments of Solomon Islands and New Zealand with The Foundation, and was sustainably designed and constructed. Immense thanks to What Power Crisis, Flocon, the World Diabetes Foundation and the Queen Elizabeth Diamond Jubilee Trust for their support.

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Over 39 outreaches across 9 Pacific Island countries, our

dedicated eye health professionals consulted 11,698 patients,

performed 2,596 surgeries and dispensed 4,097 pairs

of spectacles to eyes eager to see.

For the first time, the Pacific Outreach Team provided services in the Federated States of Micronesia, where a busy two weeks saw 536 patients come through the doors. Meanwhile, three diabetic retinopathy outreaches in Fiji and the addition of diabetic retinopathy services on our regional outreaches strengthened our response to the rapidly growing demand for laser treatment across the Pacific.

The obstacles faced by the Outreach Team are part of what makes their work so outstanding. In 2014, the team faced severe conjunctivitis, dengue and measles outbreaks, floods and visa problems, in addition to disrupted travel schedules and power cuts. Despite the hurdles, the transformative results of their work continue to reverberate throughout the Pacific region and on the smiles of patients’ faces.

Outreach

Every year we send eye doctors and nurses to remote Pacific communities, opening up new places to the benefits of quality eye care. This is one of the best ways to

eliminate avoidable blindness and address the eye care needs of the region.

“Patients who have received sight from previous outreaches advocate that no, cataracts are not a part

of ageing. We don’t have to be blind during old age.” - Dr Mundi Qalo, Outreach Team Leader

Photo: Vlad Sokhin

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Education & training

“I enjoy everything about eye care – it’s great being able to concentrate on just one area and really doing it well.” DR SAVELINA VEAMATAHAU

Training eye doctors and nurses in the Pacific is a key part of The Foundation’s strategy, building local leadership in eye care to sustain communities for decades to come. In 2014, 27 eye health professionals graduated from our training programs at the Pacific Eye Institute in Fiji and the Divine Word University in Papua New Guinea. These graduates have returned to their home countries, ready to provide thousands of people with quality eye care.

Our unique and highly successful Workforce Support program ensures our graduates remain motivated and at the top of their game. We provide upskilling opportunities through workshops, one-on-one clinic visits and hands-on outreach experiences, as well as providing essential equipment and health system strengthening support. Our team of graduate eye doctors and nurses are committed to staying at the forefront of eye health, so that patients receive the very best care possible.

Dr Rabebe TekeraoiOPHTHALMOLOGIST, KIRIBATI

Dr Rabebe is the first ever eye doctor for Kiribati, having graduated from the Pacific Eye Institute in 2014. With limited resources in her home country, workforce support is key in helping Dr Rabebe to keep her skill set current. Along with two eye nurses, she is helping to build an eye care system from humble beginnings.

“Right now I’m excited and I know it will be a big challenge. It’s something new, so things will take time. I love surgery. Sometimes I look at the patients waiting and think, if they can wait for this long, maybe I can wait for this long too. Because I know what they waited for, they want sight. That gives me hope.”

Savelina Veamatahau HEALTH EXTENSION OFFICER, TONGA

Savelina graduated to a standing ovation from the Pacific Eye Institute in 2010 with a Post Graduate Certificate in Diabetes Eye Care. Because there was no trained eye doctor in Nuku’alofa to deal with the heavy burden of diabetic eye disease, she received specialist training to deliver diabetes laser treatments. Savelina’s dedication and knowledge have had a profound impact on the needlessly blind people in her community.

“I enjoy everything about eye care – it’s great being able to concentrate on just one area and really doing it well.”

Photos: Topic / James Ensing-Trussell

Karae RovoBoiBoi is a strong, proud man, a chief in a remote pygmy village in Vanuatu. But for three long years, cataracts robbed Karae of his ability to look after his people or provide for his children.

Karae’s story

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Photo: Topic / James Ensing-Trussell

Karae heard our eye care team was coming to perform cataract surgery and restore sight to the people, but had to wait another year for our doctors and nurses to make it to his island.

When the time finally came to make the journey to our outreach clinic, Karae traveled through hills and dense jungle. A three-day walk turned into a week-long ordeal, while he relied on the support of his cousin (who was blind in one eye), to lead him safely through the terrain.

Every uncertain, barefoot step took the brave chief down steep mountains, over huge logs and branches and around sharp

rocks. Unable to see, at the end of his journey awaited the foreign mystery and fear of the surgery on his eyes.

When Karae arrived at the clinic, he was reserved and sat quietly waiting his turn. However, once the surgery was over and the bandages came off, his whole manner changed. He became a smiling, effusive man who wanted to share hugs and handshakes with everyone. He gazed in wonder at the jungle that had been hidden from him for so long, at the birds he could see sitting in the trees above. He was overjoyed to know that in just three days he could complete the return trek on his own,

unaided. He returned to his family and community a whole man, walking proudly. Karae’s restored vision means he can see to lead his people confidently, rescued from the gnawing fear that he would never see again, that his life as a chief was over.

“I can see many things!” he said. “I’m so glad that I can see. The eye doctors are incredible. Thank you to the people of New Zealand! Thank you so much. Now I can be chief to my people again.”

Restoring Karae’s sight gave him back his dignity, his freedom, and his purpose in life.

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2014 Financial report

Independent audit report: The information in this report has been summarised from the annual accounts of The Fred Hollows Foundation NZ for the year ending 31 December 2014. The full audit statement is available at hollows.org.nz or by emailing info@hollows.org.nz.

Interest & Other Income $315,341 miscellaneous

Government grants Grants $7,072,359

Donations Bequests $1,033,733 (7.5%)

Donations $5,382,842 (39%)

Programs Program activities $9,952,993

Fundraising & Fundraising, Initiatives & Donor Care $1,679,251 (12.5%)

administration Communications $166,902 (1.2%)

Administration expenses $661,484 (4.9%)

Public Education $932,940 (7%)

TOTAL INCOME

$13,804,275

2%

51%47%

TOTAL EXPENDITURE

$13,393,570

74%

26%

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Looking forward

Reallocate resources

Evidence shows that we are successfully reducing the backlog of cataract blindness in the region. It is also incredibly exciting to see local trained staff become self-sufficient in some locations where we work. Recognising these successes, 2015 will see us scale back some of our surgical outreach visits in countries where they are no longer required. The establishment of the Regional Eye Centre, staffed by three ophthalmologists and a team of qualified eye nurses, means the Solomon Islands outreach program can be fully managed by the local team.

Focus on needs

In 2015 we will refocus our efforts on new areas with greater need. These include the challenges posed by the rise of diabetic eye disease and our partnerships with the World Diabetes Foundation and the Queen Elizabeth Diamond Jubilee Trust. Whilst we have made significant inroads in developing effective strategies and partnerships to take on the problem, we will require ongoing support as we continue to develop the capability required to successfully prevent and treat diabetic retinopathy.

Child protection policy

The Foundation is pleased to begin aligning its existing child protection practices with the standards set out in New Zealand’s new Vulnerable Children Act 2014. A revised child protection policy was implemented during 2014, and a process is in place to ensure that all major contracts and funding arrangements recognise and protect children.

Programs Program activities $9,952,993

Fundraising & Fundraising, Initiatives & Donor Care $1,679,251 (12.5%)

administration Communications $166,902 (1.2%)

Administration expenses $661,484 (4.9%)

Public Education $932,940 (7%)

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Andrew BellExecutive Director

Dr Neil MurrayMedical Director

John McElhinneyGeneral Manager Fundraising & Shared Services

Marleen NelisseRegional Program Manager

People

Rob Fenwick CNZM (Chair)Founding Director, Living Earth Ltd

Franceska BangaChief Executive, NZ Venture Investment Ltd

Craig FisherChairman/Audit Director, RSM Hayes Audit

Dr Nick MantellOphthalmologist, Eye Institute

Debbie SorensonProgramme Director Health Specialists Ltd, Chief Executive, PMA

Kath Watson CEO, OMD New Zealand

Sir Maarten WeversFormer Chief Executive, Department of the Prime Minister and Cabinet

Board of trusteesExecutive teamPatrons

Gabi HollowsFounding Director and Patron

Lt Gen The Rt Hon Sir Jerry MateparaeThe Governor-General of New Zealand

Photo: Ian Waldie/CI Studio.

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Thank you

The Foundation is extremely fortunate to enjoy the support of many wonderful individuals who donate to our fundraising appeals, make one-off donations or contribute to our regular giving program, the Miracle Club. We sincerely thank each and every one of you, for sharing Fred’s vision of a world where no one is needlessly blind.

Our deepest gratitude to all of the philanthropic trusts and foundations that support our vision and ensure that we are able to make a difference to the lives of thousands of people throughout the Pacific region each year. We were deeply saddened by the passing of David Ellison, one of The Foundation’s original and very generous supporters, and the inspiration behind the David Ellison Charitable Trust.

Many amazing people made a lasting impact by remembering The Foundation in their Will. While we are rarely able to thank them personally, this unique gift leaves a lasting legacy.

Throughout the year a broad range of community supporters hosted a variety of fundraising activities. Thank you to all those inspirational individuals, generous groups, super schools and virtuous volunteers who ran, walked, knitted, read, sold sausages, baked cakes, chopped wood, waved flags, sang to strangers, danced across stages and opened their hearts to help needlessly blind people see once again.

The New Zealand Aid Programme, the Australian Department of Foreign Affairs and Trade, World Diabetes Foundation, Queen Elizabeth Diamond Jubilee Trust and The Fred Hollows Foundation in Australia contribute significantly to our programs.

In the Pacific Islands: The Ministries of Health in Vanuatu, Samoa, Kiribati, Tonga and Federated States of Micronesia; Counties Manukau District Health Board; RANZCO; New Zealand Ministry of Foreign Affairs and Trade; International Agency for the Prevention of Blindness; World Health Organisation; University of Auckland.

In Fiji: Ministry of Health; CWM Hospital; Fiji National University College of Medicine, Nursing and Health Sciences.

In Solomon Islands: Ministry of Health and Medical Services, National Referral Hospital.

In Papua New Guinea: Papua New Guinea National Department of Health; Divine Word University; Modilon General Hospital and the National Prevention of Blindness Committee.

In Timor-Leste: Ministry of Health; Fo Naroman Timor-Leste; Guido Valadares National Hospital; Royal Australasian College of Surgeons/East Timor Eye Program; Waikato District Health Board.

The Foundation is delighted to have an on-going partnership with Specsavers, who supports our work across the Pacific though the Specsavers Community Program.

A huge thanks to HealthPost and their customers for choosing to help needlessly blind people. Agility Logistics freight essential medical equipment and supplies, at no cost, to our programs around the region. A special thanks to DLA Piper, for the invaluable pro-bono legal services. Our deepest gratitude to FearFree Security and Safety Management for training our staff to be safe no matter where they are working.

Boyd Visuals, Alcon, FIJI Water Foundation, Mainfreight, Matson, Orca Communications Ltd and the many other businesses that have supported The Foundation in 2014, thank you.

Corporate supporters

Development partners

Individual donors, trusts, foundations and community groups

hollows.org.nzinfo@hollows.org.nz | Phone INTL 64 9 304 0524 NZ 0800 227 229 | Postal address Private Bag 99909 Newmarket Auckland 1149

Cover page: Professor Fred Hollows holding the intraocular lens used in cataract surgery to restore eyesight. Photo: Anthony Weate/Newspix.

Thank you, Vinaka Fa’afetai,

Malo,Obrigado,

Taggio Tumas, Tenk Yu Tumas!

Photo: Darren James