Surgical “blitzes” for cataracts solve short-term backlogs but do nothing to fix systemic problems in Indigenous eye care, according to ophthalmologists writing in the Medical Journal of Australia.
Professor Hugh Taylor, chair of Indigenous Eye Health at the University of Melbourne, and his coauthors wrote that cataract surgical blitzes first occurred in Australia in the 1970s during the National Trachoma and Eye Health Program championed by Fred Hollows.
“Everyone felt a very good job was being done, but nothing really changed”, Professor Taylor and his coauthors wrote.
“More recently, regular surgical blitzes, rebranded as ‘surgical intensives', were started in Alice Springs and elsewhere in the NT; but these were also short-term fixes.”
Blitzes are often used to redress shortfalls in service provision, and in developing countries are generally combined with building local capacity, Taylor and colleagues wrote.
However, in Australia, with no resource constraints, there is also no “concurrent development of sustainable local services”.
Aboriginal and Torres Strait Islander people have a sixfold greater rate of blindness than non- Indigenous Australians. They have 12 times higher rates of cataract blindness, but receive seven times less cataract surgery. Those who manage to get on a waiting list for surgery wait almost twice as long as non-Indigenous Australians.
“Blitzes seem to provide a quick and rewarding solution”, the authors wrote. “Blitzes usually receive government and private funding, so the investors feel good that something is being done and they obtain positive publicity. “But the patients who turn up the next week do not feel so good. They do not know how long they will have to stay blind while awaiting another blitz.
“Australia in 2015 has a sophisticated health system with the capacity to provide the services required. We cannot afford repeated short-term and unsustainable surgical blitzes.
“Australia should be leading the way in showing how to deliver eye care, rather than consistently showing how not to.”