Advocacy to Action – Stories from the regions – Papua New Guinea

Shaping Papua New Guinea’s eye care landscape   

Prevention of Blindness Committee in Papua New Guinea since a decade after its inception, continues to strive advocating, campaigning and creating a impact through its remarkable successes. Their efforts serve as compelling evidence of the power of collaboration, becoming a voice and being heard and undertaking a nationwide mapping project and serving as an inspiration. This journey highlights the importance of working together and being inclusive, tracking progress and keeping the ball rolling which are considered as important tips to consider for successful advocacy in our “Advocacy for Eye Health-A beginner’s guide”. 

Background 

Prevalence of blindness was reported to be 0.30% in Papua New Guinea in 2020 according to VLEG.1 PNG is one of the most chronically afflicted countries in the world when it comes to eye health indicators – but until we had our first RAAB in 2017, this was anecdotal knowledge. When we came together in 2012, we suspected that the situation was bad, we knew that the sector was chronically underfunded, and we knew that we had a number of like-minded organisations working in the country who could (we hoped) work together more effectively. Therefore, the PNG PBL was launched. 

The remit of the PNG PBL was to be the Voice for Vision in Papua New Guinea – in short, we were established as an advocacy group to raise the profile of eye care in the country, with the flow on effects that we would achieve more funding and facilities for our sector. The committee was a re-launch of an older Vision 2020 group and was formed in 2012. In 2023 we decided to review the progress of the National Prevention of Blindness Committee, ten years after its inception.  

The project  

“If we think of the PBL Committee as a book then it would be a story without an end, but nevertheless a series of chapters which build on each other.” This was great advice that we got at the inception of the PBL. It has allowed us to build our brand, to celebrate our advocacy successes and to not get too disheartened when we have a setback. It’s a project without end, yes, but it’s a project that has a consistent advocacy goal of increasing awareness around eye health issues in PNG – and from time-to-time we adapt, as required, or as new information comes to hand. 

Strategies  

Our strategy has adapted over time. In the beginning it was about being ‘noisy’. It was important that we were heard at the table of any medical or health discussion in the country and so we sought out ways to be on the agenda at events like the National Medical Symposium. We also adopted a plan of regular meetings (the first Thursday in March, May, July and September) so that our members knew when and where we would meet.  

As time progressed and word got around, people started to come to us as the “voice for vision”. So, despite some resistance we made a strategic decision to seize opportunities that came our way. For example, when we were asked to undertake the Global Trachoma Mapping Project it was met with some resistance as members of the PBL felt trachoma was not a big enough concern in PNG. But we saw this as an opportunity for the sector – for training, for experience and to collect some much needed data. The result was PNG’s first nation-wide mapping project. It opened the door to so much other data collection and proved to the region that the eye sector in PNG could undertake such complex activities. Seizing the initiative proved to be a very important strategy in hindsight. 

Now that we have matured as a group – and as we pass through this ten-year review process – we are looking at ways to be more strategic in our advocacy. We lead the Pacific Islands Sub-region in terms of data collection, so how can we use that to our advantage?  

Successes 

At the ten years review we were able to demonstrate considerable successes that resulted from our Advocacy efforts:  

1. A National Eye Plan 
2. PNG First National RAAB (which detailed a blindness prevalence of over 5%; as high as 11% in women in the Highlands Regions 
3. A Global Trachoma Mapping Project 
4. Research – ECSAT (first in the Pacific), TADDS: Tool for the Assessment of Diabetic retinopathy and Diabetes management systems and Research on Gender 
5. A National Resource Centre for Eye Health 
6. Curriculum Review for Ophthalmology program 
7. A UPNG position for lecturer 
8. A Twenty-Year Roadmap for eye health in the country 
9. A refurbished eye clinic in a busy teaching hospital 
10. External support staff for teaching 
11. Increase number of doctors in training and number of co-ordinated outreach 
12. Launch of World report on Vision 

We are now recognized at having the best data in the Pacific Islands – this doesn’t mean we have the best results. Far from it but it shows a significant shift in thinking in PNG, from being scared of our results to recognizing that the data is powerful! Good or Bad. That shift in thinking is a sign of our success! 

Stakeholders  

All our stakeholders have been involved throughout the journey – some more or less, depending on the activity, who was leading, whether it was a joint activity or not. For example, Brien Holden Foundation, CBM, PNG Eye Care collaborated on the development of the Resource Centre on land donated by University of PNG with funding from Lions Clubs International Foundation. 

We also did many activities to build a collaborative spirit, such as our annual World Sight Day cocktail party attended by all stakeholders and friends. 

Lessons learned   

1. In PNG you must have a twenty-year plan! The usual three-year programme and funding cycle is useless. We think many countries could learn from this. 
2. Undertake collaborative activities that all are interested in – such as World Sight Day – this builds community spirit (and creates awareness) 
3. Actively seek opportunities to engage your partners – this can be challenging in the competitive NGO environment but pays dividends. 
4. Get the Ministry involved – easier said than done! 
5. Involve both local and international partners – you learn from each other, and this creates a dynamic environment. 
6. Review! This ten-year process is a great example for learning from our successes and also from some of the hurdles.

Tips and Tricks 

1. Find a champion in the Ministry and the WHO and work with them closely. 
2. Engage partners in the media. 
3. Take every opportunity for your members to attend regional and international events – it’s a great opportunity to share your success and learn from others. For a country like PNG, it also ensures we are not forgotten! 

Authored by Dr Jambi Garap, PNG National Prevention of Blindness Committee