Ophthalmic Outreach

Husband-and-wife team bring medical help to Fiji residents in need

A new, fully equipped clinic is providing much-needed care, including cataract surgery and other ocular surgical procedures.
John A. Hovanesian, MD, FACS
John A. Hovanesian

When Marta Tooma, DDS, arrived in Fiji for a short stay nearly 10 years ago, she offered her medical services to as many people as she could in a small, makeshift clinic.

Now, a decade later, Dr. Tooma and her husband, Tom Tooma, MD, an ophthalmologist, have expanded that makeshift clinic to a new state-of-the-art medical and dental facility on the Fiji island of Vanua Levu.

Their work, the Mission at Natuvu Creek, is bringing services to the many Fiji islanders who might not otherwise have access to adequate medical care for cataracts, ocular concerns and severe dental pain, Dr. Tom Tooma said.

A Fiji patient’s pterygium is examined at the Mission at Natuvu Creek medical center
A Fiji patient’s pterygium is examined at the Mission at Natuvu Creek medical center. The center is planning an ophthalmology surgical medical mission in February, to perform surgery on cases such as these.
Images: Tooma M

On the island where the clinic is located, there is only one ophthalmologist to treat 250,000 people, he said. That ophthalmologist is 4 hours away by car from the medical center.

“The type of cataract that I mostly see there is associated with an aging population,” Dr. Tom Tooma said. “It’s probably because of lack of availability of care, that when people there find out that an eye doctor is coming, those who can’t see well come in and you’re overwhelmed with the number of cataracts that you see in one day, as a proportion to the number of people that just basically need an eye exam.”

According to the husband-and-wife medical team, the contrasts on the islands of Fiji are sharp: The country has the beauty of a tropical paradise, alongside the untreated medical needs of hundreds of residents. Dr. Marta Tooma said because residents have limited access to medical care, their medical conditions can go untreated for some time, causing pain and disability.

“There is a huge need,” she said. “It seems like in all these places that you have a paradise, you also have great human needs.”

Mission origins

The Toomas were inspired to start the medical center after Dr. Marta Tooma’s initial medical foray into the country. She was invited to provide dental care for children at a Fiji school by explorer Jacques Cousteau’s former chief diver. At the school, she helped establish a tooth-brushing program, which significantly reduced tooth decay in students in the program, she said.

“One thing led to another. … Then, about 4 or 5 years ago, right next to where I started the little clinic, 850 acres of land became available,” Dr. Marta Tooma said. “We looked into it, and it was affordable, and we thought, ‘what better place to do a state-of-the-art dental and medical clinic?’”

The Mission at Natuvu Creek joins other medical outreach work on the island provided by Australian and New Zealander physicians, Dr. Tom Tooma said. The mission’s medical center, which is open every day, year-round, is staffed by a general physician, who provides basic medical care to area villagers. The ophthalmic surgical teams will treat patients at the clinic on a visiting basis, the Toomas said.

The medical center has been open since this summer, the Toomas said, and is readying for the first surgical team visit in early 2009.

Care provided

Fiji patients were recently examined by Tom Tooma, MD, and colleagues at the Mission at Natuvu Creek medical center
Fiji patients were recently examined by Tom Tooma, MD, and colleagues at the Mission at Natuvu Creek medical center. This patient manifests a cataract that is scheduled to be extracted at the center in 2009.

The inaugural ophthalmic outreach surgical mission at the clinic is scheduled for February, with about 50 to 100 surgeries planned, Dr. Tom Tooma said. After screening patients earlier this year, it was determined that most will require cataract surgery, but there will also be phacoemulsification and IOL implantation, with some pterygium cases, a corneal transplant and several lid surgeries.

The incidence of pterygium is most likely related to sun exposure on the island, he said. Few island residents can afford sunglasses, and many are exposed to excessive sunlight.

For the first surgical mission, there will be three surgeons and others who will assist in additional roles at the clinic. Eventually, the Toomas said they hope to host three to four surgical team visits a year, treating the backlog of cataracts and other ocular cases requiring medical care and surgery.

The Mission at Natuvu Creek is always seeking ophthalmologists who can give of their time to perform surgery at the medical center. Volunteers are housed in the region, eating healthy food and staying in safe and amenable quarters amid the beauty of the land and the kindness of the Fiji people, Dr. Tom Tooma said.

“Once you go to Fiji, you will want to go there for the rest of your life because of the people,” he said. “They’re just gracious, giving, happy, content people who have nothing. … When you finish giving someone there a service, just looking at their face and their smile says it all. They’re just full of gratitude.”
by Erin L. Boyle

John A. Hovanesian, MD, FACS
John A. Hovanesian

When Marta Tooma, DDS, arrived in Fiji for a short stay nearly 10 years ago, she offered her medical services to as many people as she could in a small, makeshift clinic.

Now, a decade later, Dr. Tooma and her husband, Tom Tooma, MD, an ophthalmologist, have expanded that makeshift clinic to a new state-of-the-art medical and dental facility on the Fiji island of Vanua Levu.

Their work, the Mission at Natuvu Creek, is bringing services to the many Fiji islanders who might not otherwise have access to adequate medical care for cataracts, ocular concerns and severe dental pain, Dr. Tom Tooma said.

A Fiji patient’s pterygium is examined at the Mission at Natuvu Creek medical center
A Fiji patient’s pterygium is examined at the Mission at Natuvu Creek medical center. The center is planning an ophthalmology surgical medical mission in February, to perform surgery on cases such as these.
Images: Tooma M

On the island where the clinic is located, there is only one ophthalmologist to treat 250,000 people, he said. That ophthalmologist is 4 hours away by car from the medical center.

“The type of cataract that I mostly see there is associated with an aging population,” Dr. Tom Tooma said. “It’s probably because of lack of availability of care, that when people there find out that an eye doctor is coming, those who can’t see well come in and you’re overwhelmed with the number of cataracts that you see in one day, as a proportion to the number of people that just basically need an eye exam.”

According to the husband-and-wife medical team, the contrasts on the islands of Fiji are sharp: The country has the beauty of a tropical paradise, alongside the untreated medical needs of hundreds of residents. Dr. Marta Tooma said because residents have limited access to medical care, their medical conditions can go untreated for some time, causing pain and disability.

“There is a huge need,” she said. “It seems like in all these places that you have a paradise, you also have great human needs.”

Mission origins

The Toomas were inspired to start the medical center after Dr. Marta Tooma’s initial medical foray into the country. She was invited to provide dental care for children at a Fiji school by explorer Jacques Cousteau’s former chief diver. At the school, she helped establish a tooth-brushing program, which significantly reduced tooth decay in students in the program, she said.

“One thing led to another. … Then, about 4 or 5 years ago, right next to where I started the little clinic, 850 acres of land became available,” Dr. Marta Tooma said. “We looked into it, and it was affordable, and we thought, ‘what better place to do a state-of-the-art dental and medical clinic?’”

The Mission at Natuvu Creek joins other medical outreach work on the island provided by Australian and New Zealander physicians, Dr. Tom Tooma said. The mission’s medical center, which is open every day, year-round, is staffed by a general physician, who provides basic medical care to area villagers. The ophthalmic surgical teams will treat patients at the clinic on a visiting basis, the Toomas said.

The medical center has been open since this summer, the Toomas said, and is readying for the first surgical team visit in early 2009.

Care provided

Fiji patients were recently examined by Tom Tooma, MD, and colleagues at the Mission at Natuvu Creek medical center
Fiji patients were recently examined by Tom Tooma, MD, and colleagues at the Mission at Natuvu Creek medical center. This patient manifests a cataract that is scheduled to be extracted at the center in 2009.

The inaugural ophthalmic outreach surgical mission at the clinic is scheduled for February, with about 50 to 100 surgeries planned, Dr. Tom Tooma said. After screening patients earlier this year, it was determined that most will require cataract surgery, but there will also be phacoemulsification and IOL implantation, with some pterygium cases, a corneal transplant and several lid surgeries.

The incidence of pterygium is most likely related to sun exposure on the island, he said. Few island residents can afford sunglasses, and many are exposed to excessive sunlight.

For the first surgical mission, there will be three surgeons and others who will assist in additional roles at the clinic. Eventually, the Toomas said they hope to host three to four surgical team visits a year, treating the backlog of cataracts and other ocular cases requiring medical care and surgery.

The Mission at Natuvu Creek is always seeking ophthalmologists who can give of their time to perform surgery at the medical center. Volunteers are housed in the region, eating healthy food and staying in safe and amenable quarters amid the beauty of the land and the kindness of the Fiji people, Dr. Tom Tooma said.

“Once you go to Fiji, you will want to go there for the rest of your life because of the people,” he said. “They’re just gracious, giving, happy, content people who have nothing. … When you finish giving someone there a service, just looking at their face and their smile says it all. They’re just full of gratitude.”
by Erin L. Boyle