Dr. Astrid Bonfield CBE (l) with Dr. Kenneth Darroux. CMO Dr. David Johnson looks on

The Chief Executive of The Queen Elizabeth Diamond Jubilee Trust (the Trust), Dr Astrid Bonfield CBE, met recently with Dr. Kenneth Darroux, Minister for Health and Social Services, Ministry officials and leading eye health experts to thank and commend them for their efforts to prevent blindness caused by escalating rates of diabetes across Dominica.

With the prevalence of diabetes in the Caribbean almost 50% higher than the global average, the Trust has been working with partners in the region since 2015 to help reduce the number of people at risk of blindness from its sight-threatening complication, diabetic retinopathy. In Dominica, as a result of the Trust’s programme, through the Government’s leadership the country’s health system has now been significantly strengthened to prevent more people with diabetes from losing their sight.

Diabetes is the leading cause of blindness in working-age adults and affects 12.6% of the population in Dominica, compared to the global average of 8.8%. Diabetic retinopathy occurs when poor control of blood sugar levels, high blood pressure and high lipid levels in the blood damage the blood vessels in the retina. If left untreated, it can lead to irreversible blindness.

Over half of all people with diabetes are unaware they have the condition, and by the time their vision deteriorates, it often is too late for treatment. Regular screening, early treatment, and careful health management is crucial to ensure people with diabetes do not go blind when their sight could be saved.

As diabetes rapidly becomes a global epidemic, diabetic retinopathy is now one of the top causes of vision loss across the Commonwealth and worldwide. The Trust, together with its coordinating partner the London School of Hygiene and Tropical Medicine, has worked with the Ministry of Health to secure permanent changes to Dominica’s public health system by integrating screening and quality treatment for diabetic retinopathy into the care provided to
people with diabetes. By focusing on strengthening the health system, the aim has been to implement an effective screening and treatment plan that will not only protect the sight of those people who currently have diabetes in Dominica but also those who in the future will develop the condition.

As part of the measures taken to improve access to quality eye care for people with diabetes, the programme has established a well-equipped screening and laser treatment site for diabetic retinopathy at the Princess Margaret Hospital in Roseau, to complement its existing mobile service. Together, these services are aiming to provide full coverage and reach all people with diabetes across the island who may be at risk of losing their sight.

Awareness raising initiatives have also taken place across Dominica to highlight the issue of diabetes and its complications. In July 2018, with the support of the Ministry of Education, a Diabetes Stakeholders’ Workshop
took place which trained 100 health professionals including ophthalmologists, diabetologists, nutritionists and primary care nurses, to enable them to further improve the management and improve the management and
control of diabetes and diabetic retinopathy across the island.

The aim now is to continue scaling-up the screening and treatment services successfully implemented as part of this programme, to ensure that more people with diabetes are aware of the risk to their sight, the need for regular screening and are able to access effective treatment when it is required.

Dr. Bonefield receives a gift basket. Opthalmologist, Dr. Hazel Shillingford-Ricketts is smiling in the background  

Speaking about the work in Dominica, Dr Astrid Bonfield said:
“I commend all that has been done so far to ensure that Dominica has the systems in place to enable it to effectively tackle the world’s fastest growing cause of blindness. The efforts of the Government and our partners, in particular ophthalmologist Dr Hazel Shillingford-Ricketts who has spearheaded efforts with great energy and skill, to increase public awareness of the condition and to improve eye care services is outstanding and is ensuring people are protected against this tragic and avoidable form of blindness each and every day.

I am very grateful for the Ministry of Health’s engagement in and leadership of the Trust’s programme. Its mobile screening service, developed to ensure that all people in Dominica with diabetes continue to receive regular screening for diabetic retinopathy, is innovative and a model that other countries around the world could learn from and adopt. When Commonwealth Heads of Government met in London earlier this year, they agreed that they would “take action towards achieving access to quality eye care for all…”. Providing a permeant quality eye care for all people with diabetes is a strong response by Dominica to that commitment – and one in which the Trust is very proud to have played a part.”

The Trust was established in 2012 to create a lasting legacy in honour of Her Majesty The Queen as Head of the Commonwealth. The work undertaken in Dominica since 2015 to prevent people with diabetes from losing their sight now and in the future, and to empower young people, forms a core part of the Trust’s legacy.