Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1697633462851.pdf (Australia)
Vision for the Future of the East Timor Eye Program The East Timor Eye Program has provided eye care services and strengthened the capacity of the eye health system in Timor Leste since 2000 (see Annex A for Background).

The Program has been supported by the Australian Government, the Royal Australasian College of Surgeons (RACS), the Fred Hollows Foundation New Zealand (FHFNZ) and numerous donors for over 13 years.
The backbone of the Program has been the volunteers who have regularly donated their time and money so that the Timorese people can access to essential eye health care and treatment.

The focus of the Program has now moved towards training and capacity development, with the aim of establishing an autonomous and sustainable eye care service for the people of Timor Leste by 2020.
The next five years of the East Timor Eye Program marks the beginning of a planned phase out of overseas assistance in eye care as national capacity improves in Timor Leste.

Areas of main focus for the next five years include: • Mentoring and support of ophthalmology trainees, including preparation for overseas • specialisation.

Increasing the number of trained doctors and nurses who can screen, diagnose and manage eye problems.

• Ongoing training support for existing eye health personnel.
• Expanding outreach services and equipping sub-district clinics.

• Establishing capacity for sub-specialty services.

• Providing institutional strengthening support for the National Eye Centre in Dili and assisting the Ministry of Health in developing and implementing national eye health strategies.

• Working with disability organisations to improve vision rehabilitation support.
In 2016, current funding support for key training and service activities ceases, leaving the East Timor Eye Program critically vulnerable as Timor Leste attempts to move towards self-sufficiency.

This will significantly impact on the vast achievements and gains made in the eye health sector in Timor Leste since the country gained independence over a decade ago.

The East Timor Eye Program is at a very critical junction in its evolution.
In the process of the hand- over to the Government of Timor Leste, it is important to ensure that the Program is not impeded by lack of funds.

With this in mind, the East Timor Eye Program would like to request financial support to ensure that the Program has assured funding to the end of 2020 when the Program will be handed over to the Government of Timor Leste.

The Program enjoys a high profile in Australia and Timor Leste and is well regarded by both sides.
The cost of managing the Program is approximately AUD$1.5 million per year.

The continued impact and success of the East Timor Eye Program is a testament to the Australian people and its Government and certainly would be a Program that others can use as a model for other nations in the South Pacific and the Western Pacific rim.
Support required The East Timor Eye Program has funding to support post graduate training in ophthalmology, sub- specialty service delivery services, and vision rehabilitation activities until February 2016.

After this time, current funding support for the Program will cease.

In order to achieve the end goal of self-sufficiency and sustainability, additional funding commitment and support is required.
Approximately $1.5 million per year from 2016 to 2020 (see attached Annex B - Budget Breakdown) is required to bring the program to its conclusion.

RACS and FHFNZ will continue to run the program and oversee the transition of eye care services to the Ministry of Health.
Patron: HE Taur Matan Ruak, Presidente da República www.etep.org.au The role of the private sector in promoting economic growth and reducing poverty in the Indo-Pacific regionSubmission 134 Annex A - Context/Background The East Timor Eye Program had very humble beginnings in the year 2000 when Associate Professor Nitin Verma was invited by the World Health Organization to deliver humanitarian ophthalmic services to East Timor (now called Timor Leste) following the country’s referendum and subsequent independence from Indonesia.
The focus of the first four years of the East Timor Eye Program was to provide humanitarian aid to the people of Timor Leste and address issues like ocular trauma, untreated cataracts and the provision of spectacles for those with refractive errors.
The leaders of Timor Leste, namely His Excellency Dr Jose Ramos-Horta (former Prime Minister) and His Excellency Xanana Gusmão (current Prime Minister) then asked the Program to expand into an infrastructure building exercise with the creation of permanent eye care services in Timor Leste.

The East Timor Eye Program, managed by the Royal Australasian College of Surgeons (RACS) and its partners, have provided eye care services and strengthened the capacity of the eye health system in Timor Leste since 2000.
The Fred Hollows Foundation New Zealand (FHFNZ) has been involved since 2005.

Over the years, significant progress has been made in reducing the country’s severe cataract backlog - primarily through the combined efforts of visiting eye teams, monthly outreach visits, placement of a long term expatriate ophthalmologist in-country as well as placement of trained eye care nurses and technicians throughout the country.
The external expertise and input has been vital in ensuring that the Timorese community have access to eye care services, while national capacity is being developed further.

All eye care services are now coordinated out of the National Eye Centre in Dili, marking a significant step in the country’s journey towards establishing a comprehensive national eye health system in Timor Leste.

In addition, a low cost spectacle laboratory and an ocular prosthetics laboratory have also been set up.
Activities to date have been supported through a combination of Australian Government funding through the RACS’ managed Australia Timor Leste Program of Specialist Services (ATLASS I), FHFNZ, Australian Blindness Initiative funding through the Vision 2020 Australia Global Consortium, and individual, corporate and community donations.
In partnership with the Ministry of Health, national and international NGOs (RACS and FHFNZ), the East Timor Eye Program has established a national outreach program which provides refraction and eye surgery services in each of the country’s 13 districts, as well as previously underserviced regions of Atauro, Los Palos, Ermera and Viqueque.
Managed and coordinated by national staff (with oversight from the RACS and FHF ophthalmologists), this initiative is providing access to essential eye care services for the country’s most isolated and vulnerable communities.

Visiting eye teams from Australia have been an integral part of the eye program in Timor Leste.
Over the years, the role of the visiting eye teams to Timor-Leste has evolved significantly; they have reduced in size (to one surgeon, one nurse and one optometrist) and are increasingly focused on training and treating complex sub-specialty cases, leaving the bulk of cataract cases to be dealt by the resident ophthalmology team.
The East Timor Eye Program has built the capacity of Timorese eye health personnel, including training the country’s first and only national ophthalmologist, Dr Marcelino Correia, and developing the skills of eye care nurses and technicians to identify, treat and manage a range of eye conditions.
In 2013/14, two motivated Timorese ophthalmology trainees commenced training through a Post Graduate Diploma in Ophthalmology through the National University of Timor Leste, led by the RACS supported expatriate ophthalmologist along with key partners.

This is the first training program of its kind in eye health in Timor Leste.
A further three candidates have been selected to undertake the post Patron: HE Taur Matan Ruak, Presidente da República www.etep.org.au The role of the private sector in promoting economic growth and reducing poverty in the Indo-Pacific regionSubmission 134 graduate training program in 2015.

This is an exciting new development, and one which needs funding support to ensure success.
As the transition towards self-sufficiency commences, the aim is to hand over the National Eye Care Program to the Ministry of Health in Timor Leste, which has set up a Committee for the transition of services from the NGOs to the Government.

This process will take 5 – 7 years and will ensure that the Timorese will have sufficiently trained manpower and resources.

It is envisaged that seven Timorese ophthalmologists will be trained during this transition period.
The eye program in Timor Leste is now at a critical juncture in its journey towards establishing a comprehensive eye care service for the people of Timor Leste.

Efforts over the past 11 years have begun to produce tangible results including demonstrable improvements in national capacity to address eye health problems, and increased access to eye care services by remote communities across the country.
There have been significant improvements in partnership among eye health stakeholders in Timor Leste, with plans developed collaboratively and in a well-coordinated approach.

The attitude of the Timorese people towards eye care is improving as a result of continued efforts by the Program and its partners to raise awareness.

We are now seeing a steady preference by patients for effective medical treatment and earlier intervention versus traditional methods, some of which have had disastrous consequences.
Patron: HE Taur Matan Ruak, Presidente da República www.etep.org.au The role of the private sector in promoting economic growth and reducing poverty in the Indo-Pacific regionSubmission 134 Annex B – Budget Breakdown ETEP Activity Expatriate ophthalmologist 1 Salary - ophthalmologist LTA support (accommodation) LTA support (insurance) LTA support (mobilisation) LTA support (annual leave and CPD) Expatriate ophthalmologist 2 Salary - ophthalmologist LTA support (accommodation) LTA support (insurance) LTA support (mobilisation) LTA support (annual leave and CPD) One expatriate Clinical Nurse Educator Salary - nurse LTA support (accommodation) LTA support (insurance) LTA support (mobilisation) LTA support (annual leave and CPD) One expatriate Project Manager Salary - Project Manager LTA support (accommodation) LTA support (insurance) LTA support (mobilisation) LTA support (CPD) Educational resources and training equipment - books, DVDs, online resources GENERAL POST GRADUATE DIPLOMA RUNNING External Examiners (airfares, accommodation, honorarium payment) PGDO TRAINING COHORTS - 2016/2017, 2017/2018, 2018/2019, 2019/2020, 2020/2021 English language training Training attachments to India/Nepal - 12 week training Teaching faculty (visiting short term advisors) Includes airfares, accom, honorarium payment etc.
Attendance at PACEYES conference Attendance at RANZCO conference Subtotal Outreach and equipment costs Project Vehicle Outreach costs - petrol, vehicle maintenance, per diems, accomm for outreach team Equipment Consumables Subtotal TOTAL Unit Cost per year Total over five years Salary Package Package Package Package $ 200,000 $ 1,000,000 $ 24,000 $ 120,000 $ 10,000 $ 50,000 $ 15,000 $ 75,000 $ 10,000 $ 50,000 Subtotal $ 259,000 $ 1,295,000 Salary Package Package Package Package $ 200,000 $ 1,000,000 $ 24,000 $ 120,000 $ 10,000 $ 50,000 $ 15,000 $ 75,000 $ 10,000 $ 50,000 Subtotal $ 259,000 $ 1,295,000 Subtotal Subtotal Subtotal Salary Package Package Package Package Salary Package Package Package Package Package Package Package Package Package Package Package Unit Package Package Package $ 80,000 $ 400,000 $ 24,000 $ 120,000 $ 10,000 $ 50,000 $ 15,000 $ 75,000 $ 10,000 $ 50,000 $ 139,000 $ 695,000 $ 80,000 $ 400,000 $ 24,000 $ 120,000 $ 10,000 $ 50,000 $ 15,000 $ 45,000 $ 10,000 $ 50,000 $ 139,000 $ 665,000 $ 10,000 $ 50,000 $ 5,000 $ 25,000 $ 15,000 $ 75,000 $ 3,000 $ 15,000 $ 12,000 $ 84,000 $ 50,000 $ 250,000 $ 42,000 $ 42,000 $ 42,000 $ 42,000 $ 433,000 $ 149,000 $ 160,000 $ 160,000 $ 100,000 $ 500,000 $ 80,000 $ 400,000 $ 200,000 $ 1,000,000 $ 540,000 $ 1,500,000 $ 2,060,000 $ 6,518,000 Patron: HE Taur Matan Ruak, Presidente da República www.etep.org.au The role of the private sector in promoting economic growth and reducing poverty in the Indo-Pacific regionSubmission 134