Indigenous eye health

Enhancing eye health equity for Indigenous Australians

Indigenous Eye Health Unit

Melbourne School of Population and Global Health

Icon of SDG 2: Zero hunger, icon of SDG 3: Good health and wellbeing, icon of SDG 6: Clean water and sanitation, icon of SDG 10: Reduced inequalities and icon of SDG 17: Partnerships for the goals.

The Indigenous Eye Health (IEH) team in the Melbourne School of Population and Global Health has contributed significantly to improvements in Aboriginal and Torres Strait Islander eye health through excellence and innovation in translational research over 10 years.

Closing the gap in vision

It is a small research group, established by Melbourne Laureate Professor Hugh Taylor AC in 2008 with the singular goal of achieving eye health and care equity for Aboriginal and Torres Strait Islander people. IEH aims to close the gap for vision through world-leading research, policy formation, advocacy and implementation.

A key focus for IEH has been trachoma, a preventable infectious disease caused by the bacterium Chlamydia trachomatis. The infection causes a roughening of the inner surface of the eyelids which can lead to pain, breakdown of the cornea, and eventual blindness.

Cartoon goanna with speech bubble reading 'clean faces, strong eyes!'
Milpa the Trachoma Goanna is part of the 'Clean Faces, Strong Eyes' health promotion program.

Australia is the only developed country in the world to have trachoma that still occurs in remote Aboriginal communities. While Trachoma is treatable with antibiotics, secondary and primary prevention, in the form of health education and in the provision of clean water for washing respectively, are known to be more efficient and equitable ways of reducing the health burden.

Trachoma prevention through community engagement

Much of the activity of the IEH’s trachoma team has focused on promoting improved hygiene practices and washing facilities through a range of community engagement approaches. IEH developed its Clean Faces, Strong Eyes health promotion program spearheaded by Milpa the Trachoma Goanna. Resources include community videos, art murals, posters and other resources in local languages. IEH’s trachoma work has also to lead to significant policy changes in school curricula which have helped to dramatically reduce trachoma rates.

Building a network for collaboration

The IEH unit also uses an integrated health system approach to improve the provision of eye care services. Here, its work ranges from community-based activities to improving government policies. The work is founded in deep engagement with Indigenous organisations and individuals to facilitate and promote self-determination, capacity development and leadership.

To that end, IEH has built an extensive national collaborative network with Indigenous and non-Indigenous partners, and service providers. Evaluation research using Australian Institute of Health and Welfare data has revealed measurable improvements in Indigenous eye health and care surveys and government reports. This success is mirrored in the stories shared by the members of the Indigenous communities that have benefited from the program.

Aligning with the SDGs

The key SDGS to which the IEH contributes are SDG 3 Good Health and Well-being, and SDG 10 Reduced Inequalities. A core mission of the IEH team is to close the ‘gap in eye health’ and to enable more equal health outcomes between Indigenous Australians and the rest of the population by following the principles of universal health care. The team has made significant achievements in this space by increasing health equity; that is, creating, in partnership with local communities, more opportunities to engage in healthy behaviours like face washing, healthy housing and culturally appropriate education programs that increase health literacy and communities’ capacity to prevent trachoma.

Photo collage. Top left: Person in goanna costume posing next to children washing hands. Top right: photo of report 'The Roadmap to Close the Gap for Vision'. Bottom right: elderly woman with text that reads 'diabetes is a major cause of vision loss and blindness for Aborginal and Torres Strait Islander people'. Bottom left: woman behind a counter with sign that reads 'are you of Aboriginal or Torres Strait Islander Origin?'
The IEH has focused on promoting improved hygiene practices and washing facilities through a range of community engagement approaches.

SDG 6 Clean Water and Sanitation is also a key pillar of IEH’s work. Equitable opportunities to ­­engage in eye-healthy behaviours are only available when adequate and equitable sanitation and hygiene are available, when open defecation ceases and when the infrastructure (tanks, pipes and pumps) and service (plentiful potable water) for frequent hand and face washing are made ­­­available (UNSTATS, 2020). To that end, the IEH works closely with communities, governments and service provides to bring the essential infrastructure to communities, and to teach members of the importance of using it.

The trachoma team in IEH also recognises the importance of SDG 2 Zero Hunger to its work, particularly the target ‘to ensure access by all people, in particularly people in vulnerable situations – including infants – to safe, nutritious and sufficient food’. This is because adequate nutrition, particularly a balanced and healthy diet that provides sufficient in Vitamin A can reduce the impacts of trachoma and related childhood blindness.

Regarding SDG 17, Partnerships for the SDGs, IEH is exquisitely connected to the Indigenous and non-Indigenous health and eye-health sectors. It plays a key role connecting the sector agencies such as jurisdictional level coordinating committees for hygiene and housing to enable collaborative efforts (UNSTATS, 2020). As a result, 59 out of 64 self-identified regions (representing 98% of the Indigenous population of Australia) are now working collaboratively to identify and address needs.

IEH unit has also played a significant role to create partnerships for achieving the relevant SDGS, including 10 national roundtables, meetings and conferences to bring the sector and experts together. In 2017, IEH hosted the first annual National Indigenous Eye Health Conference in Melbourne, an event that will continue into the future, and will build the capacity of communities and researchers to close the gap for Indigenous Australians regarding trachoma and other eye disease.



Portrait of Hugh Taylor
Professor Hugh Taylor – Laureate Prof Harold Mitchell Chair in Indigenous Eye Health, Melbourne School of Population and Global Health