Atauro, November: In Atauro, the tiny island off Timor-Leste’s north coast, healthcare doesn’t always come from hospitals. Sometimes, it comes by boat.

Medical teams journey across the sea to bring essential eye care to Atauro Island. WHOTimor-Leste/Cirilo

The island’s only eye clinic, a modest building overlooking the sea, was built in 2013 with support from the Swiss Embassy, Rotary International, Lions International, Optometry Giving Sight and the East Timor Eye Program (ETEP). The building stands ready year-round. But for most of the year, it sits silent, waiting for doctors to arrive.

This year, on World Sight Day (October 9), the quiet clinic came alive as the Ministry of Health (MoH) and WHO Timor-Leste arrived with a full team of ophthalmologists, technicians, and nurses from the Guido Valadares National Hospital (HNGV) to the island. Over 5 days, the team screened 192 patients, provided 104 people with spectacles, and performed 12 cataract and seven pterygium surgeries.

The Atauro outreach was part of SPECS 2030, WHO’s global initiative to expand access to vision services through five pillars — Services, Personnel, Education, Cost, and Surveillance. Before this, in September, the same team had travelled to Oecusse, where they performed 106 cataract and five pterygium surgeries.

Together, the two outreach drives helped restore or improve vision for over 300 people, bringing sight-saving care to some of the country’s most remote communities. A week after each outreach, an ophthalmologist and a refractionist return to follow up with the patients.

“For me, this surgery was survival”

For 48-year-old Adelina Gomes, a tailor, the outreach was nothing short of life-changing. For two years, she lived with pterygium, a painful eye condition that caused redness, irritation and blurred vision.

“I couldn’t even enter the kitchen,” she said. “The smoke burned my eyes.” When she heard doctors were visiting, she came immediately. “For me, this surgery was survival,” she said. “It meant keeping my work and my income.”

Adelina Gomes, moments after successful pterygium surgery. WHOTimor-Leste/Cirilo

But in places like Atauro, getting the word out is as hard as getting the doctors in. Information rarely travels online. People hear it in church, from village heads, or from health teams going door to door. In the end, it’s often information that decides who gets care.

Eni Pelo, a 37-year-old housewife, heard the announcement about visiting doctors in church. “Reading small letters was straining my eyes,” she said. The boat to Dili runs only a few times a week, and travel costs, time, and childcare make visiting the capital difficult. “Even reading the Bible was becoming impossible,” she said. “This outreach was my only chance.”

The mission and the vision

SPECS 2030 supports countries in meeting two global goals — expanding access to cataract surgery and improving the availability of treatment for vision problems such as refractive errors.

As he spoke with patients recovering from surgery in Atauro, WHO Representative Dr Arvind Mathur said poor vision “steals independence, opportunity, and dignity.” “Cataracts and refractive errors are not just medical issues but barriers to livelihoods, and initiatives like SPECS 2030 are at the heart of addressing them,” he said.

WHO Representative Dr Arvind Mathur and Vice Minister Dr Flavio Brandão meet patients benefiting from the eye outreach programme. WHOTimor-Leste/Cirilo

According to national estimates, 157,000 people in Timor-Leste live with significant visual impairment, including 36,000 who are blind. Cataracts account for 84% of severe cases, while uncorrected refractive errors cause about one-third of moderate vision loss.

Dr Flavio Brandão Mendes de Araujo, Vice Minister of Health, called for eye health to be made a national priority. “Clear sight should be a basic right for every person,” he said, adding that outreach like this “must continue for as long as there are people still waiting to see clearly.”

A future of clear vision

Since independence, Timor-Leste has made substantial progress in eye care. Its National Eye Health Strategy (2021–2050), which is awaiting endorsement from MOH, lays out a roadmap for integrating eye care into the broader health system. But challenges persist: a shortage of trained personnel, limited infrastructure, and poor access in rural areas where over 70% of the population lives.

To address these gaps, the Ministry along with partners like WHO has begun consultations for a more immediate 2026–2030 strategy. It will be forming a National Eye Health Services Steering Committee (NEHSSC) to coordinate efforts, which provide the foundation for implementation of SPECS 2030.

Seeing change

For retina specialist Dr Valerio Andrade, who travelled from HNGV to Atauro for performing cataract surgeries, besides distance or cost, one of the biggest challenges is also fear. “People hear ‘surgery’ and think they will die,” he said. “Eye health should be promoted like dengue or tuberculosis — not something you wait for, something you act on.”

But outreach camps like this one are already changing that mindset.

Dr Valerio Andrade and his surgical team with a patient following a successful eye operation. WHOTimor-Leste/Cirilo

Eye technician Mr Filipe Soares recalled a patient from Maquili who regained vision after cataract surgery. “He came back asking for surgery on the other eye,” he said with a smile. “When people see the results, they want to be helped.”