This Christmas, the Herald and The Fred Hollows Foundation NZ are working together to bring the Gift of Sight to the Pacific, where four out of five people who are blind don't need to be. Alarmingly, an increasing number of these are young people, suffering from diabetes-related eye disease. This week, we bring you stories of just a handful of these people and invite you to help us raise money for a sight-saving machine that can improve the lives of people like them.
Karlpat Edul doesn't look the type to have had his life put on hold by a disease like diabetes.
It is often associated with obesity but Karlpat is long and lean. Look beyond the wheelchair, at his broad shoulders. They tell the story of who he was. Before the coma, Karlpat, 51, was a hard worker.
He laboured for years as a motor mechanic. He responds to a question about the time before his illness with a sad smile. "Yes," he says, "I was strong."
There were two trips to New Zealand, to orchards in Hastings and Alexandra, pruning, picking, packing; apples and peaches, apricots and cherries. In Central Otago Karlpat saw snow.
Diabetes was diagnosed in 2014 when he fell into a coma but doctors believe he developed the disease years earlier, something that is supported by the state of his eyes.
Undiagnosed diabetes has caused irreversible damage. High blood sugar levels have caused blood vessels in the back of his eye to bleed. The condition is called diabetic retinopathy and without surgery there is a real risk of total blindness.
Karlpat has had two laser surgeries to date. While the damage cannot be reversed, these have preserved his sight for the time being.
He told the Herald that his sight is "blurry". When his eyes were last checked in October, no further damage was found but further laser surgeries are almost inevitable. His eyes will be checked again early next year.
While in the coma Karlpat was flown from his home on Ambrym Island hundreds of kilometres to hospital in Port Vila.
When he came round two weeks later, he found himself trapped. "I went stiff. I couldn't use my arms or legs."
He spent 18 months in hospital with his wife Susan at his bedside.
Movement is gradually returning after four years. Karlpat has regained the use of his arms and can walk a few paces with a frame. "But my knees are stiff and get sore and then I have to sit or I might fall down."
He has not been back to his home since because he needs to be in Port Vila for treatment.
He and Susan live with Karlpat's brother and his family. Their simple room is sparsely furnished. Wires protrude from walls. A bare bulb provides the sole illumination. Outside is a stove where all the cooking is done.
They have no money as neither is able to work. "My family have to help pay for our living and our food." These are greatly reduced circumstances for a man who had a good job, a happy family and a carefree life.
Through an interpreter, Susan said that she doesn't feel free. "All she does is stay home and look after her husband."
Karlpat talks about his goal to visit his island to see his son who they left in the care of relatives. He would love to be home for Christmas. He misses the life he has lost: walking, fishing, working.
"I didn't know about diabetes or how you get it. Since I learnt about it I have changed my diet. I do exercises. But healthy food is expensive. It is difficult."
On Ambrym Island there is space to grow their own crops, life there is less expensive. In Port Vila most people don't have space to grow vegetables.
The big question is whether he will ever be able to return home permanently?
"Maybe," is all he can say.
The number of people in the world with diabetes has nearly quadrupled since 1980.
It is increasing most rapidly in low- and middle-income countries.
7 of the 10 countries with the highest incidence of diabetes are in the Pacific.
The causes are complex, but the rise is linked to obesity, diet and insufficient exercise.
Diabetes of all types can lead to complications in many parts of the body and increase the risk of premature death.
A large proportion of diabetes and its complications can be prevented by a healthy diet, regular exercise, maintaining a normal body weight and avoiding tobacco use.
Source: World Health Organisation
Diabetes and blindness
Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults.
Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision.
Other diabetic eye diseases include diabetic macular edema (swelling to an area of the retina), cataract and glaucoma.