Diabetic Vanuatuan pastor's last sermon: 'careful what you eat'

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.

Pastor Lesley Bong's final sermon may be too late for him but not, he hopes, for his kids.
At 67, he has come to be defined by his religion and his disease. Careful what you eat, he preaches.

"I have served within the Presbyterian Church of Vanuatu in many parishes for 22 years now," says Pastor Bong, who became a preacher in 1996, the same year he was diagnosed with diabetes.

He has Type 2 diabetes, the more common type, where the body does not make or use insulin well. Without enough insulin, glucose stays in the blood and over time can cause problems with kidneys, nerves, feet and eyes and increase the risk of heart disease.

"Now I have got two kidney problems," says Bong. "The diabetes has created many different problems."

• READ MORE: Diabetes 'tsunami' overwhelms Pacific

The Herald met the pastor in October at the main hospital in Port Vila, Vanuatu where he was admitted 10 days earlier with "frightening" breathing difficulties.

His eyes are shot. "This one is open but I cannot see anything," he says pointing to his left eye.

An ophthalmologist visiting with a Fred Hollows Foundation "outreach" found advanced diabetic retinopathy - damage to blood vessels of the retina - in both eyes.

The disease has also caused glaucoma in one. Treatment is difficult, prospects for that eye are bleak.

His better eye needs laser surgery but the old machine at the hospital is not up to this particular task. Though the procedure cannot restore lost sight, it is needed to guard against further damage.

There is no choice but to wait until a new eye clinic with a modern laser machine opens early next year. The wait comes with risk of further loss of sight.

Ophthalmologist Johnson Kasso, who will head the new clinic, could see through the microscope weak vessels that could bleed at any time.

"If there is a further bleed it will be very hard to salvage his vision," says Kasso.

Vanuatu has relied on the loan of an old laser machine which can do only simple operations.

"That has made treating diabetic retinopathy patients very difficult," says Dr Kasso. "The new clinic will make a really big difference."

Pausing regularly to regather his breath, the pastor tells his story of declining health. His message: beware what you eat.

It may be too late for him but not, he hopes, for his family.

"I have five kids, I have 13 grandchildren. I always remind them they have to be careful what they have eaten every day because the lifestyle changes brings us problems.
Those lifestyle changes include the drift to bigger towns such as Port Vila with less space to grow vegetables and the easy availability of cheap Western foods. Soft drinks but also white rice - a carbohydrate that quickly metabolises to sugar - which has become a staple in the islands.

"I always encourage them, tell them that they have to eat something that will build up their body that will not destroy their body."

• To make a donation go to Fred Hollows or their Givealittle page

Diabetes Facts

• 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 of Type 2 diabetes - the most common form - 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 oedema (swelling to an area of the retina), cataract and glaucoma.

Source: https://nei.nih.gov/health/diabetic/retinopathy
The Herald visited Vanuatu courtesy of the Fred Hollows Foundation NZ