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.
Hilda Hango is an athletically built woman of 22 who is hoping she won't need to have her leg cut off.
Home is on Pentecost Island, a day and a night away by boat from Port Vila, where the Herald met her last month.
She is staying with an aunt in Vanuatu's capital to be close to the hospital.
Discovering she has diabetes began for Hilda with a blister on her heel where her sandal had rubbed. The sore became infected and spread.
"I didn't know the word diabetes," she says. "I wasn't feeling sick and I didn't think I was sick.
"I was told by the nurses that is about sugar."
Hilda has Type 1 diabetes, an autoimmune disease where the body attacks the cells that make insulin. The exact causes of her type of the disease is unknown but genes and viral infections are thought to play a role.
Hilda takes insulin twice daily and needs to do her best to eat a healthy diet to limit complications such as impaired eyesight and foot issues.
Antibiotics have failed to stop sepsis, which is beginning to spread towards her leg, threatening the limb.
Hilda spoke the day before her operation to clean the wound and seal it with a graft of skin taken from her thigh.
She hopes it will mean she can return by Christmas to Pentecost Island, where she was raised by an aunt and uncle after the deaths of her mother to cancer and her father to diabetes complications.
If infection remains, part of her leg may be amputated.
People with diabetes are more susceptible to developing infections, because high blood-sugar levels can weaken their immune system.
Diabetes has also damaged Hilda's eyesight. She has diabetic retinopathy, where cells in tissue at the back of her eyes are leaking, causing cloudy vision.
She will need to return to Port Vila for laser surgery in a new Fred Hollows Foundation eye clinic due to open in February. Laser treatment can slow but not reverse the damage.
Hilda has been told to avoid sugar, cut back on foods such as white rice and tinned fish and eat more vegetables. White rice, which has become a staple in the islands, metabolises into sugar.
That is easier to do on Pentecost where her family grow vegetables. In Vila there is little space for gardens and good food is expensive while money is scarce.
Hilda finished school at 10 because her family couldn't afford the fees.
• 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 dying prematurely.
• 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.
The Herald visited Vanuatu courtesy of the Fred Hollows Foundation NZ