Erna Takazawa has the honour of being Samoa’s only optometrist at the grand old age of 28. Jai Breitnauer caught up with her while she was in New Zealand after VOSO sponsored her to attend this year’s Ocular Therapeutics Conference.
Erna Takazawa was born in Japan, but moved back to Samoa with her family when she was just one year old. Island life was all she knew, apart from a brief visit to Auckland as a teen. But a very Samoan experience when she was just 15 years old changed the course of her future.
“My younger sister was having some problems with her sight. My parents took her to the hospital, but they didn’t know what to do with her. There were no qualified optometrists in Samoa,” explains Takazawa. Eventually, an American man living locally who had some basic optometry skills diagnosed her myopia and organised a pair of glasses for her at a cost of 700 Tala (about $390).”
At the time, the minimum wage in Samoa was just 2 Tala an hour and Takazawa realised her family were lucky to be able to afford the glasses.
“I decided then that I wanted to become an optometrist to bring affordable and accessible professional eye care to local people. But I also realised it wouldn’t be easy.”
The nearest place to qualify as an optometrist was the University of Auckland. This meant living far from her family, in a foreign country for an extended period. It would also cost a lot of money: $50,000 a year, so about $250,000 in total. Her family weren’t poor, but they couldn’t afford that, she says.
“I knew the only way I could manage it was to get a scholarship. I worked very hard and graduated high school as Samoa’s top student. I was then able to get a grant from the New Zealand government, a New Zealand Scholarship, to attend Auckland University.”
After battling terrible homesickness and culture shock, Takazawa finally graduated with a first-class honours degree in optometry in 2012.
“You don’t get many opportunities when you are from Samoa, but when you do get them it’s important to make the most of them. I wasn’t just here to get a degree, I wanted to make my parents and my village proud; to be the best optometrist I could be and take that expertise back to my people.”
Takazawa was offered many lucrative roles in New Zealand, but turned them all down to focus on her dream. Back in Samoa, however, things didn’t quite go to plan, at least to begin with.
Takazawa wrote to the main hospital in Samoa to explain she had just graduated and wanted to practice there, but those in charge responded by telling her they didn’t need any technicians.
“They thought I made glasses,” Takazawa laughs. “They didn’t understand what an optometrist was.”
Eventually, she got a meeting with the hospital’s general manager who agreed to give her a room to practice from, but no equipment, and a salary equivalent to a trainee nurse – about an eighth of what she had been offered as a graduate in New Zealand.
“My mum told me I should move back to Auckland. But the whole reason I did this was to make a difference. Plus, you don’t need much money to live well in Samoa.”
Takazawa partnered with an American non-governmental organisation (NGO) to get the equipment she needed and set the fee for her services at 10 Tala (about $5) with children under 15 free. Glasses are donated by the New Zealand charitable trust, Volunteer Ophthalmic Services Overseas (VOSO). At the end of her first month of practice in 2012, Takazawa was fully booked.
There’s been some challenges, she admits, many she wouldn’t have seen working in New Zealand.
“I’ve had to extract leeches from people’s eyes. As there was no ophthalmologist on Samoa until recently, I was also assessing people with serious eye conditions like glaucoma and referring them to overseas teams. I’ve also had to remove quite a few pterygiums.”
In Samoa, Takazawa describes optometry as a “very hands on job.” She travels around Samoa to see people who can’t come to her and to explain the value of her work to each new community. Many eye conditions didn’t even have names in the Samoan language before Takazawa arrived on the scene.
“We’ve had to come up with terms, like ‘uga I’a’ for cataract,” she explains. “It literally means ‘cloudy fish eye’ and resonates with local people who fish often.”
The challenges have been great, but the rewards go far beyond money. The satisfaction of seeing people’s lives transformed has kept Takazawa going, helped by the lovely fresh fruits and vegetables people often give her from their garden as thanks for her help.
“I had this one patient very early on, a lovely old lady who came into the surgery with the help of her daughter and a walking frame. She told me she was blind and housebound. She hadn’t been able to do anything for herself for years. When I tested her sight, she was severely myopic, nothing else. I found her a pair of glasses and when she put them on she cried. She walked out of my clinic unaided. It was amazing.”
Another success story is that of a young girl who was thought to have an intellectual disability, but also was just short-sighted. She’s now the second-best student in class and plays basketball. Takazawa also helped save someone’s life when she noticed a visual field defect during a routine eye exam and recognised it as the early warning signs of a brain tumour. Those moments are particularly rewarding for all optometrists, she notes.
In 2015, Takazawa was awarded The Queen’s Young Leader Award and things began to change. In Samoa, the hospital authority and the government began to recognise the value of her work. She was allocated better practice rooms and more funding. She was also made the Samoan National Health Services national eye health coordinator, allowing her to help establish the rules around the qualifications you need to be a medical practitioner in Samoa, coordinating visiting international eye teams providing specialist care, liaising with overseas donors and training nurses across the region in eye care.
“I travel to Fiji twice a year to teach and I now have 10 nurses working with me to establish outreach clinics in the rural areas of Samoa.”
Takazawa says she was also deeply honored to be made a Fuiavailili, a type of chief by her village. “I was quite embarrassed. That honour is usually reserved for a much older person, but my mum encouraged me to accept it.”
In just five short years, Takazawa has transformed the eye care landscape of Samoa, including being involved in the appointment of the country’s first ophthalmologist in December 2016. She was named the University of Auckland’s 2017 Young Alumna of the Year for her work developing optometry in Samoa and helping to improve eye care in the Pacific.
“Working as an optometrist here, you can make a real difference. My patients are so appreciative and I see real change every day.”
Editor’s note: Erna needs help to continue her work in Samoa. Whether you can donate a used pair of glasses or a fundus camera, she would love to hear from you through VOSO. Everything helps, she says.