Shaun Tatipata was never meant to be a bystander. As the pioneer of Australia’s first Aboriginal-owned optical and eyecare provider, his work has seen a radical shift in the eyecare services provided to his local community.
During his time as an Aboriginal Health Practitioner in 2001, Mr Shaun Tatipata’s encounter with one patient would ultimately cement his career in eye health. An older gentleman came to the local Aboriginal Medical Service for help with his vision and Tatipata – working alongside an ophthalmologist – was tasked with post-operative care.
When the man first came into their care, he was blind as a result of a cataract surgery complication. The only option was a corneal graft. Later down the track, their paths crossed again. The patient was animated after re-capturing his old life.
“His whole personality had changed, and I felt a sense of great pride in what we had achieved. He was able to get his driver’s licence back and become independent from then on. His family then moved back out on to their ancestral homelands where he was able to practise and teach his culture. He was able to support his family and really play that key role model for his community,” Tatipata says.
He cites this as a formative moment that would set him on the path to establishing the first Aboriginal-owned eyecare and optical provider, the Deadly Vision Centre, in 2020. The centre works to deliver culturally safe and socially responsive eyecare, access to affordable, appropriate and fashionable (Deadly) eyewear and helps Aboriginal and Torres Strait Island people navigate the eye health system.
“After 10 years of trying to reform the system, I realised we had to completely transform it. And what better way to do that than leading by example,” he says.
Tatipata grew up on Larrakia Country in Darwin and is of Wuthathi and Ngarrindjeri descent.
His interest in Indigenous health can be traced to the ailments of immediate and extended family members growing up. This meant he was exposed to the health system early and quickly became familiar with the value of Aboriginal Health Practitioners.
So, when there were calls for expressions of interest for traineeships for Aboriginal Health Practitioners at the local Aboriginal Medical Service in 2000, Tatipata interpreted this as divine timing and took it as an opportunity to contribute in his own way.
The role of an Aboriginal Health Practitioner is a revered community position and was understandably daunting for Tatipata when he applied. However, with an eagerness to contribute, he was accepted.
In this role, he was first exposed to eyecare with a Federal Government initiative, driven by Professor Hugh Taylor, that saw the funding of Regional Eye Health Coordinator positions in Aboriginal Medical Services across the country. Tatipata supported the visiting ophthalmologists to deliver eyecare in his local service and remote communities across the Top End.
It was during this time that his world collided with the elderly gentleman. He was tasked with follow up appointments that saw him visit the patient three times a day to administer eye drops while working with his family to educate them about his condition, treatment and support he required.
“And from there, I’ve kept wanting to do more. I could see the potential for the visiting specialist services and to support them to get out into more communities and places where mob live and work,” he says.
Pay it forward
An important stint in Tatipata’s career would see him adopt a hands-on, proactive and national role to improve eyecare access. Much of his work was dedicated to establishing and running outreach programs with local Aboriginal Medical Services, but a highlight was his appointment at The Fred Hollows Foundation in 2011.
When the Australian Institute of Health and Welfare (AIHW) released the Indigenous Eye Health Measure report in 2017, Tatipata used this to quantify the coverage of eyecare services for Indigenous people against the projected needs.
“In my own community, I realised we were falling well short of the eyecare services that were needed and we were only delivering something like a third of the cataract surgeries required. We were only just scratching the surface of diabetic retinopathy,” Tatipata says.
“All my fellow community members, including my own family members, weren’t receiving the services that they needed, nor what they deserved. The current service providers didn’t necessarily have the capacity or the capability to address the needs of the Aboriginal and Torres Strait Islander community. The ophthalmology department, as passionate about the cause as they were, just didn’t have the capacity.”
With insufficient resources and consideration from governments, and with the knowledge he had accumulated during his time at The Fred Hollows Foundation, Tatipata took up the challenge of transforming the eye care landscape for his community.
He mobilised a network of likeminded people and organisations to establish the Deadly Vision Centre.
“Out of the sheer determination to give my community the best possible vision; that’s what prompted me to set up the Deadly Vision Centre,” Tatipata says.
To raise awareness and support for the service, Tatipata established the Deadly Cup Rugby League Carnival in September 2020 as part of NAIDOC week. The event featured 80 volunteers, close to 300 players, 2,500 community members and 25 sponsors driving awareness of Indigenous eye health.
“Two weeks later we had some donated and secondhand equipment. We had volunteer optometrists working alongside of us to deliver eyecare to mob. Organisations like the Brien Holden Foundation and the Optical Superstore came to the party, and they provided us with some equipment and access to their optometrists to start delivering services.”
Tatipata says the Deadly Vision Centre relies on self-generated funds and sector support. The practice marks an important milestone in Indigenous eye health, and according to Tatipata, sets the scene for success in this space.
“At the moment, it’s all self-funded. We sell T-shirts, sunglasses and we’re trying to leverage the Medicare system; whatever we can do to fund the much-needed eyecare in my community,” he says.
“We’ve got some very generous and supportive sector members. The sector and the industry are getting behind us by donating equipment, old and damaged stock, and offering advice and guidance. We take pre-loved glasses from practices around Australia, and we can provide them to people where cost remains a barrier to good vision.”
Transform, not reform
Transformation begins with an eyecare pathway where Aboriginal and Torres Strait Islander people are supported by Aboriginal people every step of the way. A local health system that’s Aboriginal-led is key to improving eye health outcomes for Indigenous Australians.
Cultural safety can play a major part in ensuring that people respond to their own health needs. Thus, Deadly Vision Centre’s rates of failure to attend are better than that of public hospitals or public eyecare services, Tatipata says.
The collaborative care model at Deadly Vision Centre is an example of this Aboriginal led system. Here, the Aboriginal Health Practitioner is the initial point of contact for patients and facilitates access to eyecare services.
“We have the Aboriginal Health Practitioner-led pathway here and so the patient will come in and then they’ll see the Aboriginal Health Practitioner, and then they see the optometrist and ophthalmologist,” Tatipata says.
“Communities value these roles and so we empower them to lead the service. The optometrists and specialists know that they’re fundamental to ensuring cultural safety and really embrace their role in supporting our Aboriginal Health Workforce.”
He explains that Indigenous eye health outcomes are better through organisations that have Aboriginal and Torres Strait Islander leadership. Thus, education and training are key determinants in eye health success and promote greater representation. Tatipata’s overarching goal is for the eye health and vision sector to realise its full potential in this space.
Empowerment is the cornerstone of success
Beyond Deadly Vision Centre, Tatipata contributes in other ways, namely through the Indigenous Eye Health Unit at The University of Melbourne. There, he is engaged as an academic specialist, assessing and strengthening Indigenous leadership, lobbying governments and contributing to the organisation’s advocacy programs, including greater representation in leadership for improved cultural safety.
“We’re thinking about how we can strengthen education and training pathways that create opportunities because we know that’s going to lead to better employment and life outcomes overall. And we’re impacting other parts of the community as well. It’s more than just providing eye checks; we’re trying to create an ecosystem which allows us to train and support mob and ultimately increase representation in the eye health and vision care sector – particularly in the leadership space,” Tatipata says.
In the Vision 2030 report that Tatipata co-authored, the need for First Nations communities to lead the development of health promotion and health interventions was outlined. He says empowerment is the cornerstone of success in the eye health sector as well as championing the next generation of Aboriginal and Torres Strait Islander eye health professionals and Aboriginal Health Practitioners.
“It’s more than just simply being measured against our non-Indigenous community members, in terms of eye health outcomes. It’s about hearing what our communities want, what our aspirations are, and what our measures of success are. And the best way to do that is to ask, so we did that. Being able to articulate those aspirations, and then support the communities to achieve them is quite powerful,” Tatipata says.
The future looks bright for Indigenous eyecare, with the introduction of ophthalmology services to the Deadly Vision Centre which will cut down surgical wait times in half. Tatipata hopes to see a dedicated surgery list and laser services at the clinic soon.
He’s also expanding the Deadly Eyewear range that helps to fund the operations of the clinic.
“We’ve got our own finishing lab where we make glasses and train other Aboriginal community members how to make and fix glasses. There’s opportunity for us to expand that support to other communities around the Northern Territory, as well as Australia,” he says.
Tatipata acknowledges the invaluable support he has received from institutions nation-wide.
“The University of Western Australia’s optometry school provides an incredible amount of support to the Deadly Vision Centre, enabling us to have increased capacity to deliver services in my community,” he says.
“I am extremely grateful for the support of The Fred Hollows Foundation, Indigenous Eye Health Unit at the University of Melbourne, the Australian and New Zealand Eye Foundation and the optometry schools at Flinders and Deakin Universities; the support has been incredible. The majority of our equipment in here has been donated by industry supporters and that’s given us a huge amount of additional capacity to do more in the community.”
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Diabetic retinopathy in Indigenous Australians
The Voice to Parliament – what a ‘yes’ vote would mean for Indigenous eye health
