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Three sisters pose for a photo while recovering from cataract surgery. The Savusavu Community Foundation has been key to providing such services in Fiji. (Courtesy photo)
The sisters, three older women in rural Fiji, were seeing each other for the first time after recovering from cataract surgery.
“You look so old!” one told another.
“Oh, my God. You were ugly before, and you’re still ugly!” another told the first.
When Ken Barasch recalls a lifetime working to improve health care access and outcomes in Fiji, many of the memories warm his heart. The scuba instructor whose hand and arm, badly damaged during an accident, were successfully repaired by a prominent reconstructive surgeon. The fisherman whose severe cataracts, as well as lung problems, were preventing him from earning a living, until the Savusavu Community Foundation, Barasch’s nonprofit, arranged surgery and treatment for him. The girl from a remote island whose family brought her in, covered in boils and barely breathing, to a local clinic. After two days of treatment, “she was walking around,” Barasch recalled. “She’s gone on to a successful career.”
The three sisters, who’d gone years without seeing one another clearly, make him chuckle.
Barasch and his wife, Donna, didn’t travel to Fiji planning to start a nonprofit, or to devote their lives to bringing more medicine, health care, education, or climate resiliency projects to the island nation.
But in 1990, after several years of vacationing in Fiji, they noticed that many of the locals were missing teeth. Cloudy eyes, where the bright sun reflecting off the sparkling water and sand had caused cataracts, were common.
“Everything was not so perfect in what seemed to be this idyllic country,” Barasch remembered. “The most frequent dental appliance was a freely wielded pair of pliers.”
While Fiji’s Ministry of Health and Medical Services was dedicated to improving health outcomes in the country through what Barasch estimated were about 220 health centers and stations throughout the country, there were often shortages of medical equipment, supplies, and providers in hospitals and clinics. People in rural areas and on smaller islands, where the nearest clinic was often a boat trip away, had a harder time accessing health care.
The Barasches formed a registered nonprofit, the Savusavu Community Foundation, and began focusing on health care. At first, the foundation’s work centered on dental care and cataract surgery and prevention.
“The more we went, the more I realized there was a need for other kinds of care in Fiji,” Barasch said. Reproductive health care, eye exams and glasses, chronic disease monitoring and treatment, and specialized surgery were all widely needed.
So Savusavu Community Foundation branched out, building and shoring up medical facilities, bringing in doctors to conduct clinics and surgical missions, and finding partners who could donate medicines and treatments, equipment and supplies. That’s when they came across Direct Relief, Ken recalled.
“I met this fellow on a Saturday, and left with four giant boxes of hand equipment” for dentistry, he recalled.
Soon, Barasch said, he was outfitting three major Fijian hospitals with equipment, medicine, and supplies from Direct Relief. Fiji’s Ministry of Health and Medical Services asked if he could scale up, equipping hospitals and health facilities throughout the country.
Anytime the foundation received a medical request — for example, a Fijian hospital searching for a specialized oncology drug — “my first call is always to Direct Relief,” Ken said.
Today, the Savusavu Community Foundation is expanded yet further. Donations pay for classrooms and school libraries, books and teachers’ salaries, hygienic community kitchens (Barasch explained that it’s common for women in rural communities to cook outside in the wind and rain). The foundation works to rehabilitate marine ecosystems, build filtered water systems, and promote and preserve Fijian culture.
But health care remains integral to their mission. Barasch is proud of procuring Covid-19 vaccines during the height of the pandemic and providing meals to quarantined households who had no way to pay for food. Education and treatment have improved chronic disease rates, dental health, and other significant health issues. Until the very end, the foundation worked to supply solar refrigerators and freezers to villages that don’t have electricity, so that patients with diabetes could safely store their insulin.
At the end of his career, early in 2025, Barasch was honored with the Order of Fiji for his support of Fijian health. Jeremaia Mataika, head of Fiji Pharmaceutical and Biomedical Services, wrote of Barasch’s “immense work” and the “respected space” he holds in bringing support to Fiji’s health system in his letter of recommendation.
Ken Barasch is honored with the Order of Fiji. (Courtesy photo)
Barasch, severely ill, decided to retire this year. Because running the Savusavu Community Foundation requires him to spend 60 hours of unpaid work each week, he said finding a replacement to fill his shoes was impossible. “It’s a lot of work and a lot of stress,” he said, even though it brings “a lot of joy.”
The only question was what to do with the remaining funds. “When you close a foundation, you have to zero it out,” Barasch explained.
He donated the remaining balance from the foundation, a total of $110,000, to Direct Relief.
“Direct Relief has been our number one partner for two decades,” Barasch said. “Whatever Direct Relief wants to use it for, I completely trust their decision-making.”
For Genevieve Bitter, Direct Relief’s vice president of program operations, the donation is a vote of high confidence. “It speaks volumes,” she said. “He could have given it all to anybody…He’s witnessed what we’ve done for years.”
Barasch’s long-term relationship with the organization demonstrates the key importance of partnership, Bitter said: “With any successful partnership we have, we need to have a person like Ken, who is totally committed and dedicated.”
Patients in Fiji pose after eye surgery to correct cataracts. (Courtesy photo)
Gordon Willcock, Direct Relief’s Asia Pacific Regional Director, said that continuing support to Fiji is an ongoing priority — not just for the country alone, but for the region at large. “It’s a strategic country in the Pacific,” he explained. “It’s a hub and connector to other Pacific Island nations”
The prevalence of archipelagos and small, outlying island nations makes Oceania a difficult region logistically, Willcock explained. During disasters such as cyclones, responders in Fiji often receive and distribute medical materials and other emergency supplies to impacted areas.
“This all makes Fiji an important area of focus for us,” he said.
Barasch is hopeful that Fijian health will continue to improve. For example, he said, while Fijians eat fish and farm vegetables, their gardens tend to be filled with starchy root crops. More education and outreach might persuade Fijian gardeners to grow spinach and other greens, carrots, beets, and other healthy vegetables.
Refrigeration for insulin is also a high priority, he said.
Bitter and Willcock are planning to travel to Fiji in April, to discuss support strategy with local officials and communities.
“It is an island nation, and there are so many rural and remote communities,” Bitter said. Vulnerability to storms — Fiji receives a large cache of Direct Relief emergency supplies each year — complicates the already high need and large number of small villages. “We want to make sure we have this continuity in donations.”
Since 2008, Direct Relief has supported the Savusavu Community Foundation with $29.9 million in material medical aid, part of a total of $159.6 million in medical support to healthcare working in Fiji.
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