Victoria M. Sheffield

Victoria Sheffield is a recognized leader in international eye health programming, training, and hospital sustainability with over 50 years’ experience in Africa, Asia, Latin America, the Middle East, and Eastern Europe. She has traveled to 109 countries (most many times), lived in 5 countries on 4 continents including the UK where she was born, and has professional experience in 48 countries.

Share your background and if there is one, a defining moment led you to where you are today.

First, I’m a proud immigrant from England, born in Nottingham and living there to the age of 5 years, then to Tewksbury until the age of 8 when my family emigrated to the United States. I was born in 1948, so post-WWII. Both my parents served in the war. My Dad, who was from Nottingham, served in the Royal Signal Corps and my mother who was from Sheffield, Yorkshire served in the Royal Air Force in intelligence. She was one of four women including Clement Attlee’s daughter Janet, who flew into the Republic of Ireland at night and also to Ceylon. I’m sure there were more adventures but I know little of what they were up to.

Post-war England was austere! I was an asthmatic spending many weeks in oxygen tents because there were no medicines back then. In the early 1950s during the Suez crisis, there was a call over the radio that everyone might be called up again. That tipped the balance of either staying in England or accepting an invitation from my mother’s cousin in New Jersey, also from Yorkshire, who said he’d sponsor us to come to the US and so we did in 1957. We traveled on a French ship, the Flandre, from Southampton and docked in New York City on the west side of Manhattan Island on the Hudson River. We missed Ellis Island by three years as it closed in 1954. There was a large exodus from the UK in the early 1950’s and we were part of that. My father’s sister, the eldest of five, was married with two sons, so she stayed in Nottingham. But Dad and his brothers and families emigrated to “the colonies” with tens of thousands of other Brits who wanted no part of another war. Dad’s eldest brother Ron went to South Africa, Uncle Bob went to Wales, Uncle Jim went to New Zealand, and my dad came to America. With first cousins around the world, we say the sun never sets on the Sheffield family.

My family became US citizens in 1962. We basically started from scratch in New Jersey. I was the eldest of three with two younger brothers. Being a girl back then and having little money, college was not an option for me. So, I joined the US Air Force in 1966 during the Vietnam war and was trained as a medic. I first served at a medium sized base (it had a flight line) in northern California which, in the 1960s, was an amazing time to be living near San Francisco. I guess I was a hippie too when I was not in uniform. In 1969, I was sent to the massive Clark Air Base Hospital in the Philippines where we received daily air evacs of the wounded who were sent for care before either returning to Vietnam or being sent back to the States. It was just after the 1968 Tet Offensive and the height of the war in Vietnam. Whilst in the Philippines, I married another New Jersey native and, because he had a few months left beyond my date of separation, I extended to his date of separation and went with him in 1971 to his next post which was a very small intelligence station in southern Italy. The station had an equally small dispensary where I spent a year. Quite a mind change from being so close to the Vietnam conflict and suddenly in sunny Italy where one heard little of the war. Of course, we lived off base and didn’t have a TV and there was no CNN nor 24-hour news cycles, even on the radio.

When we “got out” and returned to New Jersey, we realized we had been living in a military bubble and perhaps didn’t know yet who we really wanted to be and thus, amicably divorced. I got a nursing license and responding to an opening at my hometown hospital for an ophthalmic assistant in the Ophthalmology Department in 1972, I got the job. Inside of six months, the three ophthalmologists, two of them professors, trained me so well that I was taking detailed histories, performing all the technological exams and initial refractions, and assisting in surgery. A highlight was joining a Christian Medical Society mission to Liberia in 1974 where I spent a week in the eye department at the JFK Hospital in Monrovia. Visiting some rural missions, I saw patients with Hanson’s disease (leprosy) for the first time because Hanson’s has devastating eye complications. This was my first trip to Africa, and I fell in love with the continent.

What inspired you to pursue your current path or career?

Whilst still in New Jersey, I wanted to go for more general nurse training but as I loved everything about the amazing little eye, our window on what’s happening in the body, so I applied in 1975 for the 2-year Ophthalmic Medical Personnel training program at the Georgetown University School of Medicine in Washington, DC and was accepted. Eight of us trained with the ophthalmology residents and were exposed to as much or as little as we wanted to absorb beyond our classroom and hospital rotation training and I was a true sponge!

After graduation and six weeks backpacking through Europe with my best friend between our written and oral board exams, I was offered the position of Chief Technician at Georgetown’s Ophthalmology Clinic and Operating Room assisting in all types of ocular surgery and training the “assistant and technician” level students. In 1979, I was invited by the Chief of the Cornea Service to join a surgical team being sent by the International Eye Foundation (IEF) to Amman, Jordan to establish the “new” Jordan Eye Bank. The original corneal transplant service was started by Dr. David Paton at the St John Eye Hospital in Jerusalem in 1962 and supported by IEF and the US National Eye Institute at NIH in Bethesda, Maryland.

At that time, most of the ophthalmologists in Jordan had trained at St John, but when Jerusalem and the West Bank were lost to Israel in the 1967 war, Jordan established its own residency training program and services. King Hussein and his new wife Queen Noor officially opened the Eye Bank and it was a great pleasure and honor to meet them both. I’m very proud to report that the Jordan Eye Bank is still thriving.

After that amazing experience, I took a local Palestinian bus across what was the old, rickety wooden Allenby Bridge to spend a week visiting friends and sites in Israel. One of those sites was the St John Eye Hospital in East Jerusalem, the first of many full circle moments with the Order of St John and the Eye Hospital.

When I returned from Jordan, wanderlust took over! I consider myself an internationalist having left one country at the age of eight for another in 1957, served in two foreign countries in the US Air Force 1969-1972, visited my first African country in 1974, backpacked through Europe in 1977, and had a taste of ophthalmology in the Middle East in 1979, so I wanted to find a way to get back overseas. Lo and behold, the woman who joined our corneal transplant team to Jordan and worked for IEF at the time, resigned to stay in Jordan and I was offered her position at IEF as a primary eye care trainer. I jumped at the chance and in late 1979, I was sent to Puerto Rico to support IEF’s project there. IEF also sent me to Cairo, Egypt to work with the Ministry of Health to develop eye health training materials for their nurses.

In Sardidi Village near Lake Victoria training Village Health Workers in 1980

In January 1980, I was posted to Kenya for three years as the Paramedical Trainer in IEF’s USAID- funded “Kenya Rural Blindness Prevention Project”. The project had two American ophthalmologists, one epidemiologist, and administrator, and me. It was in Kenya that I found my footing and was so very fortunate to be there when giants of international public health development programs and training were there at the same time. Again, I was a sponge learning how to teach primary eye care to village health workers who have basically two years of education and English isn’t their first language. And how to train general nurses and physicians who understand medical terminology but needed the basics of ophthalmology so they could care for the eyes of the patients they saw every day. And even to ophthalmologists who were usually from wealthy families in the big cities who could afford to send their children to college and medical school, and who had never been in the countryside to see the likes of a dense cataract, the highly-infectious and blinding disease called trachoma, the ravages of vitamin A deficiency in children’s eyes, and late-stage eye conditions they don’t see in the cities. I took a zillion photographs of local conditions, local vitamin A-rich foods in the markets, outdoor toilets, water wells, and all the elements needed to prevent and treat diseases to bring to life in my presentations. I developed, field tested (the critical element), and printed manuals, posters, flash cards, and slide sets and trained a Kenyan senior Ophthalmic Clinical Officer who traveled with me around the country so she could take over when I left Kenya in early 2003. Also, I had the opportunity to travel to Sudan, Ethiopia, Malawi, and South Africa to learn how local colleagues ran their training programs.

Leaving Kenya was painful as I believe I would have stayed if I had the chance. I returned to IEF headquarters in Bethesda, Maryland, a suburb of Washington, DC and was sent for three months to the Caribbean island of St. Lucia training nurses from surrounding islands in primary eye care. Yes, lucky me, but people living on these resort islands don’t have the luxuries or health care that the tourists have and they are basically quite poor. Glaucoma is eight times higher than it is in the US, so on the islands that do not have an ophthalmologist, the nurses are the ones to try to preserve sight for their patients. I also continued working with the Ministry of Health in Egypt.

In 1984, I joined Helen Keller International (HKI) based in New York City as their Director of Paramedical Training and became a specialist in vitamin A deficiency which was HKI’s focus in two large USAID-funded programs in Sri Lanka and the Philippines. This time, I needed to learn much more about the disease, what vitamin-A rich foods were available in those countries, and when and where the disease was most prevalent. Part of my work was to take part in epidemiologic surveys to gather data on the prevalence of vitamin A deficiency amongst poor children. My main role was to work with local colleagues to develop training materials, field test and print them locally, and start training programs to address this terrible affliction which not only blinded young children but also killed them if their general health condition was very poor.

In Ethiopia in 1985 during the drought and famine in a Displaced Persons Camp examining and photographing people in the camps

In 1985, I was thrown into the midst of the major draught and famine in Ethiopia and Sudan made famous by Bob Geldof who raised millions of pounds and dollars through his “We Are The World” concerts. Whilst HKI’s support came from USAID, I saw the tremendous benefit of the relief work supported by Bob Geldof and his teams. My work included conducting surveys of children in the refugee and displaced persons camps in many areas of Ethiopia and Sudan. Also, nutrition education, which was a fools errand when the draught decimated crops, and the foods that were available in the markets were unaffordable for most people due to demand. Hundreds of photographs later, I had enough material to train health workers in the camps, develop flash cards to be carried by the health workers in order to recognize the signs of vitamin A deficiency in the eye (xerophthalmia), and to use in make-shift clinics. We advocated with the donor embassies in Addis Ababa and Khartoum to make sure the milk powder they donate is fortified with vitamin A, or else it’s useless against the deficiency.

I continued visiting and training trainers in Ethiopia and Sudan through the late 1980s and was invited by WHO’s (World Health Organization) Programme for the Prevention of Blindness to develop three posters. One addressing basic public eye heath disease prevention, one addressing trachoma, and one addressing vitamin A deficiency. The challenge was developing single-subject posters for worldwide use where Latin languages read left to right, Asian languages read right to left, and have the people depicted in the posters be relevant to a worldwide audience. Fortunately, there were experts at WHO who helped me with the machinations of design and three posters were eventually printed in 14 languages and distributed worldwide. It was invigorating not only being in the beautiful city of Geneva for weeks at a time over the late 1980s, but to have the opportunity to work with some of the smartest public health professionals in the world.

Whilst following-up the work in Ethiopia and Sudan, I was sent to Bangladesh in 1986 to work with HKI’s Bangladesh staff and the Ministry of Health to develop a “national” training program on the prevention of vitamin A deficiency. Yikes, national? Again, working with expert Bangladeshi’s and expats, we developed a national program with materials designed, field tested, and printed in the local language with local photographs (my cameras got a work-out again), and set about training the trainers to address an endemic condition amongst Bangladeshi children whose families are extremely poor. I also worked with Ministries of Health in Africa, Asia and Latin America helping design and develop eye health training programs and materials that were locally appropriate and in local languages. A great experience was traveling to Ouagadougou, Burkina Faso in West Africa where WHO’s “Onchocerciasis Control Programme” was headquartered learning as much as I could about this disease. Onchocerciasis is a parasitic disease commonly known as “river blindness” because that’s where the flies that transmit the worms to humans, breed. “Oncho” was endemic in 36 African countries, six South American countries, and Yemen at that time. People were infected from childhood and became blind by the time they were in their 30’s, the prime of life.

In early 1990, a very good friend with whom I worked in Kenya told me that the Executive Director position at IEF was open and I should apply. “Who me” I said? “I’m living an Indiana Jones life and loving my work, why should I do that?” But I had become very interested in policy development at the highest levels and thought, well, if I had that job, I could lead instead of advocating with others to do what I thought best. I figured I wouldn’t get the job, so why not apply right? Well, six months later, I got the position and moved back to the Washington, DC area in June 1990.

The title of my position changed to President and CEO, and I soon realized that the job was mainly management and fundraising, but still in the eye health space (I called it the “eyeball” business). In 1990, the Berlin Wall came down, the USSR collapsed, and Americans were clamoring for our government to assist the region. Not easy since the US had not been funding projects in the USSR at all. Funds were allocated by Congress to USAID and a call for proposals went out. IEF got one of the very first USAID grants given for Central and Eastern Europe and was the only one supporting public eye health. It’s a saga and Prof. Petja Vassileva, our country director, and I talk about writing a book about that experience and maybe one day we will. It was fascinating to work in Bulgaria and Albania and witness, intimately, the very difficult structural changes that went on in those very early years when the government people with whom we were working were the same people who had their jobs under the Communist regime. We were fortunate to have local partners who made a very exciting project work successfully through thick and thin.

WHO in Geneva as Chair of the London-based International Agency for the Prevention of Blindness's Partnership Committee (1993-1998)

Also, there was much more work collaborating with WHO which I loved. And with the International Agency for the Prevention of Blindness (IAPB) based in the UK with which I’d been active since 1982. I actually became Vice President of IAPB from 2015-2021.

A huge full circle moment was that in 1994, I was nominated for membership by one of IEF’s founding Board members into The Most Venerable Order of the Hospital of St John of Jerusalem, a British Order of chivalry headed by the monarch who was Her Majesty Queen Elizabeth II at the time. From 2009-2015, I represented the US Priory on the Board of Trustees of the St John Eye Hospital which met in London twice a year and in Jerusalem at the Eye Hospital once a year which was a tremendous experience and privilege. I served on the Clinical Governance Committee and Chaired the Strategy Committee which was right up my alley. After 19 years of promotions, I was made a Dame of the Order in 2013 by HM Queen Elizabeth II. So, remembering that first visit to the St John Eye Hospital in 1979 when I’d never even heard of the Order of St John, it was a full circle moment and a vote of confidence that I’d been on the right track in my career all along.

At the annual American Academy of Ophthalmology's "Global Eduction & Outreach Committee" meeting in San Francisco, 2019

Have you faced any significant challenges or setbacks, and how did you overcome them?

Well, I wouldn’t call them setbacks, but rather challenges. Same difference. But there were two challenges of note amongst many:

Eritrea: once the 30-year war between Ethiopia and Eritrea ended in 1990 and Eritrea gained its independence from Ethiopia, USAID started funding NGOs to help Eritrea. IEF designed a project to address vitamin A deficiency, submitted a proposal to USAID, and got funding to work in the surrounding areas of the port city of Massawa on the Red Sea coast that had been destroyed during the war. When I visited, there were bullet holes in whatever skeletons of buildings that still stood, and it was debilitatingly hot at sea level. There was very little potable water or agriculture either. We had hired an American country director and local staff, put in a vehicle, and brought a contract to the Ministry of Health so we could get started. We never work without a contract that shows what we will be responsible for and what our partners are responsible for, including governments. My Director of Programs went over to put pieces in place but could not get the contract signed by the Ministry of Health. He went again a couple of months later but neither he nor the country director could get the contract signed. I was not willing to spend more US taxpayers’ money without a contract, so I went to Asmara to meet with the Ministry of Health people, but had no luck at all. USAID never likes it if you try to give money back, so I went to USAID’s headquarters in Washington DC and asked if I could move the funds to our similar project in Ethiopia and they said yes.

Six months later, President Isaias Afwerki who is still president after 35 years, kicked out all foreign NGOs from Eritrea. So, the American NGOs who had USAID grants went to USAID to ask if they could “do what Victoria did”. A vindication of sorts.

Bulgaria: working in Bulgaria immediately after the collapse of the USSR was a challenge on many levels from setting up checking accounts so we could wire money to the project. Checking accounts didn’t exist. And I was laughed at when I tried to make up a salary budget for personnel based on expertise and responsibilities when everyone, doctors, nurses, cleaners, etc., all got the same salary under the Communist regime. Politically and as noted earlier, there was a clamoring in the US asking Congress to do something to help Central and Eastern Europe because USAID had not been funding the USSR before and there was no Central/Eastern European Bureau within USAID to which Congress could allocate funds. So, USAID set up a Central and Eastern European Task Force, Congress allocated funds, and a call for proposals was announced to US NGOs and contractors. Well, no NGOs had been working in the former USSR and had no experience. Serendipitously, an ophthalmologist named Prof. Petja Vassileva from Sofia was at Johns Hopkins doing a master’s degree in public health with a certificate in public health ophthalmology. She approached me at the American Academy of Ophthalmology meeting in 1990 in Atlanta saying that we must help her country. Having just been in my new post as IEF’s Executive Director and with no experience in the former USSR countries, I said “what do you want us to do?”. As Johns Hopkins and Baltimore were close to Washington, DC, we got together and turned her masters thesis into a proposal and got one of the first USAID grants given for Central and Eastern Europe. Going through the trials of setting up a project which included a blindness prevalence survey led by experts at Johns Hopkins and building an eye bank in Sofia in collaboration with the Baltimore Eye Bank, it turned out that the chief ophthalmologist in the Ministry of Health was a woman who was married to the mayor of Sofia. She was furious that IEF and Prof. Vassileva got a US Government grant and put awful articles in the newspapers that the US funds were meant for her and were stolen by Petja and Victoria. No amount of explaining that these funds had to be applied for by a US NGOs only and implemented through complex US government contracts, was going to change her position.

I believe it was in 1991 when the US ambassador to Bulgaria was advocating with the mayor for a new building for the US embassy instead of the broken-down old row house they were using. So, the mayor told the US ambassador he would not get a new building for the embassy unless he closed our IEF eye health program! Petja called me in a panic relating what had happened and I felt I needed to write a strong letter to the US Ambassador. I spoke with members of my Board of Directors, some of whom had been ambassadors themselves, and they advised me to be diplomatic calling it a “dust up” when I was so angry I wanted to say that a new embassy would come on the backs of a lot of blind people. I took their advice but did not use the term “dust up” and related IEF’s position in the matter. I remember driving home from the office one evening thinking “hey, I’m just an immigrant kid from England, how did I get bound up in this mess!” Still working behind the scenes and with other partners, six months later when the mayor had not given the US ambassador a new building, the ambassador called and apologized and reopened our program. Another vindication of sorts.

How do you stay motivated during difficult times?

Early on when I first got my CEO position, I missed my Indiana Jones life and was getting frustrated with the focus on personnel management and fundraising. I happened to go to an InterAction meeting of all the CEOs of US NGOs working overseas being held in DC. I asked the late C. Payne Lucas who founded Africare how he stayed motivated. He said, “read your Annual Report once a month” and I did and it worked!

How do you define leadership, and what does it mean to you?

To me, leadership is stepping up and standing up to lead. Some are born leaders, others aspire and through experience take leadership roles. Yet others aspire to leadership roles but are caught up in the Peter Principle which says that people get promoted to their level of incompetence. Men seem to lead by fiat, women lead by consensus, at least in my experience when there weren’t many women leaders around. It’s certainly a learning curve, it’s lonely at the top, and you need mentors and those who support you along the way. And in my case, I’ve always stood up for what I felt was right in my gut which fortunately, stood me in good stead.

Who do you consider a role model or mentor, and what have you learned from them?

I have always looked to my professors for advice until, when in my 30’s and certainly in my 40’s, they retired or died. I then had to build a supportive network of colleague leaders and of course, my Board of Directors, especially a smattering of ambassadors and expats who had lived overseas. Also, professors of public health ophthalmology at WHO in Geneva, Johns Hopkins in Baltimore, the International Centre for Eye Health in London, and leaders in countries with whom I worked and “grew up” of you will. They were like-minded professionals who reached C-Suite positions like me and we could commiserate together.

How do you use your platform or position to inspire or uplift others?

Being retired, my platform has become one of a sage which surprised me, but I like it. I often sit with colleagues my age at meetings, and we are amazed at how the younger ones are re-inventing the wheel. They will learn the lessons we learned when they get to the field I guess. I don’t know how to deal with that, but problems are being dealt with these days with technology and AI. It’s certainly something different than when I started out in the 1960’s and 1970’s, last century, when our technology was telex and fax and the internet was something Anna Paquin talked about in advertisements in the 1980s: “The internet superhighway is coming!”. We all said, what the hell is she talking about?? But I very much enjoy making myself available to those who have included me on their advisory boards or on panels where we can have an open dialogue about the challenges of this time and how they relate to the challenges of my time. And of course, be there for them when the wheels start falling off and they ask “what would you do in this situation?”

What do you love most about what you do?

I love the opportunity to really get to know people in different countries and of different cultures. And how better do it than by understanding their health care needs, the barriers and cultural beliefs that prevent them from getting care, and be part of solutions to improve eye care. And having the opportunity to take leadership positions in some of the global achievements in eye health in the late 1900s and early 2000s.

What’s a project or achievement you’re especially proud of?

Being in leadership roles in the International Agency for the Prevention of Blindness planning the very successful and impactful 20-year “Vision 2020: The Right to Sight” initiative which was launched in 1999 by WHO’s Director General Gro Harlem Brundtland at the Palais des Nations in Geneva, and joining IAPB leaders in efforts over the next 20 years until the initiative’s end when I happened to be Vice President of IAPB. The year 2020 also was the year when I retired as President and CEO of IEF after 30 years in that position. I wanted to make it to 2020!

What’s one thing people often misunderstand about you or your work?

I was always asked “how many patients do you see when you go overseas?” It was so difficult to explain that I don’t see individual patients. They grimace. I say that I am the head of an organization that has experts in headquarters and local professionals in the countries who help strengthen eye clinics, hospitals, and services so that local ophthalmologists and eye care providers can improve the care they provide through improved technology, training, and patient access and affordability. Then they still asked, “yes but, how many patients do you see every day?” Ugh…

What’s a habit or routine that contributes to your success?

Structure. Keeping a solid calendar for meetings, report and proposal deadlines, fundraisers and travel. I used to love going to one country and just focusing on what needed to be done in that country, rather than juggling meetings, calls, and reporting for a number of different projects in different countries in the same day back at IEF headquarters.

How do you balance work and your personal life?

It was hard. But I loved my work, so it wasn’t a chore. My husband was very understanding and supported me always – “the wind beneath my wings” as the song goes.

What are you currently working on or excited about?

I’m retired, that says a lot, right? I do serve on some advisory boards and committees and keep active in the eye health space, but I’m focusing now on projects that I always said, “I’ll do when I retire”. Well, that’s now. One major project is to catalogue my photographic slides taken between 1990 when I became head of IEF and 2005 when I switched from film cameras to a digital camera. I had no time to do that in those 15 years. Once that’s done, I’m going to send my 6,000+ slides taken since the 1960’s and send them out to be digitized.

Where do you see yourself—or hope to be—in the next five years?

Alive, active, ambulatory, and still having all my marbles! I just turned 77 and pushing 80, so there’s not a lot of time left.

What advice would you give to your younger self?

Follow your instincts! Be strong, be tough, don’t take crap from fools, stick up for yourself and your values, and listen to your gut. Also, take advice from your trusted sources, but then make your own decisions.

I’m not saying that you should dig in for what YOU want to happen. Look for compromise while still sticking to your values. I used to tell colleagues who disagreed with me to give me a good rationale on why I should adjust what I wanted to happen, because I can be dissuaded by a good argument. Bring it on! There were indeed times when I was dissuaded and changed my mind. Compromise is a good thing. When I readied for my interview for CEO of IEF, I told my brother that they will ask if I think I have any weaknesses. He said YES! Yikes, what me, I do???? He told me I’m a “perfectionist”. Well, I took that as a badge of honor. But he was right in one way, so I tried to remember the old adage “Don’t let the perfect be the enemy of the good”. And be respectful and diplomatic to the people you respect, especially your overseas colleagues. And make sure you “see” the people you’re trying to help, even in the remotest village. They’re not numbers, they’re people – walk a mile in their shoes, and be grateful to them.

What message do you hope to pass on to the next generation of women?

Same as number 1. Although for women, I still say “don’t dress for the job you have, dress for the job you want”. I did not originate that; it was passed down to me. But that adage kind of went by the wayside after Covid. Women don’t dress in suits, etc. anymore. Still, dress respectably, no cleavage – it upsets the guys, and don’t let people’s focus be on how you look but what you say and how you say it.

What does winning mean to you?

Having a successful outcome to an issue that now helps people. Sometimes it’s an easy fix, and sometimes it’s a slog with the need for a lot of negotiating and pressure but getting it done is a tick in the box! And building networks and coalitions to help you and your mission.

Victoria and Laura at The White House