Recorded on Tuesday 11 June 2019 in the Hallstrom Theatre as part of the Australian Museum's Lunchtime Conversation Series.
New Zealand born, UK trained eye surgeon Fred Hollows’ drive to end the injustice of avoidable blindness emerged from a deep commitment to social equality. The economical approach to ophthalmology – focussing on training local surgeons and reducing the cost of lens - which he and his orthoptist wife Gabi developed, has restored sight to more than 2.5 million people. The Fred Hollows Foundation which the couple established in 1992 just six months before Fred died, continues to empower poor and neglected communities across the world.
Gabi Hollows is recorded in conversation with Journalist and News anchor Sandra Sully.
Sue Saxon: And now join me in welcoming Sandra Sully to introduce Gabi Hollows.
Sandra Sully: Good morning everyone. It's a real honour to be asked to come and present some of these conversations at the Australian Museum. If you're wondering how I ended up getting involved, I'm good friends with Kim McKay, who's the CEO, and she's a dynamo that is building this museum into an incredible institution. It always has been, but I've just watched from afar with great admiration for all of the work she's doing here.
I'm not here to spruik about Kim, but did any of you come last year to meet Mr Attenborough? That was quite the treat when she brought him out. And of course today we have a chance to meet a woman I've admired for as long as I can remember, and to talk about a man—when I first started in journalism I remember that first 60 Minutes story with Ray Martin—and I thought he had a heart of gold, and he was just too generous for words, and what he gave to our community, let alone the world, is just invaluable. So it's a real honour to acknowledge him today and of course the work of his amazing wife, Gabi.
So Professor Fred Hollows AC as you know needs little introduction, but for those who are unfamiliar ,a brilliant eye surgeon with a strong sense of social justice, his career was shaped by his conviction to improve access to eye health and better the living conditions of Indigenous Australians. He was a pioneer, as we all know. His legacy is felt not only in Australia but around the world. His advances in ophthalmology and his application of that work in some of the most underprivileged parts of the world has prevented curable blindness for millions and millions of people and, in turn, transformed their lives and their futures.
From humble beginnings, Fred Hollows followed in the charitable footsteps of his family and sought a life of service for those most in need. We are indeed honoured today to welcome his wife and professional collaborator, Gabi Hollows, as our guest this afternoon. Please make Gabi feel welcome.
As Gabi makes her way up to the chairs, just to scene-set—in 1992, alongside Fred, they founded the Fred Hollows Foundation, and since Fred's passing in 1993, Gabi has been the director and driving force behind the success of the Foundation. It now works in 25 countries worldwide, and has restored sight to more than two and a half million people. In 2017 alone the Fred Hollows Foundation trained more than 100,000 surgeons, community health workers and teachers; supported more than 174,000 cataract surgeries, and distributed over 18 million doses of antibiotics for people with trachoma.
Before we begin, ladies and gentlemen, here's a quick overview of Gabi and her work; take a look at the screens.
Gabi, welcome. Welcome indeed.
Gabi Hollows: Thank you, Sandra.
Sandra Sully: Now, what I never knew, and one of the joys of doing work like this is you find out so much more than the headlines you often only have time to read. I always knew this strikingly attractive, gorgeous woman who was alongside Fred, I thought it was just an amazing love story, but what I have since found out is from the age of three you had your own eye issues, so the journey's been somewhat personal from a very young age.
Gabi Hollows: It has indeed. In fact when I was a little girl, I was about 18 months old and I ended up in the Eye Department at Royal Newcastle Hospital. That's where I fell in love and met my first ophthalmologist, Dr Ken Walters. And I was as cross-eyed as a cucumber, some people say. I don't know what a cucumber looks like when its cross-eyed, but I was really knock-kneed, pigeon-toed and cross-eyed. So in a funny kind of a way I was a bit of a wreck. So I ended up in the eye clinic at Royal Newcastle Hospital, where my family have great associations in Newcastle.
Sandra Sully: But then when you left school you graduated as an orthoptist, and took up a position at the Prince of Wales Hospital in Sydney, and that's where you met Fred.
Gabi Hollows: That's right. In fact I actually broke my leg when I was about 14 and I thought I was going to be a physiotherapist, and orthoptics was my second choice. And I had surgery the day after my third birthday, and so I never thought I'd be sitting down at the eye hospital with only eight people in a little tiny room, becoming an orthoptics student.
My very, very first optics lecture was given by Fred, and I think that first photograph tells it, he said, 'Okay, which one of you knows the optics of a slit lamp?' and I was not shy because I'd worked with a GP on a Saturday morning from when I was in year two at high school, so I knew a bit about doctors and medicine and things like that, and I sort of stood up and said, 'Well, we don't know, Sir.' And Fred just basically said, 'Well, you'd better bloody well pull it apart and find out.' And I could see Sister Shirley Palmer, who was a lovely New Zealand nurse who ran the eye department sort of looking daggers at us—don't you dare touch that machine and pull it apart. So that was my first words from Fred to myself.
Sandra Sully: Well, tell me what's the difference between an orthoptist and an ophthalmologist.
Gabi Hollows: Well, an orthoptist is like a physiotherapist is to an ophthalmologist, and a lot of people get confused between ophthalmology and optometry. Ophthalmology is a medical person who's graduated and studied medicine, which Fred did, and then they go on and become a specialist in ophthalmology. Optometry in the old days were…the opticians were the people that ground the glasses and made the lenses. So they're a bit like a pharmacist to a doctor.
And the first orthoptist was actually the daughter of an ophthalmologist, so she was the person who came out front and…and it's very subjective when you're testing eyes. Little kids, as I knew from when I was tiny, I don't know if anybody's ever been to an orthoptist, but we work out the binocular vision. And you've got six muscles on each eye, so that's 12 muscles that have to work together, and you have to work out subjectively how little kids can see, and what they can and they can't see, and right up to all ages. So if you've ever been to the eye clinic and you've ever been tested, you've probably been worked up by an orthoptist first before you go and see the ophthalmologist. And I always used to joke that we do all the hard work and they get all the money.
Sandra Sully: Well, I hadn't heard the term 'orthoptist' before, so I was curious about what that was. Tell us a little bit about your work at the Prince of Wales and how it folded into meeting Fred and working with him.
Gabi Hollows: Yeah, well I was actually very lucky because my first block as an orthoptics student was with the med students and the eye registrars that were there. As I said, orthoptics was chosen for me as a second choice. I was actually very curious—I lived on the Central Coast and my mum and I came down to Sydney to put in my enrolment for my university and I put my physio and orthoptics in and orthoptics sort of grabbed me and said that same day I was coming down to do my university admissions, we got a telegram in the old days, you know, the man with the telegram came down and my mum was meeting me because I was actually working at Gosford Hospital as a physiotherapy aide when I left school, because that's what I really, really wanted to do. And Mum said, 'We've got this telegram to go down to the Eye Hospital next Monday.' And this was on a Friday afternoon at lunchtime she met me.
So we caught the train to Sydney, we went to the University Admissions Centre, which was in Commonwealth Street just down here where the Medical Eye Service used to be, and then we snuck down to Sydney Eye Hospital and sort of pushed the button and said well this is where we have to come on Monday, we'll be a bit cheeky and have a look. We caught the old concertina lift up. Who should open the door but Miss Lance, who was the head of the School of Orthoptics, and she said, 'Oh dear, well just come in.'
So Friday afternoon they were all sitting around having a cup of tea with some of the orthoptics students, and I happened to be wearing a white uniform that I wore at the hospital; I had a pale blue jacket with white grosgrain ribbons and white buttons, and I looked like an orthoptics student. I didn't know that they were the orthoptic colours, did I? And so they went, 'Oh, come in.' So they actually worked me through, and I was such a good ophthalmic result, I had full binocular vision, that they were quite astounded that I'd had such good treatment as a little kid. So I passed the test and I kind of knew what they were doing to me.
So I never ever thought that then six weeks after I started orthoptics they chose me as an orthoptics student. There were only eight of us in our year. I had the lucky draw of going to Prince of Wales Hospital for the six-week block when you first become a student, sitting in there with the ophthalmology registrars and the medical students and having the lectures and the talks and hanging out in the eye clinic with some very, very famous now ophthalmologists that you all have heard of in these cities and towns.
Sandra Sully: When you started, was trachoma the main cause of avoidable blindness in Australia?
Gabi Hollows: Yeah, well Fred actually was…the first Indigenous person that Fred ever had, that he ever met, was brought down to Sydney by Frank Hardy, who wrote…you know, a wonderful journalist who wrote The Unlucky Australians. And he brought, actually, Vincent Lingiari and his mate Donald into the eye clinic at Prince of Wales to have a look at their eyes, because they were the ones that had gone on strike. They'd been working on the stations for years and years and years; there was a lot of support up in the Northern Territory. They were brought into Fred's eye clinic, Fred took one look at them and he could see that Vincent had had trachoma. And he said, 'I want to have a look at where you come from. They had another eye condition which is called Labrador keratopathy and I won't go on about that.
Sandra Sully: No, please don't.
Gabi Hollows: But they hopped on a plane, they went up to the Gurindji camp, there was Fred and a lovely, lovely paediatrician who I only saw like two weeks ago, Ferry Grundseit, very famous; and Fred and a couple of other doctors they flew up to Wattie Creek and saw…the very first time he ever saw, and if anyone's got a copy of Fred's biography, there's a very shocking photo of an old woman called Maudie, who's bilaterally blind from trachoma. And trachoma in the old days in Australia was known as sandy blight. It felt like you had sand in your eyes and it was really gritty.
And when they first looked at people when they were coming in to be refugees and people moving in through into some countries overseas, when they came into America, in fact, the Statue of Liberty is where they used to process all the migrants, and what did they look for? They looked for trachoma, because trachoma was a very, very blinding disease. And if you had that infection, then you were going to have trouble later on. So the governments were really thinking about how many blind people were going to go on.
And when Fred first saw his first bilaterally blind trachoma patient, he said, 'How many people have we got in this country…have we got any trachoma here?' So he rang up one of the doctors in Bourke, (Northern New South Wales where Fred's buried) and said, 'Do we have any trachoma there?' They went, 'I don't know.' So they did the very, very first clinic in the Showgrounds in Bourke.
Sandra Sully: Well, let's take you back a little bit, because I'm not sure how many people realise Fred was actually born in New Zealand, and he was always driven by a strong sense of duty; referred to himself as a humanist, and that a higher power was to be found through the best expressions of the human spirit. So how did his family and his upbringing do you think influence that world view that Fred had?
Gabi Hollows: Well, Fred was, as I always joke about, was manufactured in New Zealand, and lots of people say, you know, we steal all the New Zealanders, don't we, in Australia. All the famous ones all come over here, and I just heard that Sandra's husband actually comes from New Zealand today.
Sandra Sully: Well, he lived there for three years. But I have a real soft spot for the Kiwis as well. I think they're a little ahead of us on so many levels.
Gabi Hollows: And we actually have a Fred Hollows Foundation in New Zealand as well that was established at the same time as Fred Hollows Foundation here in Australia, because for tax purposes you have to have an independent way of doing that in each country.
But Fred and I kind of have this crazy link too, because the hobby of Fred when he was a Kiwi, when he was a young medical student his favourite thing he loved to do was go mountaineering and climb up through the hills in New Zealand. I don't know whether people know my date of birth, but I was born on the 21st May 1953, which was the same week that Tensing and Ed Hillary summited Mount Everest…and I don't want to talk about what's happening there at the moment because there's some tragic stuff that's been going on recently.
So I was always obviously connected to Nepal without me even knowing that. I had no idea that my destiny was going to be so linked to Nepal…
Sandra Sully: And New Zealand…
Gabi Hollows: …and New Zealand, yes.
Sandra Sully: We'll just indulge for a second…do you remember the day you met Fred?
Gabi Hollows: I do, as I said, that was my first meeting with Fred in the Eye Clinic at Prince of Wales. In a little room and I was only just in there a few weeks ago, up in the Eye Clinic, in the same clinic. And one of our new registrars was starting. I said, 'This is a very special corner, that's where Fred used to see all his patients.' And going through the beautiful gallery just up here, looking at some of the legends and some of the people—many, many, many of those people on the gallery have actually been Fred's patients. So he was kind of the go-to guy that people came for a second opinion or a last opinion. They'd all end up in Fred's clinic.
Sandra Sully: One of the more signature moments in Fred's career was the establishment of the Aboriginal Medical Service in Redfern in 1971, '72. The first such service in Australia. Was it that radical at the time?
Gabi Hollows: Oh yes, there was no medical service. Aboriginal people that Fred first saw were struggling really in so many remote areas. You'd go into a country town and there would be a whole lot of Indigenous people having all sorts of problems, and very shy and embarrassed about fronting up to the hospital or to the local GP or wherever we had rural communities there was always some Indigenous people. And that was very, very sort of active. And of course when our Indigenous people came into Sydney, I caught the train from the Central Coast and from Newcastle where I was from; what happened was country people they came to Sydney, the Indigenous people, where do they hop off the train? They didn't hop off at Central Station, they hopped off at Redfern, because that's where the community was, in Redfern, and we all know the history of Redfern and how things are changing now.
So there was a struggle there and Fred was made aware of that and so they went, okay, we'll lobby for that, and Fred thought he was going to a meeting about establishing the first legal service, but it was actually about establishing the first medical service. And Gordon Bristow, who was one of Fred's mentors, who's the godfather to one of my twins, Rosa, and Jilipia who's the Aboriginal nurse you'll see in some of that footage, today you'll see some of that, they were the two people that were some of the very, very founding directors. And in fact Naomi Myers was the original director, who's my son Cam's godmother. So we've got a very strong link to the AMS, and that was established in those old days in Regent Street. It's around the corner now of course in the old church where Ted Kennedy used to be, it's where the front door of the…and Regent Street in Redfern as you know is now a very famous, trendy kind of place to go, but in those days it was pretty rough and pretty ready, and so there's a lot of history there.
We don't have enough time to talk about that, but it was my greatest privilege and my greatest honour to have worked so much with our wonderful Australians, and I pay my respects to all the amazing people that I met on the National Trachoma and Eye Health Program. It was a…I can't say it was an eye-opening experience because that's a little bit too clichéd, but I seriously, seriously, seriously had the most amazing and unbelievable introduction to Indigenous affairs.
Sandra Sully: The AMS was a significant milestone in their health services and in the Australian medical history. But I want you to tell us about…I mean Fred was always known to be quite gnarly, quite blunt. And as legend would have it he browbeat his medical colleagues to help establish the AMS and contribute to his success. Do you recall any of those moments where…?
Gabi Hollows: Well, I came along in Fred's life just when I was an orthoptics student. That was in 1971, '72, so it was when it was all happening, and I was a little bit naïve about Indigenous affairs, and in fact when we first started on the Trachoma program—and I was only just talking about this to a little boy who's doing a project, one of our neighbours, yesterday—I said I couldn't believe that it would be so hard to speak and communicate in my own language, English, in Australia. I felt really cheated as an Australian student who'd been educated here, because I never, ever, ever thought that I would not be able to communicate. I did not know there was so much Indigenous languages; hundreds and hundreds of languages. And when we got to Indulkana, which is in the central Australian area in the Pindara area, in our first month of working, there we were with all these old, beautiful, beautiful old people, and I just went around behind the vehicles that we had parked in a row—it was windy, it was cold, it was right up on the ridge, Indulkana's a pretty rough place, I can tell you now—and I just sobbed. I was so angry because I was so ignorant about what the history of our Indigenous people was…
Sandra Sully: And how denied they'd been to the everyday accesses that white Australia had been given privilege to.
Gabi Hollows: That's right. And the legend is that Fred went off to Prince of Wales and backed the truck up and knocked off all the drugs from the pharmacy. He was very naughty, but it wasn't him…
Sandra Sully: They're the stories we want to hear, Gabi.
Gabi Hollows: And in fact Dr Grundseit, who I met only two weeks ago, Ferry was there and he was in the Hearing Clinic and I was there with my son's mother-in-law who was having a few problems. She'd been flying and her hearing's a bit blocked up and I said, 'I've got to go and give this man in the corner a cuddle.' And she sort of looked at me as though she was saying, 'What are you doing, hugging this old guy in the corner?' And it was Dr Grundseit. And I often go up the hill near where we live in Randwick and I toot the horn and I wave and Ferry says, 'I'm trying so hard not to sort of fall in front of the bus that I don't wave to anybody.' And he's very deaf, and he said, 'It's because of all those bloody children who've been screaming in my ears for years and years and years.' And he used to work at Camperdown at the Children's Hospital as well as Prince of Wales in those days, so there was a great camaraderie of people who helped Fred establish the Medical Service and many, many of those doctors are very famous in our medical history in New South Wales, and I just want to pay tribute to all those people who helped kicked that along.
Sandra Sully: The Indigenous Australians' plight became stuck in your heart and in Fred's heart, largely directed his future, didn't it, it was a personal passion.
Gabi Hollows: Absolutely. My mother always said to me, 'Gabriel,' (that's my full name, it's actually Gabriel Beryl O'Sullivan, that's my real name) she said, 'Just make sure, before you go travelling overseas, you should go and have a look at your own country first.' I said, 'Oh, Mum…' I didn't even know they were called Grey Nomads in those days. 'I'll go along with my caravan one day and poke around and have a look.' And I'm a real country person. I'm a horse person, I spent my whole life with horses and riding and country stuff. I love the country.
Little did I know that I would be in more communities than probably anybody's ever been in this country—465 communities is a pretty amazing place to go, and we were always on the ground, we drove everywhere. We never went on the flying team that went on the trachoma program. We had a couple of road teams and sometimes they had to fly. I've never been to Mornington Island. I've never been to Croker Island and I've never been to Melville Island, but I think I've been to just about every other place in this country, and down every road and every stock route and every place you could ever imagine where there was an Aboriginal community.
Sandra Sully: And every ditch and every humpy you visited. Are those three still on your bucket list?
Gabi Hollows: Well, of course, yes. I was actually in Elko Island only just 18 months ago, you know. Those places in the Torres Strait were very, very magical places, and I was just looking up at Eddie Mabo and all the people, like…the history that we have had, the blessings that I have had to meet so many of our beautiful, beautiful Indigenous and rural people, country people. I'm a real bushy so I just love our history, and I just watched the last show on Sunday of Insiders, Barrie Cassidy and his wife Heather Ewart, who goes around and has these amazing times. I'm so jealous of the work that Heather did, and I think yeah, gee, you know if we could all hop in that truck together…we'd be off tomorrow, I tell you now.
Sandra Sully: Well, we talked about the very early years, but let's leap through to 1975 and a critical point in the trajectory of Fred's work was the development of the National Trachoma and Eye Health Program. That was established in '75, financed by the federal government. You were an integral part of that program, as you say, travelling across 450 communities. One of the largest public health studies ever done in the world at the time.
Gabi Hollows: That's right. Fred was…I just want to go back a little bit into Fred's history, because he was an ophthalmologist who…he trained, he did medicine in New Zealand and then went to the UK and studied his ophthalmology. But he trained with a very famous man called Archie Cochrane. Dr Archie Cochrane was a medical epidemiologist and Fred studied, and he did the first glaucoma studies when he was a medical student, on glaucoma. And unless you understand about counting things in epidemiology, if you can't count it you should be doing it, if you can't prove it you shouldn't be talking about it, and if you don't do it properly, the right way is what Fred's father always taught him, you may as well not even start.
So Fred had these really strong morals grounded into him, and so that's why he wanted to go and have a look in Bourke to see, okay, do we have trachoma? Yes, we did have trachoma in Northern New South Wales, and yes, they had the first treatment program they ever, ever did with one of Fred's mountaineering mates in New Zealand, a guy called Johnny Glasgow. They had the first treatment at Enngonia, which is right on the border, near Cullamulla and when you come into Northern New South Wales, north of Bourke where Fred is now buried. That's what Archie taught Fred, to learn to measure, to do it properly and, you know, the rest is history.
So on the National Trachoma and Eye Health Program in 1975 I had no idea what I was heading up for and a little bit later you'll see a little bit of that footage. But it was just the most amazing, incredible time. And Fred said, 'I do not want that money to go to my Eye Department at Prince of Wales Hospital, because I want it to go to my collegiate, I want it to go to the Royal Australian College of Ophthalmologists.' Malcolm Fraser was our prime minister in those days. And Fred said, 'I want my mates to help me.'
So we had over 80 ophthalmologists that came out on the road with us. Some of them came for weeks, some of them came for longer than that time. Some of them came several times backwards and forwards, where they were absolutely immersed in the work that we were doing. It was one of the most amazing studies. And it hadn't been done like that before. And we had a very famous Sri Lankan ophthalmologist, Dr Pararajah Seagram, and he and his wife Ruby were both ophthalmologists. Para came for a whole year, Ruby came for…God bless her she's off to the angels now, but she came for six months. So Para was the one who worked with us very intensively, and he was really the mentor as well to Fred and the work that we were doing about measuring and studying and looking at people's eyes properly.
Sandra Sully: Well, clearly you were confronted about the scale of work that needed to be done, what needed to be accomplished, and he managed to convince so many colleagues to travel with you to make a start, and as you say, for him to educate them about how this program could be expanded. But can you paint a picture for us about the environments that you found yourself in? Those great images of Fred driving along in the red dirt and the dust…literally throwing a bit of canvas and a slapstick table became the operating theatre?
Gabi Hollows: Absolutely, yeah. We actually rolled out our swags, you know, the best motel to stay in those days, and in fact I gave the first ever, ever talk when Fred was so well he could go to Vietnam, but I gave the first talk in the Four Seasons Hotel just up here near Hyde Park, as the Hotels Association Australia they had their very first function there, and I said, 'I'm sorry that Fred can't be here. I'm so excited he's well enough to be travelling overseas.' But I said, 'The best hotel I ever stayed in was in the Starlight Motel.' Under the stars, under the swag, head at the foot of our vehicles. And it was an amazing experience.
So we really, really, really had an immersion into that culture of being on the road. We worked for days and days and weeks and weeks. And I think the first month we were working, one of our staff said, 'When are we going to get a day off?' And we said 'You're not having a day off until we get to where we're going.' So we based ourselves in…the first clinic we ever went to was in Port Augusta near Port Augusta in Davenport Mission. We went up through the Centre, as I said. We ended up in Alice Springs at another base camp.
We had several places along the way, and as you can see on this brochure here, Charlie Perkins, you know very famously from Central Australia, Gordon Briscoe, one of the first directors of the first Medical Service—those guys came from Central Australia and that's where we were immersed in that early, early history. The very first time we'd ever, ever had a mass treatment program, Sandra. We talked and they said, 'We don't want to talk about eyes, we want to talk about stuff down here. And Indigenous people in those days were just starting to have, in 1975 by that stage there was the Central Australian Aboriginal Congress, and they wanted to talk about venereal diseases and problems that were in some of the communities.
So we were really, really leading the way in many, many areas. And on that trachoma program in 1975 it so challenging about Indigenous health. And Fred was one of those very, very feisty people—no nonsense, you just get on and you did it. And the first treatment program we ever had for trachoma in Central Australia and we involved a lot of our Australian medical students. In fact I'm about to go to Hobart in a few weeks time and talk at the Australian Medical Students Association conference. The very first time any of us spoke in Tasmania was back in…we flew from Broome to Hobart in an overnight trip. We came down from 40 degrees to Perth, I bought myself a leather jacket; I never took it off when I got to Hobart.
But that was many, many, many years ago, and I think that was about 1976. And we had a lot of medical students that came and dosed the patients…in those days they had to have 10 days of Septran, which was the drug that they used to treat trachoma with. These days it's a very different drug where you have different doses, and we'd do a huge, huge mass treatment in Ethiopia now and Eritrea and other places.
Sandra Sully: But you and the team, and Fred, must have had to be really innovative, because this is all mobile operating theatres. I mean how did you ensure that the sterilisation techniques, everything that you had to develop for something that was portable?
Gabi Hollows: Well, on the first big surgery campaign that we had within Central Australia… You know of course Fred was already going up to Bourke, and the Eye Department at Prince of Wales today still does the Outback Eye Service with Professor Coroneo and Prince of Wales Hospital still takes a team all the time. They still go about every three or four months to Bourke, and that's where the Outback Eye Service is, New South Wales. And many of the registrars that Fred trained and many other doctors that have gone to other places in Northern New South Wales or Western New South Wales, and other people in Victoria have done the same.
But in Alice Springs Fred said okay, we're going to have our first cataract surgery on the first trachoma stuff. And he said, 'Right, we're going to put it in Alice Springs Hospital.' And the authorities at Alice Springs Hospital kind of went, [gasp] 'You can't do that. The sheets might get dirty because we've got Indigenous people and…' So Fred said, 'Right, we'll stick it right up their noses and we'll put it in the car park at Alice Springs Hospital.'
That didn't actually happen, because the Australian army came on board. And they had a medical corp. And they were really, really wanting to sort of see real live patients. And so we actually had our very, very first surgical event was held at Amata, where the Royal Australian Army came along with engineers and we had the first surgical treatment done there.
And then later on a few other times in Utopia and up near Katherine the Australian Medical Department came and helped us do the surgery. So we didn't go around operating on people, because when we actually looked at people we actually referred them to surgery. We referred them for glasses, we referred them for GP actions. Kids who had candle stick noses and custard ears as we called it.
Sandra Sully: What's a custard ear?
Gabi Hollows: A custard ear is when kids have got perforated eardrums with pus coming out their ears. I remember syringing—and this is not a very nice thing—with Jilipia, one of the nurses who'd been the first nurse at the Medical Service that came out on the bush with us (and she's in that footage) we once got 17 flies out of a young kid's ear that we syringed with an ear syringe. Stuff like that was very, very…Professor Paul Torzillo now is a respiratory physician, he was out in the bush with us. We had so many amazing people that came with us, looking at general health. And in fact Jack Waterford who was the journalist from the Canberra Times, he met his wife Sue there and Jack now has…well we just saw him last week because we just had our AGM on the 28th. He wrote some of those very first stories about 'If you were talking about the health of our Indigenous people…', Fred was comparing it to 'If these were animals not human beings they would be reported to the RSPCA.'
So there was a lot of stuff that happened. And we had Sean McGilvray who was a very famous health reporter from the ABC. He was there with his little typewriter on his knees, came to Ernabella with us. So much history going back there, Sandra, it's just amazing.
Sandra Sully: We never overstated it in the introduction that Fred and you, everything that you've done, you were and are pioneers, not just in obviously all eye treatments, but in Indigenous health, yeah.
Gabi Hollows: So it's a long time ago now and I just had my birthday, as I said, on 21st May, and if you can do your sums, I always make kids do their sums and I was born 1953, you can tell how old I am. I might be a little bit younger than some of our members in our room here, but seriously, how many of you have known people who had trachoma or sandy blight or that uncomfortable scratchy feeling. In fact my granddaughter this morning just got a tiny bit of grit, a little bit of sand in her eye, and I said, 'Now sit there, Matilda, sit still and just let your tears well up and blinky-blink…' She's going, 'Oww.' She had a tiny bit of grit from the ball from their dog in her eye. So I sat her on the table out the front and you know, you just don't think…and I always use the analogy of when I get into my car I'm not sure which car I'm driving, whether it's a European car or a Japanese car and I turn the windscreen wipers on and I put the wrong light switch on and I'm backing out of my driveway and we've got a big Jacaranda tree and a camellia bush and all that sprinkles down on my windscreen at home.
So when my windscreen wipers are going and my water squirters are going, and scratch, scratch, scratch—the first thing I've got to do is always run my finger along the windscreen wipers and flip them up and get all that off, because when I'm about to take off, I don't want that going scratch, scratch, scratch. And in fact my daughter Anna, my middle daughter, who works in ICU at Don Hunter in Newcastle, she was overseas with the World Rugby Tour a couple of years ago and she was in Ireland; I was in Ethiopia at the time with that t-shirt you'll see in the footage, and she said, 'Mummy, I can't believe how I feel so bad, I had one eyelash in my eye and I nearly was demented, I couldn't get it out. How do you think those people with trachoma feel?' And I said, 'It's just like my windscreen wipers scratching up and down on people's corneas.' Very uncomfortable.
Sandra Sully: All the work that you've done with Indigenous Australians emboldened you to carry it on, but I wonder how special it's been as well to be able to educate so many fellow specialists and medical staff who have then been able to continue on the work. And at the time they didn't know what they were about to learn.
Gabi Hollows: No, they didn't. And I think every person that Fred engaged with or talked to, he would want someone to teach him something that he didn't know, and if they were med students they'd have to ask a lot of questions. We used to do a lot of GP quizzes and we used to do…of course the medical students if they were lucky enough studying medicine would be sneaky enough to come into ophthalmology lectures and some of them were too scared to come near Fred because he was a bit too scary. And other people remember that.
We had a lot of ophthalmologists who came as young medical students who were on that first treatment program who now are very famous ophthalmologists. But the registrars that Fred taught in his clinic are very famous ophthalmologists in not only this town here but in many other parts of the country. But one of the things was, you know, if a journalist came along, Sandra, and they hadn't done their homework (and you've done your homework today talking to me) and they said, 'Okay, Fred, I want to talk about glaucoma.' And he said, 'Hang on a minute, Sandra, I'm talking about trachoma, not glaucoma.' So he would give the journalists heaps if they didn't know what he was talking about or if they were asking the wrong questions.
Sandra Sully: But it's about getting the story right, isn't it?
Gabi Hollows: That's right, absolutely…
Sandra Sully: About getting the story right. Now…
Gabi Hollows: And it's a very, very big story, this one. It's been happening for a very long time and I'm so proud that you're here to listen to some of those early days.
Sandra Sully: Well, I'm honoured to be able to help share the story and the remarkable work. I've been a fan, as I said, for as long as I can remember. And when I look through some of the notes I was given to prepare for today, I remembered seeing Fred's work all of a sudden, you know, word spread about how remarkable his work was, and such a pioneer. And then before I knew it he was consulting to the World Health Organisation.
Gabi Hollows: That's right.
Sandra Sully: So he wasn't just acclaimed here, he was acclaimed on the world stage.
Gabi Hollows: No, people sort of thought, where's Fred gone, his eye clinic was…we were three years out in the bush and all the other people kept the kettle boiling at Prince of Wales and Fred was out doing his stuff and we'd come and go and he'd come backwards and forwards and… I won't even talk about what happened in Queensland with Joh Bjelke-Petersen, because that's another story and that's too long.
Sandra Sully: Let's not go there.
Gabi Hollows: But what I was going to say, Fred had Dr Para, as I said, came from Sri Lanka. His next job was then to go and be employed by the World Health Organisation, WHO, as a consultant ophthalmologist to study the prevention of blindness programs overseas. So he invited Fred to be one of his mentors, to come and have a look at some of the other countries. Fred was invited of course to go to Thailand, to Myanmar, or Burma as we remember it, to go to Bangladesh, to go to Vietnam, to go to Nepal, to go up into some of the hardest places in the world to have a look and consult. And I tagged along with him. And the only place I didn't go was Myanmar because it was a little bit difficult at the time, but Fred was asked to go and have a look at those programs.
And of course the place that he really wanted to go to, where do you think that would be, where there's snow and mountains and high hills? Of course it was Nepal. So he thought he was just going to come cruising in float in there and have a bit of a gander and have a bit of a look around and then head for the hills, literally. But that's when he met the very famous Sanduk Ruit, who is our Nepalese surgeon, who came and lived at Farnham House with us in 1987, who is the godfather to my daughter Anna Louise, who's now 32. Fred and Ruit were bonded by the head of the eye hospital in Kathmandu, and he was way, way out in the desert when he first met Fred and I don't know whether you've seen just recently we had Dr Ruit's book launch here in Australia last year in July. We did the launch at Farnham House and we had I think about 400 people at Farnham House.
Of course Ruit now has done more surgeries than anyone else on this planet. He is the one who's pioneered them, teaching, and we've now got the lens laboratory in Eritrea, which we opened in 1994 after Fred passed away. And then the second one was done in Nepal. Those little intraocular lenses that Sandra might tell you about are very precious. But Ruit was learning how to do that. We used to call it the Prince of Wales technique, and then Fred called it the Ruit technique or the Nepali technique. And Dr Ruit now, seriously, we just launched his book and it's called The Barefoot Surgeon, I don't know whether you saw any of it; did any of you get that book or know about that book? No. Well, it's out there in the bookshops, you might have to order it in. It was in Dymocks, in a lot of the book stores right around the country. Dr Ruit did a speaking tour when we launched that book.
He has done more surgeries than anyone else on this planet. He says he stopped counting at about 130,000 people, personally, seriously, and his assistant and some of the surgeons. When I was in Vietnam just recently, Sandra, I was in the middle of the Mekong Delta river and there's some of that footage again in some of the footage you might see very quickly. I was with this young, gung-ho Vietnamese surgeon who was hopping on this ferry on his motorbike; we were going into an island in the middle of the Mekong. And just talking to him when we got there, and I said, 'How many surgeries have you done?' And he said, 'Oh, about 11,000.' These guys are incredible. They learned so well, they are such good doctors. And I was asked to go to Vietnam—I don't know what your next question's going to be, Sandra, I've forgotten—but seriously…
Sandra Sully: She'll keep me on my toes, won't she…
Gabi Hollows: Yeah, I will. But seriously, when we were talking about training to do this modern eye surgery, the new type of cataract surgery, do you know why it was new? They found out that they could use an intraocular lens? It was from world war two, from when the Spitfire pilots crashed their planes, they had little tiny bits of Perspex that went into the eye, and some very smart people in optics thought if we can put a bit of Perspex in the eye and the eye doesn't reject it…you know if you have a kidney transplant or a heart transplant or you've got a thorn or a prickle in your finger, your body tries to spit it out, doesn't it. Guess what, the eye did not try to spit out the Perspex in the eye. And that's when they first realised that if we could put a piece of Perspex or optical quality Perspex in the eye, that's when they pioneered their very first intraocular lenses.
Sandra Sully: So you had initially started, and Fred's passion clearly was to treat trachoma. And then through the World Health Organisation and meeting Sanduk Ruit, you discover that cataracts were also a significant contributor to blindness worldwide.
Gabi Hollows: Of course. We knew it was a problem in Australia with our Indigenous people. Of course they hadn't fronted up to the eye clinics and been seen by the ophthalmologists. Everywhere in the world where you go, why is there so much blindness? There is so much blindness because there is not enough eye doctors to go around. What happens when your hair goes a little bit grey, we go a bit foggy round the edges, what happens? Your eyes also start to lose that ability to focus when you need your reading glasses (unless you're a short-sighted person). But when you can't see the beginnings of the chart and you start getting a bit rusty in there…
Sandra Sully: Gets cloudy, doesn't it.
Gabi Hollows: It does get cloudy, it really does. And we have sometimes what we call our cataract stimulators which are fuzzy kind of contact paper we used to put on like an eye mask with a bit of elastic, and now we've got these glasses that we give to school kids to walk around, it's like walking in the bathroom when you haven't dusted down the mirror, and everyone knows what it's like in the shower. So I wonder, how many people here have had any cataract surgery? Can you put your hands up? A few hands are going up there. Do you remember your grandparents having those very thick lenses like Mahatma Ghandi, which Ray Martin used to love calling the 'Coke bottle glasses'? Yes. What happens to those when you lean over? They fall down and they break and they scratch and everything.
When I used to go to the eye doctor when I was only 18 months old till three and a half until when I was about five, my ophthalmologist used to say, 'Ah, my Gabriella, have you been polishing your glasses on the concrete?' Because they get scratched, right? And I grew out of my long-sightedness as I got older. I didn't need my glasses and I was such a great binocular result I didn't need them anyway. But when you think about people in the old days when they used to have the very, very first memories in the Bible of people being cured from blindness was when the eyes were being poked so the lenses dislocated and they dropped down, and people could suddenly see. But they had very disturbed vision. If you know the optics of a camera, you've got to have that thick lens to focus it back onto the back of the retina. That's what your lens does.
Sandra Sully: Cataract surgery is really quite a simple surgery, now that we know…
Gabi Hollows: Well…yes and no. A prick to an eye, if you puncture an eye, and ophthalmologists have to be very careful and trained very well to do this, and that's why we need ophthalmologists to be able to do eye surgery, it takes a long time to be a very learned eye doctor. When you put a scalpel or an incision into the eye, you run the risk of that eye getting an infection. And if you've got that very famous photograph of Giap the Vietnamese boy that you see around on the bus stops and that little boy with Fred pointing at this kid's eye, he had a perforating eye injury. He actually had a piece of something, a foreign body in his eye.
And one of the other things about the eye is…and I can't really describe it to you now because I'm holding my mic, but if you've got…you know, your eyes cross over in the middle of your brain, the optic nerve and the vessels at the back of the brain, they swap on either side. If you can imagine, if you have an incision on one side you can have someone who's had a stroke who's lost their vision on one side. But also if you lose a blood vessel you can have a retinal occlusion or you can go blind from all those things. But the eyes are supplied by the nerves and both sides cross over. So if you get an infection in one eye, the blood-brain barrier can go to the other eye, so you can actually lose sight of both eyes.
So that lucky little boy was leaving the hospital in Hanoi when Fred first got there, and his father grabbed Fred by the shirt and said, 'Hey,' because he was being told nothing could be done for him. And there happened to be Fred and Dr Sanduk Ruit there. They went, 'Hey, get a load of this kid, he's got a really hot eye.' That's what an ophthalmologist will say, meaning it's got a really bad infection happening.
So they took him into theatre and they operated on him. And if that little boy hadn't had that surgery he would have lost the sight in his second eye. That eye's not a good eye, but he never lost the second eye. So he's actually our poster boy that Mike Amendolia, a photographer from News Limited, who came on that first trip with Fred, flashed that photo of Fred, and Michael is now one of the most famous photographers in the country and internationally. I just spent last week with him. Michael is one of our dearest and trusted friends and one of Dr Ruit's amazing friends and he always takes so many photos of the Hollows Foundation. So that is a very iconic image.
Sandra Sully: So we are talking about the intraocular lens. Fred once described them as the most expensive little pieces of plastic in existence. Most of us in the western world, at least in Australia, if you have cataract surgery you're subsidised by the government. But the third world and many places outside of here aren't lucky enough to benefit from that. So you guys decided to build your own intraocular lens factory, initially in Eritrea and then secondly in Nepal. A pretty vital piece in the puzzle that promised to deliver Fred's dream of affordable cure for cataract blindness in the developing world.
Gabi Hollows: Yes, well when we first…as I said, Fred was teaching Dr Ruit and many of his registrars how to do that new type of modern intraocular lens surgery. Those lenses used to cost hundreds and hundreds of dollars. They were being made by the companies that manufacture them, and of course everyone's saying, 'You can't afford to do that type of expensive surgery in developing countries,' or third world countries. And I don't like using that word 'third world'. Because why? They cost so much.
So Fred, again, they knocked off a few and got a few donated to Ruit when he was going home to Nepal back in 1988 when he was going back. And he was going back without the tools of his trade: the tools of Fred's trade were, he was a micro-surgeon, what do you need? You need operating microscopes, you need loupes to look at things. You need the operating instruments. You also need the lenses and you need the sutures. So poor Ruit and some of the other doctors from Eritrea, they were going home empty-handed with nothing. Fred was also a micro-surgeon, but what was his hobby? His hobby was woodworking other than mountaineering.
So if you don't have the right tools and the lathes and all the things that you do to be a good woodworker, you can't do your job. So if you don't have your tools of your trade, Mark over here can't make this work if his machine doesn't work and we can't show the footage, and you can't do it if you haven't got a camera if you're on television.
So if you don't have the gear to do it, it's so frustrating. And it was really, really hard for those guys going back thinking, Oh, I'm only going to be able to do a few operations because we don't have the lenses. And so the powers that be said, 'Fred, you can't afford to do this.' He said, 'Okay,' he'd been in Eritrea, he'd seen the Eritreans struggle in the war of independence with Ethiopia. He'd seen them manufacturing pharmaceuticals and drugs and all sorts of things underground in the laboratories, underground in the mountains. He said, 'If those guys are really smart they should be the first people to be able to make a lens and make a laboratory work.'
So to have those little pieces of plastic, they're cut out, a little stamp, a little sheet of Perspex, they're counted up and they go through a very huge, thousand-hour process to manufacture those. So it's like, everyone thinks about polishing gemstones, and I've got a little tiny, magic little stone in my pocket here that my friend gave me, and it's not because of today, but my friend Jilly Pascoe…this has been polished on a tumbling thing, right? The same thing that happens with the lenses. And those lenses go tumbling, tumbling, tumbling, and are looked at by electron microscopes, big microscopy, blown up like in that gallery here, you can make it really big to see if they've got any faults in them. If they don't pass that manufacturing process, the manufacturer will see a mark of manufacture, you can't sell them medically. If you've got an implantable medical device like a hip or a heart valve or something foreign, or a knee, which I need new…or a lens, if it's going to go into the body, any part that has to go in has to have that medical mark of manufacture and authority to have that passed, a big tick by the medical people.
Sandra Sully: But this development is a game changer worldwide. Do you remember the price differential, you know, what was available to other surgeons and then take us down the track to Fred developed at what, one hundredth of the price, one thousandth of the price?
Gabi Hollows: Oh, absolutely. Well, we've stuck to $25. We said it cost $25 to do this operation. That's the one message we've had—'Five fivers for Fred.' Remember? Five fivers. And we've stuck to it. That's what it roughly costs to run and do those clinics in those countries. Many of those places now do their own…they work out who can afford to pay and who can't, the same as our government here. We've got public patients and we've got private patients, and sometimes it costs thousands of dollars here to have it done, or you can get it done privately, or you can get it done publicly. When it's public, what is there? There's always a queue. You have to wait. Why isn't it fast enough? Because the authorities saying, 'Okay, we can't sponsor this many.'
So it's the same in a developing country as it here, and it's a hot potato. People say, 'Well, why can't we only pay $25 in Australia?' But you think about how much it costs to run a hospital or an eye clinic or an eye department, or an operating theatre, and all the staff and all the people that are included in it. When Dr Ruit and those surgeons do that surgery on those eye camps way, way up in the Himalayas or many of the other places, it can be done with an incredibly good team who are doing it all the time. They've got to know what they're doing. And they do hundreds and hundreds and hundreds of them. Sometimes in an eye camp they might do, over a day they might do over 150. They used to talk about cricket, because the Nepalese and the Pakistanis and the Indians all know about an innings, right? If they got to a hundred they thought that was a pretty good score for the day and they'd go home happy.
But one of those surgeons taking that surgery and doing that surgery in one of those countries makes an incredible difference to those people. So every person who has the surgery has to have somebody to look after them, to bring them to the eye camp, to bring them down from the hills, to bring them along those horrible long, long tracks, to manage the pre-operative and post-operative. And every person who's blind, you might have an unsighted person, they're shrivelled up in the camp like that old Maudie that Fred saw in Wattie Creek, up in the Gurindji camp. Who's going to feed those old ladies in the old widows camp that Fred saw and we saw on the Trachoma Program. They'd have to feel very gently in case they burned their fingers on the cinders where they were cooking their dinner if the kids or people couldn't help them. They were all together in one little humpy or whatever.
In many of the places you see people, they're all shrivelled up because, as I say, when your hair goes grey and your eyes go grey, you start withdrawing and you go into the camp. When you've seen lovely photos of our people having their surgery, the most amazing thing Dr Ruit says and many, many of the eye surgeons, every time they take a patch off, sometimes it takes a bit of time to focus and you might have a bit of eye ointment in your eyes or it's very bright or whatever, and that's when we give the people the sunglasses afterwards, because it is, like literally eye-opening, very dazzling. They haven't seen for a very long time. Some of those lenses that we take out in some of those countries are almost black. I've got some earrings again in my little magic thing and they're a lovely dark pearl. Some of them are that colour, literally. They come out and you think, my gosh. Or brown and yucky and horrible, and you think, Oh my goodness me, how long has that person had that problem? And who had to look after them?
So someone there is being held back from going on. It's usually a young child. It's usually a young girl, and of course who always lines up first in the line? It's always the men who are pushed forward first, because they're the ones who are the most demanding. It's always the women…so one out of four people are often…the other three people who haven't had the surgery are going to be women and girls, and we've got a huge, big thing on gender that's happening too.
So it's a pretty amazing thing when you think about it. They often have to wait to see, to feel, they know what their kids feel like. They've never seen the faces of their children, some of them, or their grandchildren or their nieces or nephews. They have to wait for the kids to speak, because they recognise their voices, or feel their hair, is it long hair or short hair or whatever. That's how moving it is. And sometimes you'll see them dancing for joy and jumping up, because it is incredible.
At a lot of the eye camps they sometimes are able to come back for a second eye, because you never operated on the other eye the same day, just in case you have a problem, and because you want that real trained ophthalmologist to do that. The other surgery that you see us doing is for trachoma, where they make an incision on the top of the lid and fold the lid back to pull the lashes back so they're not scratching up and down on the cornea. And that's trachoma trichiasis surgery, different to the intraocular lens surgery. So the doctors and the people and surgeons and the ophthalmic assistants who are often trained to do that surgery may not have done ophthalmology, because that's only external. It's not internal eye surgery.
Sandra Sully: But I think what you're saying, though, is we know being able to restore someone's vision is not only life changing for them, but arguably their entire family, and as a consequence their community.
Gabi Hollows: Oh, totally. And we've got beautiful footages. If you're able to have a look at a computer and look at the Fred Hollows Foundation website, there are so many YouTube videos and so many stories about people just dancing again and going back to work and being productive. The old saying, if you feed a fish you feed the whole…you know, throw a little bit in and it just spirals out. It's incredible, so it is an amazing thing. And of course Fred was asked to look, and cataracts were the biggest amount.
In the year 2000 they actually did a very good study in ophthalmology, because if you can imagine, when you go to a community, and Fred learned how to count, you always know that there's one, two, three, four, five, six, seven, eight, nine people sitting in that row waiting to be seen, or they might be in a community. Everyone knows where the blind are, because someone always has to be looking after them. So the statistics in world blindness are very, very accurate. They reckoned there was about 45 million people who were blind in around the year 2000.
And so they said, 'Let's try and do something.' So all the people working in ophthalmology and optometry and orthoptics, and anybody having anything to do with eyes all joined hands together and said, 'We're going to try and eliminate avoidable blindness by the year 2020.' So we had 2020 Vision: The Right to Sight. And that's a bit of a play on words. Everybody wanted to talk about 20-20 then. Not just the eye doctors, because that's how we measure it. Twenty-twenty is like six metres. So 20-20 vision. So around about 45 million people. They were the people that were counted who had really bad, severe blindness. They weren't people who had refractive blindness, because they just needed a pair of glasses, little kids in a lot of the places are very short-sighted and a lot of people are long-sighted. They don't have their spectacles, so that's where optometry and ophthalmology overlap.
So those figures are very, very huge. So by the year 2020—what year is it this year? 2019, so we've gone down a lot. We've achieved a lot, and we still talk about 39 million people, and of course we're actually talking not only about cataract blindness, we're talking about refractive blindness and all those things. And as we all get older, people live longer, what happens? You're all losing your vision. So it's just how the world's health has improved. It's come up a long way. Our life expectancy now is so much longer, isn't it? So I'm hoping that I'm going to be 95 like my daughter-in-law's nanna who just passed away on Saturday at 95. That was pretty amazing. I always said I wanted to be at least 93. But we might be more than the Queen Mother and go till we're 110. Who knows?
Sandra Sully: So the journey's long and continuing, but so is the work, and that's ever-expanding. Significantly along Fred's path was receiving the Australian of the Year honour in 1990-91. What did that do for you and Fred's cause in terms of spreading the word? How did that change things?
Gabi Hollows: Well, that changed things because at that time we actually didn't know that Fred had a renal cell carcinoma. No, sorry, we did. When Anna was born in 1987 we found out probably…well, I'll tell you. My daughter Emma was born in 1984. My son Cam was born in 1982. When Emma started school, on the day she started school, Fred had his kidney taken out at Royal Prince Alfred Hospital. He had a tumour on his kidney, a very nasty tumour. He had no idea how long he was going to live for, so he knew he was on a lighted fuse. So that's when he got very, very vocal, and that's when he was named to be Australian of the Year, in 1990-91. I hadn't even conceived the twins at that stage. I didn't even know I was going to have two more babies, but that was incredible. So we were on a very tight, tight time-frame. So that's when Fred got very, very outspoken and said what he thought. And if he trod on people's toes he didn't care.
Sandra Sully: So being the Australian of the Year, though, gave him a brand new platform to take your story, your message and your work not just Australia-wide. It was already out there on the world stage. Do you think having cancer prompted him to perhaps expedite all the pleasantries and just be as blunt as a shovel about what needed to be done.
Gabi Hollows: He actually had renal cell carcinoma but he also got secondaries in his lungs and he had a whole lot of other problems health-wise because that blood carried around and seeded other tumours and things that he had. But one of the things with Fred was that when you're Australian of the Year, and I know you've met many Australians of the Year and a lot of them are up there in the gallery, you go on a speaking circuit.
Sandra Sully: Very demanding.
Gabi Hollows: It's very demanding and you're speaking in I think it was something like 1,500 places he spoke. I could be out every day, breakfast, lunch and dinner talking about the work that we did. And we did a lot of stuff with Rotary and the service clubs and Lions clubs and all sorts of other people were fundraising for us in the early days. And Ray and I to this day, Ray Martin who was our chairman for ten years, are still shaking our heads thinking, you know when Fred used to go on the Midday Show, pass a hat around and put a few bucks in the hat. When we first started with Ruit talking about what we wanted to do, fundraising is just such an incredible thing. It can be private, it can be public, it can be anonymous, it could be a brown paper bag gets sent to the office. You just don't know.
Sandra Sully: It's always exhausting.
Gabi Hollows: It's very exhausting, and you never know quite how much you're going to have in your budget. The government had an amazing ability to…on both sides of government whichever side was on, with us, we're very, very bipartisan, and we've had very, very good commitments from our government. But you know Foreign Affairs and funding gets cut, what gets cut all the time? Those sort of overseas funds for the work that we do.
So a lot of the work that we do is funded by our community. And the Australian community to me have been incredibly important to Fred and myself and the Hollows Foundation, and that's what Lucinda does, she links and talks with our people who are our donors. And I don't care whether someone raises five cents or five dollars or a little school kid has a gold coin day or whatever. It all adds up, it all goes into our funds, and we spend it how we say we're going to do it. And if you just have a look at our annual report every year it's an amazing thing.
Sandra Sully: So in those final two years of Fred's life you said there was at least 1,500 public appearances to raise awareness of the newly created Foundation and all the work that you wanted to continue to do. But during that time, Fred's in and out of hospital, he checks himself out of hospital and flies to Vietnam.
Gabi Hollows: He does. And that's pretty incredible, and that's when he saw that Giap, that little boy. He promised that he was going to train 300 surgeons in three years, and what happened, 1992 that's when he was there, just before he passed away in February of '93 and six weeks later I followed up and I went up to Vietnam to promise that we would still contribute and we would still keep that promise. We were very lucky in Vietnam when Fred was there, because the then minister for health was actually an ophthalmologist, a professor at the Eye Hospital in Hanoi, and he gave it his blessing, a bit like the pope or something, gave it his imprimatur, and said, 'Yes, we will train 300 surgeons in three years,' and we actually trained 360 surgeons in three years, so that was a remarkable thing.
Sandra Sully: But he's your great love, Gabi, and he's arguably only got a couple of years left to live. Did you ever have any resentment that he was giving himself to everyone else other than you and the family?
Gabi Hollows: Well, it was hard, and it's been very hard for my kids, because some of my kids, the three eldest children remember their dad…Anna not so much, but Cam and Emma. Cam was coming up for 11, Emma was two years younger than Cam. So it's hard when they go to school and they see Fred on the bus stop, see Fred everywhere, see Fred posted all over the place. That's their dad. When their friends say, 'How's Fred going?' 'Well actually he passed away 26 years ago.' It's hard for them sometimes. It was very hard for me. But we've always had a very communal sort of background.
Our house, Farnham House, has always been a very open house where people would come in; sometimes we'd have the front door open and the back door open and you would never know who was coming in one door and out the other. And when Fred was dying…a lot of people when they're dying, some people want to come and talk to you and Fred wanted to meet those people, want to say their last things and their final goodbyes, or some people just want to come and give you a hug or a kiss or whatever. Many, many hundreds of people came through our doors in those last five years when we knew Fred was so sick. And that's a very enriching thing. And it's a community that has been so, honestly, listening to what we're doing and listening to our story, and we are very grateful for that.
So for me, I've always had, as I say, my own boots on, and I've talked about it because it's part of my DNA as well to be able to be passionate enough to speak about the work of the Foundation and what Fred had taught everybody about. And it's my job now to talk to people and say thank you for believing in our story, because it's an amazing story, 25 countries plus other places we've worked really, really hard in. We've got huge stuff happening in Vietnam and Pakistan, in Bangladesh, in Africa, go on and on and on, Cambodia, in Laos. Our Indigenous program in Australia is an amazing program that we're still doing.
Sandra Sully: Gabi, when Fred passed, how difficult was it to reassure your corporate partners, government partners, that…I mean you had to carry on the work even though you were grieving. And I know you had a personal investment and a personal passion. But how difficult was it to convince your commercial partners to stay on board and follow through?
Gabi Hollows: We had a very big, wonderful group of our board members. Our members of the Hollows Foundation. Our fellow ophthalmologists who knew what we were talking about. The country knew the story, and you're still listening to it now, today. That story is an amazing story. And for me, I got great enrichment…we knew Fred was dying, and the day that Fred passed away we were kind of on pause. We knew he was really, really sick. When that switch flicked off I think all that energy went into everybody, to just make that promise happen. Seriously. I'm wearing this, I'm a very sentimental person, and I'm wearing this scarf which I wore to Fred's funeral at St Mary's, just like literally a few hundred yards up the road here. And I wear that on special occasions, and I wore that today because I'm really being very sentimental about how the people we've told the story to are still continuing that story.
On Friday we've got our wonderful ex prime minister Bob Hawke's funeral. I'll be an observer there to that. And it was Bob who gave Fred that Australian of the Year trophy. It sits in my study in the front room under a beautiful portrait of Fred. There were so many mementoes to the special moments, and it must be my Irish connection, I don't know, I've got such an incredible background in all sorts of ways in many religions in my family. I'm a bit of an old witch I always say, but my kids…I'm very, very connected to things and I always say that Fred's looking over us out there in the wherever he is up there, and there's always a special rainbow or a storm. The day that we flew up Fred's body, we had the funeral at St Mary's and then we had the pause and the next day we flew everybody to Bourke. Why did Fred want to be buried in Bourke?
Sandra Sully: Why did he want to be buried in Bourke?
Gabi Hollows: He's buried under nine tonnes of granite, and my kids said, 'Mum, the grave can't look like a bed.' Thirteen years later, along came Andreas Buisman who's a beautiful sculptor, was one of the sculptors by the sea. And I actually spoke to his wife Sandra in Vienna last night. The reason why—and Mike Lynskey, who was our first CEO of the Hollows Foundation was actually in Vienna yesterday. I got so excited, Mike was actually given an AM yesterday as an accolade because he did so much work in those grounding days. We had Brian Doolan, who still is very involved with the Hollows Foundation. We've now got John Brumby as our chairman. We've got amazing people and amazing board members who've continued the work of the foundation and make it driven.
And for me, that moment when that energy went into that, Mike and all the media and Ray and a whole lot of people flew up to Bourke. They took off at 7 o'clock in the morning and they left Mascot, half past six, seven o'clock, all these guys with all their leads and the media and television. We didn't film it in the cathedral but we did in Bourke. They were all there, flying up to Bourke. And what happened? There was the most amazing hail storm at Sydney Airport. They had to close the airport down. That was bloody Fred for sure, absolutely. And just only, seriously, when we just had coast trek down in the Mornington Peninsula, another beautiful halo came over. My little grandchildren too, only last week went for a little walk and they came back and they'd been in the gully which is named after Fred. There was this beautiful rainbow, looking over Randwick. The weather gods! Fred is one of those, and I tell you what, he controls the weather, and parking spots, he's very good on parking spots.
Anyway, we'd better shush up because a lot of people need to go and catch their transport.
Sandra Sully: I do want to say, though, we can't thank you enough. Obviously the indefatigable Fred and his irascible self have managed to spread the story worldwide, but your story, I think, is now our story, and we see pictures of Fred everywhere and we know his story. We couldn't be more grateful I think as a nation…
Gabi Hollows: And the Fred Hollows Foundation name, it's ridiculous, you go to places in kids workshops they talk about Hollows or you go overseas and they talk about Hollows or they talk about Fred. You get taxi drivers who go, 'Oh, you're Australian, you must know that Fred Hollows or that Tom Keneally.' They're often Eritreans. Seriously, but I'll go to Mark now because he's got a beautiful bit of footage just to wind it up, okay? We'll have a look at that before we go.
Sandra Sully: As we wrap up today's conversation, are there any questions from the audience at all for Gabi?
Audience question 1: Thank you very much for the talk. I just want to quickly ask, in places like Eritrea, where you're in developing countries, when you're doing the lenses in those early days, what did you do about anaesthesia?
Gabi Hollows: One of the things that an ophthalmologist does is do a retrobulbar injection, which is a needle that goes behind the eye, and it's not a general anaesthetic, it's a local anaesthetic. And they have to put a weight on the eye, sometimes you might see people with this funny like a balancing act. It's a weight on the eye and then that needle is injected at the back of the retina and that's called a retrobulbar injection. Very good question.
Audience member: Does that work for children?
Gabi Hollows: Well, not usually. We usually give children ketamine or another drug that's for children. It's a little bit different. They're usually done in a theatre.
Audience question 2: Hi, that was just amazing, thank you. You mentioned fish before and it made me think about teaching people to fish. Are there many Indigenous ophthalmic surgeons now?
Gabi Hollows: Well, that's a lovely question. We've got a lot of Indigenous medical graduates now, and we've only just last year we got Kris Rallah-Baker, who is the first Indigenous ophthalmologist who graduated and was awarded his fellowship at the Royal Australian College—and the Royal Australian and New Zealand College of Ophthalmologists, they've combined together now—at their meeting in Adelaide last year. Kris Rallah-Baker is a beautiful man, he comes from Queensland. He's a very, very beautiful boy and it was hard for him, studying as being an Indigenous doctor, and whatever you're going to be, there's a lot of people put their hand up to be an eye doctor but it's another big, long slog to be a real ophthalmologist and to have that amazing medical training. In fact Dr Ruit's son Sagar is now really lucky because he's got into the ophthalmology training program in Tilganga in Nepal. And it was hard for his son to even pass those exams to get in, and he was the same way, the same hard tests, you've got to line up and pass all those exams to be even thought about as being an eye registrar. So we don't make it easy for people, but we make it very, very well, thoroughly trained surgeons.
Audience member: The other quick question is, you know we're talking constantly about the cure, but what about prevention?
Gabi Hollows: Well, there's a lot of work being done, of course. One of the main things, Professor Hugh Taylor, we did a thing with…we called it super sight, how Indigenous Australians have wonderful eyesight. And I used to go, when we did the trachoma program with Hugh and some of the other orthoptists and people that were working, we would test vision at a really extended distance. And we did a lot of that in the jails. In fact I've probably been in more jails than most people in the country. And the best testing we ever did was from an Aboriginal girl in Jigalong which is in Western Australia. She wasn't in jail, mind you, but there was another man who was in Geraldton jail and he was such a sort of a good…you know visually, you talk about Aboriginal trackers and people being able to see stuff, that the governor of the jail at the time wouldn't let him out because he was such a naughty boy. And they wouldn't let him…because they thought he would take off.
I've been in many, many jails looking at eyesight. But I tell you, Indigenous people also have that huge amount of ultraviolet light and sunlight. And one of the things I didn't talk about, I mentioned it very briefly, was Labrador keratopathy, which is where our Indigenous people have been stockmen—that's what Vincent had—they have a stripe across their cornea. And that's what the Inuit and the people in the northern part of the Arctic have from too much refraction from the light. And when you have ultra violet and sunlight you do get changes in your lenses. And Professor Hugh Taylor from Melbourne who is shown in that footage there when he was a young registrar, he went on and became the professor of the Eye and Ear in Melbourne. He's doing a lot of work on trachoma now. He is like one of the world experts on trachoma and on visual problems due to sunlight intensity.
So nutrition, sunlight intensity. You should wear your sunglasses, seriously, and your hat for your skin and your eyes as well. And if you've got good healthy tucker then you're not going to go on and get all those other things. And of course our beautiful Indigenous people have things like rheumatic heart disease and renal failure because they've had scabies and infective things and it's too much of another story to go on to. But we are really, really lucky that we've got very good studies that are being done in ophthalmology on why. And people are saying, well are we going to have something that can dissolve the lens, or what can you eat—and there's all those kind of stories.
There's a lot of work being done in medicine on all sorts of reasons for health. The world is a changing place. I would love to think that I don't need a new knee or a new whatever. Sandra's got her own little story, she might like to tell you something, a little secret. Come on Sandra.
Sandra Sully: Well, I had a full lens replacement in both eyes last year. There's cataracts in my family and because of the work I do I can read the autocue very easily, but I was starting to need glasses just for the close-up work. And then when you're doing…on a big story I had no problem reading the autocue, but it was moving down between the desk, checking my scripts if the autocue failed, staying connected with the computer as stories were developing, and it was just that juggle of putting your glasses on and off while you're working, and so I was recommended to trial a sequence of recipes of contact lens, because one eye was short-sighted and one eye was long-sighted. And I went to see if I was suitable to get Lasik surgery or what were my options. And I was actually completely suitable for a full lens replacement in both eyes.
Gabi Hollows: Different strengths in each eye. No two eyes are the same sometimes.
Sandra Sully: And so I persevered. One was 0.5 and the other was 1.5. And so I had to persevere for six months to get the right combination of contacts. And once the ophthalmologist was certain that he had the right recipe I went in for day surgery one morning, did it towards the end of the week. The next day I could see out of that eye. I had a series of different drops for a couple of weeks and two weeks later I had the other eye done and I'll have this quality eye vision until I die. Extraordinary.
Gabi Hollows: We do put intraocular lenses in children. Sometimes they have to be upgraded and changed a little bit when they're a little bit older. But mostly we just give them the spectacles to start with. But it depends on how much access you're going to have to the surgery. And we've got lovely stories of twins…there's so many stories on the Hollows website about the type of surgery they've had and all that sort of stuff.
Sandra Sully: I was very lucky to be suitable for that sort of surgery. My twin sister's now going to the same surgeon to see if she can have the same thing, because you know you get so frustrated about having a set of glasses next to the bed, one in the car, one in the kitchen. You're constantly trying to find them to read whatever you need to read. And because there's cataracts in my family, somewhere over the next 10 years it may get a little bit cloudy, so they literally laser an incision, take out your old lens, insert a new one, and he said the sac—it's like a grape really—and he said that sac may get cloudy, which is what happens with cataracts, so the surgery was as simple as cataract surgery, which both my parents have had, which as you know there's tremendous coverage with the rebate here. But because while my surgery was equivalent to cataract, I wasn't eligible, nor was I interested.
The fact that I could afford to pay and have this essentially almost 20-20 vision until I die is one of the greatest gifts. I am so lucky, but I had no idea till last year that this was actually available to people, and I told one of my colleagues that had worn glasses his whole life and his marriage had broken down, he was starting to go out with a new girl and he said, 'I'd just like to go out and not wear these glasses.' So he went along and the surgeon found a melanoma on his eye, and while he has progressed to have the surgery this year, what he didn't know was that talking to me and getting recommended to that surgeon, he actually saved his eyesight, because he had a melanoma on the pupil and he didn't even know.
I've always admired the work that you and Fred have done. I never realised until our chat today how much—of course you loved the man and everything he did—but it was your mission as well. This is as much your personal story as it is Fred's, and I think I can say collectively and honestly that we couldn't be more grateful for everything that you do, everything you've done, the amazing husband you had but the work that you continue to do. We are very privileged for you to share your time and your story today, and we can't thank you enough.
Gabi Hollows: Thank you, Sandra. I just want to say thank you to everybody who's believed in our story, but I also have a very lovely new husband, a new old husband, John Balazs. He's not an eye doctor, he's a tax lawyer actually. And John allows me to do what I do. If I didn't have John, who helped raise all our children, I wouldn't be able to have done the work that I've done, so he's a bit shy sometimes, he hates coming to listen to me talk. He always goes, 'Oh, Gabi, just wind it up. Stop talking so much.' But seriously, if I hadn't had John to help me with the kids, and all the wonderful godmothers and godparents and friends and community that made this magic happen, and our wonderful staff, I'm so jealous of all the people that work for the Hollows Foundation overseas and…
Sandra Sully: But how could you not…is this woman not clearly infectious? And can I ask you, as we wrap it up, and I do need to point to the next conversation series, it's on the extraordinary Albert Namatjira, Francheska Cubillo in conversation with the outstanding Tracey Holmes.
Gabi Hollows: And let me tell you about Hermannsburg. It's one of the most beautiful places you can go, and you're all very familiar with all the Namatjira paintings and all the Hermannsburg paintings and all those beautiful watercolours. They used to have the most amazing bakeries out there in Armidale and Hermannsburg, and I just remember the very first time I went there and you'd see those hills and the beautiful morning and daytime stuff…
Sandra Sully: He captured that lemon and lavender in the northwestern light, didn't he?
Gabi Hollows: Yeah, it's magic. You should come and listen to the next talk.
Sandra Sully: As we wrap it up I would ask you all, and Gabi doesn't know I'm going to do this, but don't you think it was a tragedy—incorrect use of word I know—that Fred isn't on our fiver? And there's a campaign that continues to run…
Gabi Hollows: I know, fivers for Fred, and that was that photo of us taken down with Bob Hawke down at the Opera House. But he is on a ferry. There's a Fred Hollows ferry. And I just said, 'Well, I'd rather he wasn't in someone's dirty old pocket, with their dirty old cigarette butts and their bits and bobs.'
Sandra Sully: So you don't want us to maintain the rage that Fred should be on the fiver?
Gabi Hollows: No. I'd much rather he'd be on a ferry. And he's on a dollar coin, too, remember, the Mint minted a coin a long time ago. So I'm okay with that, seriously. And I think if Fred was pulling change out of your purse or your pocket, you know… Five fivers for Fred is a pretty good campaign. So if you make it 25 bucks…we don't have a 25-dollar note and we probably never will…
Sandra Sully: Let's stop the campaign and just get more people to support the work that you and Fred started.
Gabi Hollows: And I actually haven't had a ride on the Fred Hollows ferry yet. It was extraordinary, we've got a Fred Hollows ferry, a Catherine Hamlin ferry was the first one they brought up, then they had Fred's ferry and then they had Victor Chang. And I've got associations with all of them, because Victor Chang operated on my father for his mitral valve. So I'm linked up. And we went on the ferry just before it had the plastic seats taken off.
My step-granddaughter, Fred's eldest daughter Tanya's Isabella, it was her 21st birthday and it was only a couple of years ago, not that long ago when the ferries came up. They were manufactured in Hobart, and do you know how they steer those little ferries, Sandra? When you saw that ship crashing into the…the horrible thing in Venice last week. A tiny little joystick, it's about this big, and my little granddaughter Matilda, she wasn't four then, she was only three. How they steer those ferries is just by these tiny little things.
And we as a family have never been on the Fred. So many people say, 'I caught Fred to work today.' He used to do the eastern suburbs, Watsons Bay, and he's now going over to the zoo and over to Manly. He gets around a bit in the harbour. And my great-grandfather, my Irish grandfather was one of the very first directors of Sydney Ferries. He was an Irish sea captain. In fact Maeve O'Mara, you know lovely cooking Maeve? Well, she's a cousin of mine. Her great-grandmother was my grandfather's big sister. But Maeve got into trouble as a journalist, coming in the door when Fred was sick when we said everyone was coming in and they said, 'Hey, you're a reporter. You can't come into our front door at Farnham House.' And she said, 'Well actually…' (They didn't know that Maeve and I were cousins and that she'd done a lovely, lovely interview with Father Frank Flynn). And Frank Flynn was one of the very first ophthalmologists who was a Catholic priest, a Sacred Heart priest, and he and Ida Mann, another very famous doctor in Western Australia, were the first people to work on trachoma in Australia when they used to call it sandy blight. So there you go.
Sandra Sully: Sandy blight. That says it all. Ladies and gentlemen please let Gabi Hollows know how grateful we are for her to share her story today.
2019 Lunchtime Conversation Series: Australians Shaping the Nation.
Australia has been shaped by the remarkable work of many individuals whose achievements have resonated beyond our shores. In this second season of the Australian Museum Lunchtime Conversation Series, drawing on the 200 Treasures of the Australian Museum exhibition in the Westpac Long Gallery, a stellar selection of distinguished Australians share insights into the inspiration behind their groundbreaking contributions, which have helped define the nation across science, politics, sport and the arts.
Lunchtime Conversation Series: Australians Shaping the Nation is available as a series of six lectures.