There are some Australians remembered for what they built.
Others are remembered for what they discovered.
Fred Hollows is remembered for helping people see.
With his untidy beard, straight-talking manner and determination to take medical care to people who were being overlooked, Professor Fred Hollows became one of the most recognisable figures in Australian medicine.
He was an eye surgeon who could have spent his career working comfortably in city hospitals.
Instead, much of his life’s work took him down dusty outback roads, into remote Aboriginal communities and eventually to some of the poorest communities in the world.
Fred believed something remarkably simple.
People should not lose their sight because they were poor or because they happened to live a long way from medical care.
That belief became his life’s work.
Fred Hollows Was Born Across the Tasman
Although Australians came to claim Fred Hollows as one of their own, he was actually born in Dunedin, New Zealand, on 9 April 1929.
He grew up in New Zealand and studied medicine at the University of Otago.
After graduating, Fred eventually specialised in ophthalmology — the branch of medicine concerned with the eyes and the treatment of eye disease.
His medical career took him to Britain for further training before he moved to Australia during the 1960s.
Sydney would become his home.
Australia would become central to his life’s work.
And the problems he encountered here would eventually take that work around the world.
An Eye Surgeon in Sydney
Fred worked at the Prince of Wales Hospital in Sydney and became associated with the University of New South Wales, where he later became Professor of Ophthalmology.
He was building a successful medical career.
But events outside the conventional hospital system began to change its direction.
During the late 1960s and early 1970s, Fred encountered Aboriginal patients suffering from serious eye disease.
Among those diseases was trachoma.
Trachoma is an infectious eye disease which, after repeated infections, can damage the eye and eventually cause blindness.
For Fred, the disturbing part was that much of this blindness was preventable.
He began travelling to Aboriginal communities in remote Australia.
What he saw there changed his life.
What Fred Saw in Remote Australia
Fred visited communities including Wattie Creek — now known as Daguragu — in the Northern Territory.
He later travelled through communities around Bourke and other parts of regional Australia.
He found people living with eye diseases that could be treated or prevented.
But the problem went far beyond eyes.
Poor housing, inadequate sanitation, limited access to clean water and difficulty accessing healthcare all contributed to preventable illness.
The contrast between medical care available in Australia’s cities and conditions in some remote communities deeply affected him.
Fred was not particularly interested in quietly accepting that situation.
Quietly accepting things was never really his style.
Helping Establish the Aboriginal Medical Service
Fred became involved with Aboriginal activists and health advocates campaigning for better healthcare.
In 1971, he helped establish the Aboriginal Medical Service in Redfern, Sydney.
It became Australia’s first Aboriginal community-controlled health service.
This was an important change in the way healthcare could be delivered.
Rather than Aboriginal people simply being patients within a system designed by somebody else, community-controlled health services allowed Aboriginal communities to play a central role in determining their own healthcare.
That principle — working with communities rather than simply arriving and telling people what they needed — would become increasingly important in Indigenous healthcare.
The National Trachoma and Eye Health Program
By the mid-1970s, Fred and others were pushing for a much larger response to eye disease in Aboriginal and Torres Strait Islander communities.
Australian Government funding helped establish the National Trachoma and Eye Health Program.
Beginning in the 1970s, teams travelled enormous distances across Australia.
Doctors went.
Nurses went.
Eye specialists went.
Aboriginal health workers and community leaders went.
And Fred and his wife Gabi Hollows were among them.
The teams travelled in four-wheel drives through some of the most remote parts of the country.
There were no neat city consulting rooms waiting at the other end.
Equipment had to travel with them.
Dust was everywhere.
Distances were enormous.
But the patients were there.
So the medical teams went to them.
Hundreds of Communities and Thousands of People
The scale of the program was extraordinary.
Teams travelled to more than 465 Aboriginal communities across Australia.
More than 100,000 people were examined during the program.
Thousands received treatment for trachoma and other eye conditions, and around 1,000 operations were performed.
But those figures only tell part of the story.
The program also documented the extent of eye disease in remote communities.
It demonstrated that preventable blindness was not simply an overseas problem.
It was happening here in Australia.
And once Australians could see the scale of the problem, it became much harder to ignore.
Fred Wasn’t Doing It Alone
The story of Fred Hollows can easily become a story about one determined doctor.
The reality was much broader.
Aboriginal health workers and community leaders were essential to the National Trachoma and Eye Health Program.
People including Gordon Briscoe, Jilpia Jones, Trevor Buzzacott, Rose Murray and Reg Murray worked alongside specialist medical teams.
They helped connect health workers with communities, build trust and ensure local knowledge was part of the program.
Gabi Hollows was also deeply involved.
She was an orthoptist who worked with Fred during the national eye-health program and later became instrumental in continuing the work they had begun together.
Fred may have become the famous face.
But improving eye health across remote Australia required many faces.
Fred Hollows Wasn’t Famous for Being Diplomatic
Fred developed a reputation for speaking plainly.
Sometimes very plainly.
He was prepared to criticise governments, institutions and systems when he believed people were being denied proper healthcare.
That occasionally made him controversial.
It also made him difficult to ignore.
Fred believed preventable blindness was closely connected with poverty and living conditions.
Treating someone’s eyes was important.
But if the conditions contributing to disease remained unchanged, the underlying problem remained too.
Clean water mattered.
Housing mattered.
Sanitation mattered.
Access to healthcare mattered.
Fred wanted Australians to understand the connection.
His Work Began Reaching Beyond Australia
By the 1980s, Fred’s attention was increasingly turning overseas.
He travelled through countries including Nepal, India, Bangladesh, Sri Lanka and Burma, now Myanmar.
He also travelled to Eritrea in Africa.
Again he encountered people who were blind from conditions that could often be treated.
Cataract was one of the biggest problems.
Cataracts cloud the natural lens inside the eye.
Surgery can remove the cloudy lens and replace it with an artificial intraocular lens.
The operation could restore sight.
But there was a problem.
The artificial lenses were expensive.
For people living in poorer countries, the price could make treatment inaccessible.
Fred looked at that problem and asked a very Fred Hollows sort of question.
Why did they have to cost so much?
Making Eye Surgery Affordable
Fred became determined to reduce the cost of intraocular lenses.
Rather than continually importing expensive lenses manufactured elsewhere, he supported plans to manufacture high-quality lenses in countries where they were desperately needed.
Work began towards establishing lens factories in Nepal and Eritrea.
Local production could dramatically reduce costs.
It could also help countries develop their own medical capacity rather than remaining permanently dependent on overseas assistance.
Fred’s approach was increasingly about more than treating individual patients.
Train local doctors.
Build local facilities.
Manufacture equipment locally.
Create systems that could continue working long after visiting medical teams had gone home.
The Fred Hollows Foundation
By the early 1990s, Fred was seriously ill with cancer.
But he had no intention of quietly retiring.
In 1992, The Fred Hollows Foundation was established in Australia to continue and expand the work he had spent years pursuing.
Fred lived long enough to see the Foundation begin.
He died on 10 February 1993, aged 63.
Australia had lost one of its best-known doctors.
But the work did not stop.
The Work Continued Without Fred
The lens-manufacturing projects Fred had championed became reality after his death.
Factories in Eritrea and Nepal produced affordable intraocular lenses that could be used in cataract surgery.
Doctors and health workers continued to be trained.
Eye-health programs expanded.
The Fred Hollows Foundation continued working in Australia and internationally.
Fred’s idea had grown beyond one surgeon.
That was precisely the point.
A surgeon can perform only so many operations.
But train another surgeon and that person can perform thousands more.
Build a hospital and generations of doctors can work there.
Create affordable medical supplies and thousands of patients can gain access to treatment.
Build a sustainable health system and the impact can continue for decades.
Gabi Hollows Helped Carry the Legacy Forward
Fred’s story cannot really be separated from Gabi Hollows.
The pair met while working on the National Trachoma and Eye Health Program and married in 1980.
They raised a large family while continuing their work in eye health.
After Fred’s death, Gabi became one of the most recognisable supporters of The Fred Hollows Foundation and helped ensure the work they had begun continued.
For Australians who remembered Fred during his lifetime, Gabi became an important link between the man and the organisation carrying his name.
An Australian by Choice
Fred never forgot his New Zealand beginnings.
But Australia became his home.
In 1989, he became an Australian citizen.
By then he had spent decades working in Australian medicine and campaigning for better healthcare for Aboriginal and Torres Strait Islander people.
His identity had become closely connected with this country.
Perhaps that is one reason Australians embraced him so strongly.
Fred Hollows was not Australian because he happened to be born here.
He chose Australia.
Then he spent much of his life trying to make it better.
A Different Kind of Australian Icon
Fred did not look much like a traditional national hero.
There was no carefully polished public image.
The beard was famously unruly.
His language could be blunt.
His opinions could be even blunter.
And he seemed considerably more interested in getting things done than worrying about whether everyone approved of the way he did them.
That became part of his appeal.
Australians often admire people who are practical, determined and unimpressed by unnecessary fuss.
Fred fitted that mould rather well.
There was work to do.
So he got on with it.
Why Fred Hollows Still Matters
Fred Hollows died more than three decades ago.
Yet his name remains familiar to Australians who were not even born during his lifetime.
That is unusual.
It happened because the organisation carrying his name continued the work rather than simply preserving his memory.
But there is another reason.
The idea behind Fred’s work is very easy to understand.
A person who can be helped should not remain blind simply because they are poor, isolated or were born in the wrong place.
Fred saw preventable blindness as a practical problem.
If doctors were needed, train doctors.
If patients were too remote, travel to them.
If lenses were too expensive, make them cheaper.
If people were being overlooked, make Australians look.
It was not complicated.
Doing it was the difficult part.
Fred Hollows – A Vision That Outlived the Man
Fred Hollows began as a New Zealand medical student and became one of Australia’s most recognisable doctors.
His work took him from Sydney hospitals to dusty roads across remote Australia and eventually to communities around the world.
Along the way he helped expose preventable eye disease among Aboriginal Australians, supported community-controlled healthcare, helped lead one of Australia’s largest eye-health programs and pushed for affordable cataract surgery internationally.
But perhaps his greatest achievement was ensuring the work did not depend entirely on Fred Hollows.
Doctors were trained.
Communities became involved.
Facilities were established.
And a Foundation was created that continued after he was gone.
Fred spent his career helping people regain their sight.
In doing so, he also forced Australians to look at something many had not seen.
Sometimes the difference between blindness and sight was not medical knowledge.
It was whether somebody cared enough to make sure that knowledge reached the people who needed it.
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