Obituary: Professor Fred Hollows (CORRECTED)

CORRECTION (PUBLISHED 20 FEBRUARY 1993) APPENDED TO THIS ARTICLE

Frederick Cossom Hollows, eye surgeon, born Dunedin New Zealand 9 April 1929, Australian of the Year 1990, AO 1991, died Sydney Australia 15 February 1993.

FRED HOLLOWS, the eye doctor, was a modern Australian hero. a straight-talking, irascible man and fine surgeon, he had worked tirelessly for many years in Australia and the Third World at his self-imposed task of bringing modern health care to those who do not receive it. After decades of struggling against professional, bureaucratic and political opposition to his activities, he captured the Australian public's imagination and support over the last five years as a common man with an uncommon vision.

Fred was young in the late 1930s and had a Christian Socialist upbringing that exposed him to the meaning of social and economic inequality. His early tertiary education in the Classics, done with the object of becoming a missionary, was untypical and took place between efforts to climb every significant mountain in New Zealand, with friends and acquaintances that included Sir Edmund Hillary.

While he retained a lifelong love of prose, poetry and history, he soon gave away Christianity, but not its sense of mission and human values. He switched to medicine, training in New Zealand and Wales under Archie Cochrane, the great epidemiologist and political radical. He then set to work with the energy and stamina that were his hallmark, doing what he was always proud to call a 'skilled trade' and 'good work', with a professional team at the University of New South Wales and growing community support wherever he worked.

Fred Hollows did not seek personal attention, but considered there were some things nobody could ignore. In the 1960s, with white Australians finally recognising Aborigines as part of the human race, by including them in the country's population census, there was also growing awareness of their social and health inequality. Hollows and his friend Frank Hardy, the writer, were part of this exposure by taking up the cause of the Gurindji Aboriginal people of Wattie Creek in Central Australia. In Hollows's case he pointed out the extent of trachoma, an eye disease caused by poor hygiene and living conditions in the community and resulting in blindness. As Hollows said of the situation, in his typically direct way, if the RSPCA found animals living in the health conditions of many Aborigines, it would have prosecuted the perpetrators and put them in prison.

As a man of action, Hollows set about addressing the problems, in the face of opposition from both health bureaucrats and politicians with reputations to protect and other interests to serve. His first move was to provide medical support for Aboriginal initiatives to set up self-run community-health services and he helped in creating the first Aboriginal Medical Service, in Redfern, Sydney. Today there are 76 such organisations established around Australia.

Hollows's second initative, using the support and voluntary services of his professional colleagues and Aboriginal activists, was to undertake the National Trachoma and Eye Health Programme, to address the eye-health problems of Aborigines. The programme visited over 900 Aboriginal communities, examined over 100,000 people and treated tens of thousands of them over four years. The data collected provided the basis for one of the largest, most detailed and authoritative public-health studies ever done anywhere. It was not completed without opposition. To achieve his objectives, Hollows was often outspoken, using against his critics what he called his 'no bullshit' approach, but never without getting his facts straight and his strategies clear. On being attacked by a politician (a doctor) who suggested as an eye doctor he could not legitimately comment on the number or condition of Aborigines with leprosy, Hollows commented, 'I am also a doctor and can recognise leprosy when I see it. I think I can say I have shaken hands with more lepers than any other doctor in Australia.'

The strategy of providing the best of modern medicine and its technologies to those in need, with steps to promote community organisations with the capacity to promote and sustain it, led Hollows to expand his work to Eritrea, Nepal and Vietnam late in the 1980s, despite growing ill-health. He tirelessly followed up exploratory field-trips to identify eye-health needs with ophthalmological surgical teams to meet them. He single-mindedly organised, both in Australia and in the recipient countries, the resources and organisation needed to train people and transfer technologies, particularly interocular lens manufacturing facilities, to enable self-sufficient community- based campaigns to wipe out trachoma-caused blindness. He was interested in helping people to help themselves and believed, in contrast to the current political ideology, that the most basic motivation of people in a progressive society is to help each other.

To get the resources he and the Hollows Foundation (set up by his supporters) needed, Hollows appealed to the Australian public and he did so through an unabashed appeal for support for his work, at thousands of personal appearances at meetings and through the media. Support him they did, drawn by his call for help; his rough but honest character; his obvious courage in working on while ill; and the fact that, unlike the present crop of empty- headed politicians, he had a vision and a means of achieving it.

Some of Fred Hollows's ideas also sparked controversy. In the Aids debate in Australia in 1992, he attacked the lack of knowledge of the changing incidence of the disease; he voiced concerns about the potential spread of Aids to Aboriginal communities and attacked medical and homosexual organisations that he considered had 'captured' the debate (and the available resources), and swung the campaign against Aids away from measures to prevent the spread of the disease. He was accused of 'homophobia' and taking an autocratic line on the issue and for the first time in his life appeared on the other side of the picket lines. He responded that direct action was needed to stop the spread of a disease that had killed both his male nephews, whom he dearly loved, and had the potential to cripple the Aboriginal communities he supported.

The controversy over Aids did not reduce popular support for Fred Hollows or the foundation that was created in 1992 to help him carry out his work and it continued to grow up to the time of his death. He had struck a chord with Australians, who took to the whisky-drinking, plain-speaking man, with the touch of larrikin. In the process of becoming an Australian hero, Hollows seemed to nudge aside the professional cricketers, football players and surfers whose images are increasingly less of people but products, and replaced them with someone of honest purpose and straightforward expression that Australians respected.

Fred Hollows, who will be remembered as the man who wanted 'all the world to see', receives a state funeral in Sydney today, before his family and mates take him out to the edge of the desert country that he loved so much, to yarn about him and bury him.

CORRECTION

Fred Hollows died 10 February 1993, not as printed.

(Photograph omitted)