Professor Brien Holden was a giant within the global eye health community, his contributions extended across research, education, public health and social enterprise.
Professor Holden was born on 6 January 1942 and passed away suddenly on Monday 27 July 2015.
Among many awards and acknowledgments, Professor Holden received the Order of Australia Medal for his work in eye health and vision science; the Schwab Social Entrepreneur Award for Africa 2010 at the regional World Economic Forum; and eight honorary doctorates from universities in Africa, Australia, Canada, Europe and the United States.
Professor Holden was once described by Professor Earl Smith as, “the most influential optometrist of our generation”.In January 2015, mivision interviewed Professor Holden for an article that was published in our February issue. We provide here a full transcript of the interview that demonstrates the passion, commitment, and self-described “anger” that fuelled Professor Holden’s global effort to eliminate unavoidable blindness.
What do you hope to have achieved within your lifetime?
Well, I hope firstly that in my lifetime, my family – my children and my grandchildren – are all healthy, well and have a good sense of values and enjoy life. My contribution to that is relatively minor compared to the contribution of my magnificent wife but certainly that is what I hope to have partly achieved in my lifetime personally, for my family.
Job wise, I hope to leave a lasting legacy in the BHVI – of an institution that is creative, productive, self-sustainable, generates ideas and delivers massively on the whole issue of how to see better and how to deliver to people everywhere the vision that they require. A sustained and sustainable Institute that has the resources to chase the goals of vision for everyone, everywhere and create new and better ways to do just about everything we do.
If you could eradicate one eye disease in the world – just one – what would it be and why?
I’m a little biased here, because what I’d like to eradicate is the serious risk of high myopia and myopic blindness which is, as yet, a very unrecognised cause of loss of sight for many, many people – in fact myopic macular degeneration is the number one cause of blindness in adults over 40 in Japan – now that’s incredible – so I think it would be a great thing for optometry, for the Institute, for the Government, for society, for us to reduce the rate of progress of myopia in children so that later in life they’re less at risk from retinal damage, glaucoma and cataract.
…the giant is somebody who is creative, who cares about people, who is at the top of their field…
What is the one achievement you are most proud of and why?
I guess the one achievement I’m most proud of is that during my lifetime I have collected as friends, colleagues and partners many giants and great collaborators.
When preparing for a lecture recently and reflecting on what it’s all about, it is about that – it’s about the giants I’ve met – and the giant is somebody who is creative, who cares about people, who is at the top of their field… someone who is generous of spirit enough to share and want you to achieve your potential by interaction, and giving anything that they’ve got by way of ideas and knowledge to the common goal of better lives for people at large.
They’re the giants – the people who have made it – people like Otto Wichterle, Antti Vannas, Serge Reznikoff, Earl Smith, Nag Rao, Monty Ruben, Dick Hill, Kovin Naidoo – too many to mention really. People who are absolute leaders of their field and have an incredible generosity of spirit. So knowing those people and working with them, as someone said to me the other day, “I don’t like you very much but the people you work with are fantastic” – I think that’s a great achievement; a compliment.
And collaborators – I’ve had something like 360 collaborators on research publications and every one of those people – PhD students, colleagues, friends; there’s been a joy involved in creating knowledge and disseminating it with them.
As the leader of BHVI how do you inspire and motivate people to come up with the next idea?
Well, it’s very interesting – the subject of creativity, and the circumstances that lead to innovation and the development of new ideas and new technology.
Part of it – the most successful part of it for me – is to sit in a room with a group of people who are interested; have the same sense of values with regard to innovation and creation, who are creative people, or knowledgeable people or people who understand various aspects of a challenge – and talk about ways we might be able to tackle something as simple as contact lenses for presbyopes – or how to deliver vision care in the remote parts of Africa.
It’s the interaction of people and quite often that interaction doesn’t capture the idea at that moment, the most creative idea. Certainly I go away and think about what’s been said and that’s often when I think; well why don’t we try this. I think that’s the same for my friends and colleagues who are also in the process of creating new ideas.
There are many different not for profit eye health groups, all lobbying / advocating / fund raising – how do you believe they can best work together for a greater outcome?
I think this is one of the biggest disappointments of my life; that the big NGOs don’t work together – they work together at a superficial and self-interested level but genuinely interested in the common good and using the expertise of each NGO to best advantage? That hasn’t happened yet. That doesn’t mean to say that we don’t cooperate with other NGOs but in general, there’s not a lot of interest in the collaborative spirit in the NGO movement to use the skills and knowledge in each NGO most effectively.
Conversely that’s exactly why the Cooperative Research Centre Scheme, which the government is now dismantling, is so successful. Because you go to the best in the world who know a lot more about the subject than you do and you say ‘Earl (Smith, Dean of the College of Optometry, University of Houston), we want to do a project on myopia’, or ‘Jean-Marie (Parel, Bascom Palmer Eye Institute), or Nag (Rao, Chair LV Prasad Eye Institute), we want to find out the best way to deliver vision care to people in need. Those collaborations have been absolutely fantastic.
What attracted you to the profession of eye health – was it to practice or were you primarily drawn to academia?
Initially my mother said “what are you going to do when you go to university?” And I said “Medicine, too long; dentistry – teeth; pharmacy – pill pushing”, she said “well I know an optometrist, maybe we should go and talk to him.”
It seemed to me that when we discussed optometry that it was a nice, simple, people-related profession, 9–5, you make good money and had an opportunity to relate to people and do something of value in the community but it was pretty low key.
When I’d studied optometry I found it a little tough to seriously study all the science related to the physiology, anatomy and pathology and so forth but I liked the clinical part and that was validation that optometry would be a good profession.
I eventually graduated after failing in my second year and went into practice for a year in Melbourne with Harry Held, who was great to me and very patient. I then got married and jumped on the boat with my new wife (with half my football team) and sailed to England to do my DCLP (Diploma of Contact Lens Practice) and to see Europe.
You said you were on the way to the UK when you saw poverty and eye disease and decided you wanted to make a difference – it was 20 years before you were able to do so… many people have that impassioned moment but the ambition to make a difference fades very quickly. What do you think kept your ambition alive?
My upbringing, both family and school, was very much around ‘do unto others as you would unto yourself’ – or some related quote from the Bible – it was about honouring, respecting and loving your fellow man.
In those days, in the ‘50s, the definition of what to do to help your fellow man was about recovery after the war and the building of society, but the fundamental values of people being the most important part of the whole universe, and that you should treat every person as you would like to be treated yourself, were just fundamental values from family, school and friends.
So when I saw the devastating poverty (which I’d not seen in Australia) in Sri Lanka and PNG and got to England and saw what was going on around the world related to the Vietnam war and especially the poverty in the United States, it staggered me.
I became angry about it and still am. In 1967 we went to the Health Education and Welfare building in Washington to see a whole floor related to malnutrition and starvation in the United States – the richest country in the world – it was just staggering that the world had such wealth and such lack of concern for human beings and that stayed with me; the combination of family and school values and the injustice of poverty and malnutrition, in a society that had all the wherewithal to do away with such problems.
Even today the politicians and the political process cares little for those in need. Cutting billions from aid budgets – where is the outcry?
But a chance to do something useful came when Nag Rao (Dr. Gullapalli Rao) said to me in 1999 “you know, you should do something about uncorrected refractive error”. I said “why?” He said “because it’s the major cause of vision impairment and along with vision impairment goes disability and poverty” – and of course this came to be understood very dramatically during that period of time… and a mere six years later the World Health Organization (WHO) said exactly that and we went after making a real difference at BHVI, through Optometry Giving Sight and through eye and vision care development in societies in need.
What is the single driving force that makes you want to make a difference to the world we live in?
The single driving force is an anger – and a sadness – that our world does not eliminate unnecessary disease, poverty, disability, tribulation and suffering for the poorest people in the world, indeed for all people. I heard that the top three people in Australia have as much wealth as the million lowest paid in Australia – if you multiply that by 1,000 for countries like India or Africa – it is totally inappropriate that a society like ours, or the other developed countries around the world, do not have a driving mandate to eliminate suffering and poverty around the world.
It’s an unpopular expenditure of funds – there is no outrage that we are cutting billions out of our aid budget – that means death, damage, lack of opportunity, disability for hundreds of thousands of people, and yet it goes by without a whimper. That drives me, that makes me really angry and if I could do something about it, I would. And if any of our work contributes to easing the disability and poverty related to vision, or blindness, or if any of our work creates an opportunity for great scientists to produce new inventions like Ravi Bakaraju has done recently; that is a very exciting contribution to our society, using the creativity of scientists and researchers to develop new ways of delivering on the promise of vision for everyone, everywhere.
You’ve said working with funding from corporates is limiting when you are trying to innovate and that the returns have been fractional relative to the overall profit the companies you’ve worked with have generated. What do you believe would be the ideal, sustainable solution to innovating for the good of the general public and developing countries?
Well, there is no doubt that the major vehicle for alleviating poverty and disability and even uncorrected refractive error and preventing blindness is a responsibility of society – it’s a responsibility of the leadership of society to sell the concept to every person and every country; that if your fellow human being is disadvantaged, suffering, and especially if they are unnecessarily in poverty and poor socio-economic circumstances, that society should do something about it; that government should be there for the people – for all the people – their education, health, housing, physical wellbeing – all of those things are rights and every citizen of every country has the right to all of those things as well as the right to sight. So it has to be that society provides an opportunity for people to think about, and contribute to, the welfare of every person in society.
Now it’s not popular – election after election nobody has mentioned spending what is really necessary to close the gap on Aboriginal eye health, health and longevity.
The foreign aid budget – imagine a government going to the people and cutting AU$5 billion out of the aid budget because we can’t afford it, as Australians, to help our neighbors, to prevent them from being pushed further into disability and poverty.
The massive changes that have been wrought, in my experience, by the appropriate and focused investment of government funds in helping people to see overseas, is just phenomenal. To back away from that because we want eight lane highways or the next big refrigerator – as a society it demeans our contribution to the world to not take care of the needs of other people. It’s sad.
Eliminating disability, poverty and malnutrition demands our contribution to the world, to help take care of the needs of other people through development programs, educational initiatives and sharing technology.
It’s also part of the security of our country that our neighbours are stable and prosperous and that everything is done to create opportunities for people in need.
For us – and both political parties – to demonise the refugee pathway to control our borders is so disappointing – it made me ashamed to be an Australian to hear what was said about the way we are treating people – it just doesn’t make sense as a society to not do what is appropriate to help your fellow citizen or your fellow citizen outside the country when they’re in trouble – that’s the way society should be.
Professor Holden is survived by his wife Yvonne, three children Anthony, Karen and Daniel and