Gabi Hollows: Chipping Away at Global Blindness

At 62-years of age, Gabi Hollows is bursting with energy and passion for the collective work being achieved by The Fred Hollows Foundation in 25 countries around the world.

As Founding Director of The Foundation, she says her day-to-day job is primarily to thank those who have supported The Foundation in its growth. But looking around the Sydney head office, you can see it’s much more than that. Gabi is a powerhouse; a motivator of people. She may not drop by every day, but when she does, there is a tangible sense of excitement in the air.

I visited The Foundation on a special day, when two primary aged children – one from NSW and one from ACT – were to be presented with The Fred Hollows Foundation Humanity Award. The Foundation’s commitment to this award, and to encouraging humanitarian effort was obvious. Having been shown around, the two recipients and their mothers, were invited into the staff room, where the entire Foundation staff stopped work to join them, to celebrate their efforts and share afternoon tea.

If you can always think of other people rather than yourself it’s a good way to be. It makes things a bit better

Speaking off-the-cuff at the presentation, Gabi told the children, “If you can always think of other people rather than yourself it’s a good way to be. It makes things a bit better. There are a lot of times when you find it hard to think about how we can do things better. There are people who say ‘we can’t do it, but there are others who say let’s do it, let’s have a go – and when we can say we did have a go, we did do it, I think that’s a great philosophy in life.”

Just prior to the presentation, Gabi had been telling me about her early days, when, just a few years after The Foundation had been established Fred died, aged 63, of metastatic renal cancer. It was 1993 and Gabi said there was a feeling among some that it would be “too hard to drive the engine without the driver”.

However Gabi said, the wheels were already in motion and she was prepared to keep moving forward.

“I think Fred had reached a lot of people because of our history on the trachoma program – we’d travelled all over Australia in the 70s, we’d been to 465 communities over almost three years, we’d seen 112,000 people – 68,000 of them Indigenous Australians – and we’d done lots of follow up,” she said.

“One of the things that Fred wanted to do was to ensure that we delivered good eye care to the poorest people – he never differentiated any of his patients whether they were his public patients or his private patients – they were just people who needed to be seen. That’s been the core of The Foundation’s work.”

Indeed, having started her career as an orthoptist alongside Fred at the Prince of Wales Hospital, it is a philosophy that Gabi has always lived and worked by.

Rewards and Challenges in the Field

Out in the field, it was Gabi’s role to quickly screen patients then direct them on to the appropriate health care provider for treatment.

“The hardest thing is when you go into a community and everybody comes out of the woodwork because they’ve heard there is an eye doctor in town. You want to be able to see everybody but you hate the idea that there will be some that you have to disappoint, because you’re unable to help them.

“Eye disease is very comprehensive – there are so many parts to the eye and so many different problems and issues. You have to be able to really truly imagine that you can’t fix it all up. The saddest thing for an ophthalmologist is not being able to give someone back their sight. Fred used to get to all the most difficult cases, which was very hard for him.”

While it has been many years since Gabi has worked in the clinical sphere, (she pulled back from the frontline when she had children, some of whom now have children of their own) she says she has never lost the feeling of joy that came when she and the team were able to give people back their independence by restoring sight.

These days, her work is more about encouraging the growth and development of the people who work at The Fred Hollows Foundation. “We have so many beautiful people working with us around the world. Of course we have turnover – people come and go – but those who are with us grow so much. One of our guys in Kenya started off as the cleaner and now he’s one of the key people communicating our work, and he’s writing beautiful stuff about our work right across Africa. We give people the opportunity to step up all the time, which I think is a great way to run an organisation.”

She said the many different Fred Hollows Foundation teams that work around the world aim to share and learn from each other as much as possible. However, with challenges, available resources and expertise varying so much from country to country, collaboration can be difficult. “There are no two places that face the same challenges, no two places for which we can predict the outcomes. Every combination of people, every combination of places is different – it’s like a growing family or child – it’s all about exploring and learning and growing.”

As an orthoptist, Gabi said one of her greatest joys is being out in the field. Unfortunately, as a global figurehead – and a busy one at that – this is no longer easy to do. “I’m not being precious, but I hate any fuss and so I like to be anonymous if I can. If I could just be a fly on the wall it would be a really nice thing to be out there in the field. But these days it’s always a bit of a hurry, a bit of a rush. When you’ve got so much to see, it’s hard to have that really strong connection… and really strong connections are important to me. Sometimes I feel sad about that.”

Work to be Done

Gabi is emphatic about The Foundation’s focus and its reason for being. “In 2000 an estimated 45 million people in the world were blind, of those people 90 per cent had a treatable condition, of those people 80 per cent lived in a developing country, and 65 per cent had cataract blindness. For this reason, The Foundation is primarily focused on offering cataract surgery in developing countries, and in Australia, on managing trachoma.”

Gabi says this work requires constant and continued attention.

“Unfortunately, trachoma is a secretion swapping disease and it’s something that if you don’t get on top of, if you don’t have, as Fred would say, follicle free five year olds, then you go on to get the next stages of trachoma. That infectious pool remains active, causing scarring on the lids where the lashes run up and down and in turn, leading on to cataract.

“Every new crop of kids that come through communities where there are issues with health hardware – ablutions, hot and cold running water, kids top and tailing in the same beds or on the floor – come in contact with those bugs. That’s where education on face washing and ablutions is so important.

Vision 2020

“The coming together of health professionals for Vision 2020 is one of the best things that’s ever happened in ophthalmology. We can now work together to improve community housing, to improve standards of hygiene and nutrition and to eliminate trachoma, but it’s a matter of chipping away all the time.”

One thing that The Fred Hollows Foundation has always been absolutely committed to is building sustainable eye health and measuring the impact of it’s efforts.

“Fred used to say that unless you can count it, you can’t prove it and if you can’t prove it you shouldn’t be doing it in health. He worked with the world leading epidemiologist Professor Archie Cochrane who agreed that there was to be ‘no survey without the service’, so when we did the trachoma program, we were incredibly strict about our numbers and our records, our surgical actions, our spectacle actions and what we did for follow up for general practice or whatever was wrong with those patients.”

This is important, she said, because “if you’re going to offer an eye health service, it’s got to happen properly – you can’t just buzz in and buzz out – people have to be followed up – there are so many eye problems that have to be seen again and again, especially if people have something like glaucoma”.

The Magic Still Happens

Twenty-three years after his death, the name Fred Hollows continues to rouse heart-felt emotions and attract support. Despite the fact that Gabi has been instrumental to The Foundation’s continued success, she says she hopes that he will always be its “king pin” and that she finds no reason to add her name to –
or delete Fred’s from – the mix.

“The Foundation has really been held together by Fred’s image and so we are operating in Fred’s name, using it to the best advantage. Some people even think Fred is still alive – kids do projects about him, they open a science book and up pops Fred and they just assume he’s still here. He is one of those wonderful heroes that kids want to know about. If we could have all the ‘Freds’ together that kids have done for school projects, we could fill the walls. It’s really lovely – it’s very cute.”

And as for The Foundation’s future, there’s no doubt it is secure. “The Foundation is highly regarded in terms of Indigenous health in Australia and also an international organisation because of our really big commitment to the many countries we are working in. We’ve been very fortunate that our Australian community has supported us.

“My job has been so enriching just meeting people, talking to them, and thanking them for their wonderful, continued participation. I always say it hasn’t happened because Fred had a good idea, it’s happened because people believed… and it’s still happening, the magic still exists, people still put their hands in their pockets to give to Fred, which is incredible, really.”