The Australian always, quietly, making a big difference

Experts, local and international, told him his plan was foolish and impractical, running the risk of becoming a cruel hoax, of demolishing his reputation and a massive waste of money. Fred's plan was for some of the poorest countries in the world. It was not to be a system of handouts, or of making the recipients conform to Australian precepts. It was not established to glorify Australia, or to make heroes of the doctors and other healthcare professionals who became involved. The plan was to make self-supporting partnerships with the recipient nations, seeding them to run and control programs themselves. Around the world, tens of millions were blind from conditions, such as cataracts, which were easily treatable, in the developed world at least, with surgery and intraocular lenses costing hundreds of dollars.

The argument against Fred's idea was that no one in the poorest countries could afford a fraction of that current cost. If such sums of money were to become available for third world healthcare, there would, in any event, be higher priorities than providing surgery for blindness. In some of these nations, the total public health budget was well under $50 per head a year. Nice as it might be to do something for these sufferers, it could not command the priority and ran the risk of providing second rate eye care for the very few.

Hollows had run a successful program attacking trachoma and other eye health conditions in rural Australia, particularly among Indigenous Australians. He had helped establish Aboriginal-run medical services around Australia, including the first at Redfern. He was not interested in second-rate services.

His aspiration was for services in Africa and Asia, and other countries, of the same quality as could be obtained in an expensive clinic in Switzerland or Randwick, NSW. The secret, he thought, would be in building high-quality intraocular lens factories in some of these nations. The factories would be set to produce a surplus beyond local needs, able to be exported to the industrialised world and thus used to help make programs self-sustaining. The surgical model did not involve eye doctors coming from Australia to perform cataract operations but visiting to help train locals to do the work. (In many countries, Australian doctors have now moved to training the trainers of the trainers. And the actual cost of an intraocular lens kit with sterile surgical pack is now less than $10 at source - an astonishing achievement.)

On Thursday, one of those who, along with Fred's wife Gabi, was there at the beginning, Michael Johnson died of a blood cancer. He would have turned 80 this July. He was a running and cycling mate of Fred who had moved into Fred's house in Randwick, and who, in the three years Hollows and his teams travelled to more than 500 communities, seeing 110,000 people all around Australia, managed a group of householders constantly supplemented by visitors, informal seminars, Scottish dancing and suicidal bike rides around the South Head roads. Michael Johnson was very popular among those who knew him, and very respected among those who had dealings with him. But he was not a big noter and, if a recipient of a medal of the Order of Australia, not loudly celebrated in the media or in the social columns. A good man, a decent man. A lover of life who had an amazing giggle, and sometimes a habit of saying "gosh" and "golly".

I have spent much of recent months despairing of the calibre and directions of Australian leadership, the hopelessness and lack of ambition of Australian and world politicians, and the way in which, in so many areas, the world seems to be going to hell in a handbasket. By no means all of it is due to the attitude of mind brought to issues of helping others by Donald Trump. Some of it comes from the essential meanness of spirit exhibited by our prime minister, Anthony Albanese, made manifest this week again with the decision that Australia will do all in its power to prevent Iranians coming to Australia, lest they take advantage of a visa by applying for refugee status. I seem to remember that only a week or two before, Albanese and our pathetic Minister for Home Affairs Tony Burke, were waving welcome flags, if not very successfully at Iranian soccer players.

They were engaging in this publicity stunt even as they were delaying or denying entry to genuine refugees. This is apparently because ASIO has taken the word of Israeli intelligence services that the wicked Iranians, not necessarily any relations to the asylum seekers, had been involved, somehow in subcontracting attacks on Jewish Australians to Australian criminals.

On Sunday, some of these whitened sepulchres will be attending Christian church services at which they will be reminded that Jesus himself was once a refugee, and other Christians will march for justice and mercy for people fleeing war and want.

In such dispiriting and shameful times - ones most Australians will come to regret - it is good to be able to turn to the activities of some Australians of whose work, and energies, all Australians can be proud.

Proud of people who have been making Australia, our neighbourhood, and the world a better and more peaceful place. Proud of people whose work has not been based on cheap political calculation, least of all about the very minimum amount of action for which they think they can get a slight moral credit. Proud of people who have been good citizens of Australia in doing something practical without grandstanding for their least advantaged fellow countrymen and women. Proud of the dedicated and deliberate actions of ordinary Australians who have done much more than most of our politicians to make Australia the citizen of the world that one might expect of a nation that enjoys one of the highest standards of living in the world.

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One might not have always thought Michael, later Professor Johnson, marked out for the leadership and the character he came to represent. He was born in England but his family moved to Rhodesia for his father's health when Michael was young. He came to Australia in about 1972 as a migrant, if somewhat as a refugee because of his unwillingness to fight as a conscript in a murderous civil war against the disenfranchised black population. He initially worked with an oil company with something of an accountancy role and became active in a crowd of young men and women deeply into high-exertion sports in the eastern suburbs. One, a friend of Fred Hollows, introduced the pair, and it was not long after that Johnson became one of the denizens of Farnham House, a Randwick sandstone mansion coming again to be a residence after periods as a boarding school, boarding house, and, according to Fred, a brothel.

At any one time, Farnham House might have half a dozen or more full-time residents, and an array of casual visitors, many involved in Indigenous causes, in Fred's activities as the founder president of the Redfern Aboriginal Medical Centre, Fred's mountain climber mates, male and female and people associated with what was to become the national trachoma and eye health program travelling to rural communities around the mainland. Some of the runners ran when they were bored, and when they were stimulated, when they were tired and when they had to go to work on the other side of Sydney Harbour. Several in the group were champion marathoners. Early on Sunday mornings, assorted lunatics including Johnson and Hollows would charge at breakneck speed around Old and New South Head Road before meeting at Bondi for croissants. The then Ms Gabi O'Sullivan was not a fan, and nor, when I lived there, was I. We would rise several hours later and be at Bondi in time to order the croissants.

The Farnham House dinner table, ever with an articulate and combative array of visitors, was a great university of life, with long and impassioned, but also friendly debates and arguments about politics, culture, history and sport. Fred had a way of challenging participants not only for their reasoned opinions but of pushing them towards showing their sincerity by action. He introduced an array of new thinkers into arguments about matters such as effective work in Indigenous communities; among them were South American apostles of liberation literacy such as Paulo Freire, one of his own mentors, Dr Archie Cochrane (now famous for the Cochrane Collaboration), and even the Brazilian Catholic Archbishop, Helda Camarra. Johnson was already interested in economic development and aid issues but came to be strongly influenced in the directions his economics studies took.

Johnson later worked an apprenticeship as a political minder in Canberra before refocusing back towards the University of NSW where he became a lecturer, later a professor of economics and business studies. He married Paula O'Sullivan and had two sons, Sean and Sam, but stayed close to Hollows and his own young family as Hollows was winding back some of his intense involvement with Indigenous health issues and refocusing on running an ophthalmology department at the Prince of Wales Hospital. Partly because of his growing international reputation in organising health programs against trachoma and other scourges, he also became involved in recruiting and training doctrines from third world countries, not least in Eritrea, then engaged in war with Ethiopia. In a manner not dissimilar from Archie Cochrane, Hollows was to travel to Eritrea, sometimes operating in trenches near the front lines.

In the late 1980s, however, Hollows was diagnosed as having pancreatic cancer and began to concentrate on lasting activity to help developing economies such as Eritrea, East African nations, Nepal and Vietnam with sustainable eye healthcare programs. Over the six years before he died in 1993, he and some of those he inveigled into the task, such as Mike Lynsky and Michael Johnson, and other colleague ophthalmologists and people engaged in Indigenous health issues into a working model of the work a foundation could and should do.

Fred lived to see lens factories established in Eritrea and Nepal, and major facilities in Vietnam. The foundation is now a more than $100 million operation, working in more than 30 countries, and is now regarded as one of the best development services of its type in the world. Most host countries work with self-managing local services, the Australian foundation helps with training, screening for poor vision, and subsidised treatment and assistance with equipment and infrastructure.

It is not impossible that the work of the foundation is the thing which has made the greatest difference to the lives of citizens of the world, something of which all Australians can be proud. Fred Hollows died in 1993.

Lynsky established a funding base and generous public champions, as well as links into the aid and development lobbies. Others stood ready, almost immediately to pick up training and teaching tasks abroad. Johnson had an intense interest in all of that but had a particular focus on establishing the structures and making sure that the organisation was responsible, accountable and focused on the tasks at hand. From being a member of the original board, he was to remain on it, in one position or another, for most of the next 33 years. Gabi Hollows has been much the same. The work has involved regular travel in Africa and Asia, and, often, partnership participation in local boards, or in fundraising arms such as in Britain and New Zealand.

But apart from these constant figures have been scores of senior men and women from business, accountancy, international health and development bodies, in a continuous process of renewal and re-examination of the most efficient and effective ways of getting things done. The foundation has scores of volunteers focused on fundraising, educational and promotional activities, a small core of paid professionals working with Indigenous and international programs, including partner programs abroad, and a small, highly professional board, working pro bono, of a calibre that would match almost any operation in the world. It is not for nothing that the foundation has a high national and international rating among aid, development and charity organisations. Michael Johnson was the grey, often too uncelebrated, eminence who ensured that the eye was on the ball.

Like Fred, Michael Johnson worked to make sure the foundation stayed focused on transforming lives. Not a bureaucracy mechanically repeating past actions or merely doling out goodies to good causes. There was no movement away from practicality, efficiency or focus on agreed outcomes, but it involved a host of commitments about empowering communities, about having local champions taking a practical lead with the work, and about standing by them through adversity.

Some of the early partners of the foundation, such as Dr Sanduk Ruit of Nepal have become important leaders of eye and surgical programs in their own countries, sometime evangelists for their methods in neighbouring countries, and as heroic, famous and important locally as Fred Hollows had come to be in Australia.

The governing philosophy also came to mean that the Foundation has been adamant about efforts by politicians in some countries to have their hands greased in exchange for permissions or a blessing or efficiency, or efforts to divert money or resources away from agreed outcomes.

The growth of the foundation, and its adherence and development of the ideas and ideals set by Hollows has not just happened. Millions have contributed money. Thousands have volunteered, some abroad in active programs. Some have become actively engaged in only recent years but found both the tasks and the enthusiasm as refreshing and challenging as when it was first established. Mickey J, as he was always known, operated with a smile, some sense of purpose but also a sense of fun. Alas, he never lost the zeal for exercise. He was cycling, with his wife Paula, in Europe in October when he collapsed with what proved to be acute renal failure. Flown back to Australia it was further seen that he had a blood cancer and a very poor prognosis. He was soon at home, like his old mate Fred when he was plainly dying, but doing his best to maintain as normal a life as was left to him. He had kept his eye on the ball to the end until he slipped away.

Jack Waterford is a former editor of The Canberra Times. jwaterfordcanberra@gmail.com