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Hollows, Frederick Cossom (Fred) (1929–1993)

by Jack Waterford

from Canberra Times

Professor Frederick Cossim Hollows became a household name for a life of achievement in public health only after it was realised that he was dying of cancer. But he made even the best of that: he set himself a target of raising $400,000 for an Eritrean eye program and ended up raising more than $6 million to improve sight in the Third World.

This did not happen by accident but by relentless driving of himself. Over the past two years he made more than 1500 public appearances – often three or four a day – travelled in all states of Australia, made trips to Eritrea, Nepal, Vietnam and his native New Zealand, allowed his slow succumbing to disease to become a public spectacle (since it helped raise funds for projects he regarded as vital) and sacrificed any chance of dying in quiet dignity with a very young family. He even began new crusades and controversies, despite the clear toll they took upon his health.

Fred Hollows was a very Australian hero: egalitarian, not remote, a bit of a larrikin, but a professional who put his energies into social concerns rather than the accumulation of wealth, who spoke in the vernacular and spared no-one, least of all himself, when things had to be done. That he captured the national imagination and received such a broad and generous response says as much of the national character as about himself.

Fred Hollows was born in 1929 in Dunedin, New Zealand. His father, Joe Hollows, was a train driver, a solid Christian of a strong English socialist background and sense of duty, an internationally known chrysanthemum grower, the antithesis of the irascible and driven son, but both the source of Fred's sense of duty and mission and of a remarkable technical patience and ability to focus on the main issue. As a doctor, a technician or a craftsman woodworker, Fred Hollows had steady hands and great calm, he talked intimately to patients and gave them his total attention, but could suddenly snap at a nurse who by failing to do a job properly, was preventing him doing his.

After completing school at Palmerston North, Fred Hollows decided to become a Church of Christ missionary, but, after some time in a cloistered seminary, decided to see a bit of life first. He worked in a mental hospital, where, he said "sex, alcohol and secular goodness surgically removed my Christianity, leaving no scars", dropped divinity, but continued at university in arts, and, rather unexpectedly, was offered a position in a medical school.

He took it, began a tempestuous relationship with his first wife, Mary Skiller, travelled with her about Papua New Guinea and western Queensland – where they worked as station hands, cooks and bore drillers – and went back to New Zealand to complete his degree before travelling to Britain for post-graduate study in ophthalmology.

Later, in Wales, he worked with Archie Cochrane, the father of modem epidemiology, who added to an already radical disposition a strong focus on medical research being closely allied to actual service to the community. Fred Hollows's most important early work was in patterns of glaucoma and means of measuring its intensity.

He came to Australia as an associate professor of ophthalmology at the University of NSW in the 1960s. He first attracted public prominence, however, with his interventions, inspired by author Frank Hardy, on behalf of the Gurindji, at Wattie Creek, then on their celebrated walk-off from Wave Hill station (the beginning of the Aboriginal land-rights movement) and amongst whom, Professor Hollows found, and loudly complained about, appalling levels of eye disease, particularly trachoma. Trachoma is a form of conjunctivitis which can cause severe scarring of the eyelid, and eventually scratching of the cornea and blindness: it is rooted in poor hygiene and living conditions.

About this time, a group of young Aborigines in Sydney were discussing setting up their own medical service and one of them, Gordon Briscoe, enlisted his help. Fred Hollows became the first president of the Redfern medical service, and helped scrounge material, and browbeat other doctors to keep it going. It was the first such service in Australia: there are now more than 50 owing much to his proselytism.

He also began doing regular medical trips to Aboriginal communities in western NSW.

In 1971, Hollows, though an ardent rugby fan, played a prominent role in the anti-apartheid protests and was arrested while trying to cut barbed wire strands around the playing area at the Sydney Cricket Ground.

Gordon Briscoe had gone to the federal Department of Health, and with Dr Pip Ivil began working on an idea of a national attack on trachoma in Aboriginal communities. Professor Hollows led the teams; he pushed the Royal Australian College of Ophthalmologists into sponsoring it. Eye doctors worked voluntarily with the program for weeks each at a stretch.

Between 1976 and 1979, the program travelled hundreds of thousands of kilometres, visiting more than 500 rural Aboriginal communities in all states, and examined in all 110,000 people, white and black, at least once, and many five or six times. Many had never had access to even basic eye-health care before. Up to 800 different types of pathology were recorded; treatment was given on the spot where needed. It was one of the most extensive public health studies ever done in the world, and is still used as a source of information and a bench-mark program for others to emulate.

More than 18,000 pairs of spectacles were prescribed; 30,000 Aborigines were treated in mass treatment programs, often extending over half a state, and involving scores of young medical students and Aboriginal health workers. About 1500 eye operations were performed; some in special Army hospitals. Ongoing services were also organised.

To the fury of state, and often federal, politicians and administrators, Fred Hollows did not see his task as mere ministering to the afflicted. Rather he wanted to help Aborigines to organise their way into better conditions. The trachoma program employed Aboriginal liaison officers to advise about conditions in communities; it complained loudly about the appalling findings and the lack of existing systems capable of dealing with them, and it identified with Aboriginal political movements.

On one occasion Professor Hollows commented that if the health services were being organised for animals, the RSPCA would prosecute. In 1978, the trachoma program arrived in Queensland just before the then Premier, Joh Bjelke-Petersen, announced an election: the Premier, convinced that some of its liaison officers would use the opportunity to organise votes against him in Aboriginal communities, ordered the team out of the state. It went back the next year, and saw a further 30,000 people.

Professor Hollows clashed publicly with a number of federal politicians over the period, particularly Dr Peter Baume, when Minister for Aboriginal Affairs. They learnt to quail from his fluency with the media. One politician was briefed to attack him for talking about the numbers of Aborigines he had seen with the stigmata of leprosy, supposedly out of the jurisdiction of an eye doctor. Fred Hollows replied: "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."

But he respected and got along with the Prime Minister, Malcolm Fraser, and Ralph Hunt, Minister for Health, and their support saw him through some crises with government. During this period, Professor Hollows, then a widower, married Gabi O'Sullivan, an orthoptist on the program, a remarkable person who seems to remember, by name, each of the 100,000 people met on the program. Gabi now has five young children, including twins conceived after she knew her husband was dying, to bring up; far from slowing her, however, her energies are usually in helping others.

The Hollows house – a double-story sandstone mansion in Randwick which had been restored from internal dereliction by Professor Hollows – has always been full of Aborigines from all over, passing through Sydney, as well as a wealth of other Hollows's mates and acquaintances, such as poet and ex-convict Max Williams, Frank Hardy, film-maker Pat Fiske, economist Professor Michael Johnson, publicist Mike Lynskey, Professor Bill Glass. His dinner table was always lively, if ever dominated by Hollows. Agreeing with him was by no means compulsory – his friends were remarkably eclectic; being prepared to be challenged by him was.

Fred Hollows was more than a doer: he had a broad framework of ideas and a strong sense and its purpose, and an unwillingness to allow goals to be obscured by trivialities. He asked people what they were doing and why – the why was often more challenging. One should not waste one's energies, but suck the pomegranate of life, he argued. No-one could be indifferent to his intensity and passion.

Professor Hollows's interests, obsessions and conversation were extremely wide. He was an accomplished mountaineer; he once commented that there was nothing like hanging from a rope and imagining oneself as a speck of blood on the ground hundreds of metres below to learn what was important and what was not, and had strong friendships with other climbers, including Tom Barcham, Edmund Hilary and Tim McCartney-Snape.

He had a deep love of the bush and of outback Australia, of camping and bush-bashing. He loved children and could talk to them at their level; he had strong views on population policy, the issue, he thought, was not how many but how their needs were met. A voracious and wide-ranging reader, he had a love of poetry and history.

He was a first-rate scientist and a natural teacher, particularly at the one-to-one level, who not only inspired other outstanding ophthalmologists, such as his friend Professor Hugh Taylor, of Melbourne (a world trader in public eye health), but who also tweaked and prodded many other doctors and students to share his concerns about and give their energies to public health.

Though he could be outrageously sexist, he had very strong friendships with many women, including prominent feminists. He continually drew attention to the unrecognised achievements of women in public health, in Aboriginal affairs, for example, people such as "Mum" Shirley Smith, Naomi Mayers, Rose Murray, Margaret Mallard, Marcia Langton and Pat O'Shane.

By the mid-1980s, Professor Hollows became somewhat disillusioned with what was happening in Aboriginal affairs, and its bureaucratisation; he thought careerists were running it to their own ends, and that central concepts, such as Aboriginal control and a focus on prevention, had become mere slogans. Aborigines had to liberate themselves, he would say. If they had the will and the sense of direction, support from outside could help. But too many had become over-reliant on the support. He became also increasingly critical of a focus on traditionalism; he supported the right of people to choose for themselves what they wanted to do but thought government, in embracing Aboriginal culture as it swung from assimilationist policies, had stacked the deck to the benefit of old men and the disadvantage of women and children. Many of his old Aboriginal friends resented his public comments and thought him inclined to be very bossy; few, because of the old links, would attack him publicly.

His trachoma work gave him an international reputation, and he was invited to advise and assist programs in Third World countries. His bluntness did not always impress. Once, at an international conference in a plush hotel in Egypt, only metres from dirt and dust and rampant disease, he told the Egyptian doctors that the contrast strikingly demonstrated the real problems.

Professor Hollows first became interested in Eritrea when an Eritrean doctor in Rome described to him the war in his country, and how 21 Eritrean doctors were working with the resistance. Hollows persuaded the Australian Development Assistance Bureau to give a grant for training an Eritrean eye doctor in Sydney. Later, he visited the country and was completely captivated by the people and the way in which they were dealing with enormous adversity and problems confronting them. Struck by the sophistication of pharmaceutical and chemical factories, built underground or under camouflage, he conceived the idea of Eritrea having its own artificial lens factories, so that first world eye technology could be brought to the community.

The model programs he campaigned for and the ones the Hollows Foundation, in carrying on his work, pushes involve the transfer of technology to Third World communities, using existing skills and commitment, to create self-sustaining improvements in eye care. They are not band-aid programs. They work with community organisations in Australia and overseas.

It became the work of the end of his life: so successful was he in enthusing others to the idea, and in spruiking for funds, that there are now three projects for such factories, in Eritrea, Nepal and Vietnam, and millions have been contributed for it. An accomplished public-relations man, Mike Lynskey, has voluntarily given nearly two years to coordinating the effort, and on capitalising on the recognition Fred's work had gained: as, say, 1990 Australian of the Year, a Companionship in the Order of Australia (nearly a decade earlier he rejected an earlier Order of Australia, saying that "now is not the time for anyone to be receiving accolades for work in Aboriginal health") and, early this year, an international Rotary award.

He also got involved in a more complex controversy, again one in which his opponents pulled their punches, feeling him to be very wrong and damaging but where there was nothing to be gained by attacking a man known to be dying. The controversy was over AIDS, and, initially at least, over Professor Hollows's concerns, first, that if AIDS established a foothold in Aboriginal communities, it would spread rapidly and, second, that public health preventive methods appropriate for dealing with AIDS in middle-class Australia were not appropriate for Aboriginal communities.

Although what he actually said, initially at least, was not offensive to the AIDS lobby, he allowed his remarks to become trivialised into futile debates about isolation for carriers of the HIV virus, then, into an argument about whether or not anti-AIDS efforts had been captured by the homosexual lobby less for effective prevention than legitimisation of their lobby. Certain truths were not being discussed; they were being hidden behind a smoke screen, he thought. He had many homosexual friends and was genuinely tolerant; he could not see, however, that one should pull any punches about the clear danger of anal intercourse, or that individual rights stood higher than public safety.

The personal Fred Hollows was a complex character. He had genuine charisma and enormous charm, though he could speak harsh, and often unfair words. His impact on the Australian psyche over the past few years came not only from admiration of his selflessness but also from a clear larrikin streak, and a capacity for plain-speaking. He was no plaster saint.

He had a thoroughly no-bullshit approach. When, two years ago, the College of Ophthalmologists organised a major conference in his honour and Hollows heard peer after peer sing his praises, he told them "You are only pissing in my pocket because I am dying". He could get very angry, sometimes unfairly on his friends and on his wife. Even Prime Ministers feared that if they stood together at a public meeting Hollows would embarrass them by nagging them aloud about aid, or Timor, or Bougainville.

Though he eschewed formal religion and remained Marxist in his leanings, he retained a strong spiritual streak, became a fellow traveller with the Roman Catholic Church, and was fond of quoting Catholic liberationist theologian and activist Paolo Friere: "God is the force in man that strives for liberation".

Some people praised Hollows as "unselfish" for his dedication to public health when he could have made a fortune. Hollows would have none of it. Why, he asked, did people think that humans were intrinsically selfish people only interested in their own welfare, and that anything done for others involved great personal sacrifice and hardship. He had worked with Aborigines because he liked them. They were far less neurotic and easy to get along with than whingey middle-class patients. The technical work, which he always enjoyed ("fancy getting paid for having fun") was also intrinsically more interesting than operations on the rich. When people such as the Eritreans were organising themselves for their own development, it was exhilarating to be alongside them.

"I am a humanist," he said in an autobiography, put together by author Peter Corris from tapes of long raves with Fred. "I don't believe in any higher power than the best expressions of the human spirit, and those are to be found in personal and social relationships. Evaluating my life in those terms, I've had some mixed results. I've hurt some people and disappointed others, but I hope that on balance, I've given more than I've taken. I believe that my view of what a redeemed social condition is has been consistent – equity between people – and I've tried always to work to that end."

Fred Hollows is survived by his wife Gabi, their children Cam, 10, Emma, 8, Anna-Louise, 5, and two-year-old twins Rosa and Ruth, and by grown children Ben and Tanya.

Jack Waterford was a friend and colleague of Professor Hollows for more than 20 years, and worked with him on the national trachoma program.

Original publication

  • Canberra Times, 11 February 1993, p 8

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Citation details

Jack Waterford, 'Hollows, Frederick Cossom (Fred) (1929–1993)', Obituaries Australia, National Centre of Biography, Australian National University, http://oa.anu.edu.au/obituary/hollows-frederick-cossom-fred-25508/text35249, accessed 19 October 2019.

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