Fred Hollows’ trachoma program exposed appalling Aboriginal health conditions and helped drive the growth of community-controlled health services.

In 1975, an Aboriginal friend in the federal health department, Gordon Briscoe invited me to ask his department questions about the prevalence of trachoma in Aboriginal Australia, and what was being done about it. He suggested that I get some preliminary information from an ophthalmologist, Professor Fred Hollows, at the University of NSW. He and Hollows, he said, had put in a submission for a national campaign to attack trachoma, but it was languishing in departmental in-trays.

I was being used, but I knew it and it seemed a noble enough cause. Gordon was one of the founders of the Redfern Aboriginal Medical Service, the first such service in Australia. What particularly galvanised the development of the service was his convincing Fred Hollows to get involved as a founding president. Hollows scrounged equipment from the Prince of Wales hospital and pushed doctors, young and old, to work as volunteers. An Aboriginal nurse, Naomi Mayers, who died earlier this year, became the chief executive and an array of Aboriginal helpers, including the immortal Mum Shirl, began establishing and developing services controlled by Aboriginal people and focused on diseases and conditions affecting them rather than out of a public and private health system operating for Australians whose health was generally good, and for whom illness was an occasional uncomfortable incident. By contrast many Indigenous health conditions were endemic, and in many cases quite treatable other than for cultural and economic reasons.

Hollows gave me his estimates of the prevalence of trachoma and other eye conditions, including blinding ones, in remote parts of Australia. His figures were based on work he had been doing in Bourke, NSW, and at Hooker Creek and Wattie Creek, now known as Lajamanu and Daguragu respectively. This was at the scene of the Wave-Hill walk-off of 1966, when Gurindji went on strike against pastoral controls.

The health department asserted that Hollows’ figures were exaggerated but allowed that it had somewhere in its system a submission for a plan to do something about the problem, which was serious whatever it was. (In fact, Hollows’ figures turned out to be major underestimates, not least in areas where the federal health department had a primary responsibility.) Soon after, the Whitlam government announced it would be funding Professor Hollows to lead a team into all mainland states to examine and deal with the problem. But before anything happened, the Whitlam government fell and the program seemed to lapse.

But the new prime minister, Malcolm Fraser, revived and funded the idea, and the Royal Australian College of Ophthalmologists who would have responsibility for managing the funds got into action. They came in a pioneering block grant that assumed those being seen would be receiving a GP and specialist service, which was not being bulk billed but estimated and paid annually. In later years, if there were disputes about what the program was doing, Hollows issued a veiled threat that he would walk out of the funding agreement and operate a bulk-billed service, in something of the manner of the Sydney AMS. That would have given the program more........

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