Recently, KnowTheGlow Co-Founder, Megan Webber, had the pleasure of a zoom get-together with Dr. James Muecke, Co-Founder of Sight For All and also 2020 Australian of the Year. It did not take long for Megan to see how the humble and genuinely giving ophthalmologist received this honor. Dr. Muecke told Megan that 2/3 of the world’s blind children live in Asia and since Australia is close to Asia, he and his fellow Aussie eye specialists have felt a moral responsibility to take care of their neighbors. Long haul travel can be quite exhausting, so it makes sense for Sight For All’s trainers to stick close to home so that they can be at the top of their game in the operating room! Sight For All has now supported ten countries in Asia, two in Africa and one in the Pacific, as well as providing sight-saving initiatives to mainstream communities and the First Nations peoples within Australia.
Every country has a different story. In Vietnam for example, Dr. Muecke’s fellow Co-Founder, Dr. Henry Newland, was a consultant with WHO and had existing contacts with the Vietnam National Institute of Ophthalmology (VNIO) in Hanoi. Dr. Muecke visited Hanoi on a reconnaissance teaching mission. He discovered many children with retinoblastoma and other complex blinding conditions and soon realized that there were no fully-trained pediatric ophthalmologists to care for these children at the highest level. There was an urgent need to train a cohort of ophthalmologists to be able to comprehensively and sustainably fight childhood blindness in Northern Vietnam. Unable to bring doctors to Australia to train because of the significant language barrier, Dr. Muecke solved that challenge by gathering together a team of Australian and New Zealand pediatric ophthalmologists to travel to Hanoi to intensively train three local ophthalmologists over one year, two from VNIO (Drs. Trang and Chau) and one from Central Vietnam.
On Dr. Muecke’s second visit to VNIO as part of this training program in 2012, he saw a total of 12 children with retinoblastoma, over half of whom were likely to die from their cancer because of a lack of expertise at the center. Confronted by children with life-threatening extraocular extension and secondary spread from retinoblastoma that had been poorly managed, the entire team was absolutely heartbroken and each night at dinner, with head in hands, they would weep as a result of what they were witnessing during the day.
On another trip to Vietnam in 2016, Dr Muecke brought along documentary journalist Lara Damiani, who subsequently created the moving documentary Little Bang’s New Eye about a girl from a minority ethnic group who needed to have an eye removed because of retinoblastoma (https://knowtheglow.org/little-bangs-new-eye/).
Dr. Muecke stressed to Megan that while there has been a focus on cataract blindness in poorer countries, all blinding diseases need to be comprehensively addressed. He explained that when you establish an ophthalmic development relationship with a low-income country, you must be prepared to undertake collaborative research, provide high-level education, and then supplement that education with appropriate diagnostic equipment and surgical instruments. Additionally, it is essential that you create sustainability within these programs. For example, in 2007, Dr. Muecke and his research team discovered that the leading cause of blindness in Myanmar was measles. This prompted the training and equipping of the country’s first pediatric ophthalmologist. Fast forward to the present day (pre-covid-19) and Dr. Than Htun Aung, along with his two annual trainees, provides close to 30,000 treatments each year. To date, Dr. Aung has trained another nine pediatric ophthalmologists for the country. This is the model that Sight For All has followed across the Asia-Pacific and into Africa, and their work is impacting the lives of over one million people each year. “Once you have colleagues with the skills and knowledge to comprehensively manage eye conditions, it is then time to raise awareness about the blinding diseases that afflict each community.”
Megan asked Dr. Muecke how he decides which country to focus on next? He told her of the various countries where Sight For All have set up programs: Bangladesh, Bhutan, Cambodia, Ethiopia, Laos, Mongolia, Myanmar, Nepal, Papua New Guinea, Sri Lanka, and Vietnam. Each country has its own story. One such opportunity arises at ophthalmic conferences, when colleagues may come up to Dr. Muecke saying they are in need of an ophthalmologist trained in a specific sub-specialty such as pediatric ophthalmology. Another opportunity is through joint research projects, an excellent way to build trust and a rapport with a potential partner country before facilitating training programs. For example, he was approached by a professor to undertake a refractive error study in Laos. Once he fulfilled that request, a natural relationship developed and he could build the country program more easily from that point.
Some NGOs do not have a deep understanding of the real needs of ophthalmologists in low-income countries. While some NGOs are well-intentioned, they may neglect critical areas such as childhood blindness or eye cancer. Lest we forget the last year and a half of Covid-19 and the curveball it has thrown so many healthcare systems around the world. Funding has been the biggest challenge as a result of this pandemic, but fortunately, Dr. Muecke and his team at Sight for All have been able to host online symposia and workshops and thereby continue their vital education and mentorship throughout the ordeal.
There is a natural synergy between Sight for All and KnowTheGlow. They are each tackling the problem of avoidable childhood blindness, just from unique angles. As Dr. Muecke and his amazing team at Sight for All train and equip pediatric ophthalmologists through Asia, KnowTheGlow can help follow and spread awareness of the Glow and the more than 20 eye conditions it can indicate, giving people the confidence to move forward to find the very resources Sight for All has put in place.
Congratulations, Dr. Muecke, on being Australian of The Year for 2020, but more importantly, on being someone whose life’s mission is to reduce the number of blind children in the world and for laying the groundwork that will continue to protect them for years to come.