Q and A with Dr James Muecke AM
Dr James Mueke
A good news story with the 2020 Australian of the Year, Adelaide eye surgeon Dr James Muecke. He speaks to ODMA CEO, Finola Carey about his life and work in helping to prevent blindness with Sight For All a not-for-profit organisation dedicated to fighting avoidable blindness in the world.
When did you decide that you wanted to become an ophthalmologist/eye surgeon?
I wanted to be a doctor for as long as I can remember. There was no one single experience that steered me toward medicine. It was simply a desire to help, to cure, to make people’s lives better. Following my internship in 1988, I spent a year as a volunteer general doctor at Tumu Tumu Hospital in central Kenya, where I had the privilege of helping patients with a range of diseases, most of which were infective and imminently curable. The idea of being able to cure blindness in disadvantaged communities using microsurgery was really appealing. It combined my growing love of public health and the lifelong appeal of using my hands to do fine work. And so, I returned to Adelaide in 1990 to train as an ophthalmologist.
Who was your greatest mentor/influencer?
When I was toying with the idea of working in Africa for a year, most of the senior medical colleagues I consulted warned me against leaving the system. “You’ll never get back into speciality training programs.”, they exclaimed.
Colin Moore, the Head of Ophthalmology at Royal Adelaide Hospital at the time, gave me the opposite advice and encouraged me to follow my dream. I still remember receiving the phone call whilst I was in the operating theatre at Tumu Tumu Hospital when Colin gave me the wonderful and life-changing news that I’d been accepted into the ophthalmology program in Adelaide.
What did you hope to achieve when you set up Sight For All?
I co-founded Sight For All with colleagues from Royal Adelaide Hospital in 2009, to better coordinate and fundraise for projects that we were undertaking in a number of countries in Asia. Little did I realise that it would become a consuming passion and within a decade be impacting on the lives of over one million people every year.
Which countries does Sight For All service?
Sight For All has completed projects in nine countries in Asia (Bangladesh, Bhutan, Cambodia, Lao, Mongolia, Myanmar, Nepal, Sri Lanka, and Vietnam) and two in Africa (Ethiopia and Kenya). We also have initiatives in Australia which are primarily focused on raising awareness of the major blinding diseases that afflict Aboriginal and mainstream communities.
What are the most common treatments you provide in these countries?
Our projects are aimed at sustainably training and equipping colleagues in poorer countries so that they can comprehensively deal with all the blinding diseases that they encounter – cataract, glaucoma, diabetic retinal disease, and the blinding conditions of childhood, just to name a few. We are a ‘teach a man to fish’ organisation rather than having a ‘fly-in-fly-out’ approach.
Do you receive government assistance in addition to your fundraising activities?
Sight For All has been accredited with the Australian Government’s Department of Foreign Affairs & Trade for three years. This gives us a small funding stream, however, more importantly, has allowed us to elevate our organisation to the highest level of international development work.
Richard Grills mentioned that you told him measles is the number one cause of blindness in children in Asia. How did this information come to your attention?
Sight For All has conducted childhood blindness studies in five countries in Asia. During our study in Myanmar in 2007, we discovered that measles was the leading cause of blindness. We also found that it was a leading cause of blindness in Cambodia in 2008 and Laos in 2013.
To be surrounded by children in schools for the blind in each of these countries, who were permanently blind and horribly disfigured from measles, was the most disturbing experience of my medical life. It filled me with a passion to make a difference and spearheaded Sight For All’s fight against childhood blindness in Asia. We have now trained and equipped paediatric ophthalmologists in eight countries in Asia, in many the first for their countries.
What types of equipment does Sight For All use in its work?
All too often, we see equipment that’s been donated to low income countries and yet the doctors and their staff have no idea how to use them. Whenever we train an ophthalmologist, we ensure they receive the specialised equipment that we’ve trained them on, and also a critical training in the use of such equipment. Our donated equipment is often brand new and spans the whole range of subspecialty fields in our profession, from argon lasers for retinal disease to phacoemulsification for cataract surgery and the highly specialised instruments required to treat the range of blinding diseases of childhood.
What is the smallest most effective instrument that you use most?
Some of the finest eye surgeries involve the use of ultra-microsurgical instrumentation to conduct procedures on the delicate tissue of the retina which lines the inside the back of our eyes. The diabetic retinal disease usually presents late in poor countries and so restoring sight often requires the finest of instruments such as intra-ocular forceps, scissors, and suction tubes that can be manipulated inside the eye to remove blinding scar tissue and blood.
What is the equipment you find hardest to fund?
Sight For All is needing to fund the next generation of vitrector for use in a number of our partner countries. This device powers the instrumentation discussed above, that is so critical for dealing with the ophthalmic complications of diabetes, which is a huge, rapidly growing and often poorly managed cause of blindness in the low-income countries of the world.
Now that you have received the Australian Of The Year Award will this alter any of the plans for Sight For All?
I’m hoping that the Award will raise awareness of the high impact work being undertaken by Sight For All, work that’s being supported by the voluntary expertise of nearly 170 ophthalmologists, optometrists, orthoptists, scientists and nurse from across Australia, New Zealand and further afield. I’m also using the platform to raise awareness of diabetes, a growing epidemic that’s now the leading cause of blindness amongst working-age adults in Australia, and, at a cost of close to $20 billion annually, the greatest threat to Australia’s health system.
