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“Addressing inequalities needs bolder action.”

Published: 19 November 2021

This article may contain personal views which are not the views of St George’s, University of London, unless specifically stated.

Former BBC reporter and Medicine alumna, Dr Lucy Mathen, was the BBC’s first female Asian reporter when she joined Newsround in 1976. Her curiosity about everyone and everything, and her love of the written word, drew her to journalism. During a TV assignment in Afghanistan in 1988, Dr Mathen had a ‘lightbulb moment’ which led her to join St George’s to retrain as a doctor, later specialising in Ophthalmology.  

In 2000 she founded the charity Second Sight after learning more about the prevalence of blindness in India. Taking a month off from her NHS work, she travelled the breadth of rural north India and confirmed through this field work that the core of the blindness problem was the shortage of eye surgeons in the areas of greatest need. The charity began by providing those ‘missing’ surgeons who also trained local staff.

Twenty years on, nearly 500,000 blind people have had their sight restored with cataract surgery.  Today the work of Second Sight focuses on India’s poorest state, Bihar, and the operations are all carried out by local surgeons.

We spoke to Dr Mathen about founding Second Sight, the importance of community action in creating a lasting impact, and why we need to address inequalities in the charity sector and beyond. 

You left journalism to retrain as a doctor at St George’s. What caused you to make this career change and how was the transition into Medicine?

“I loved every moment of my career in journalism. However, whilst making a documentary in Afghanistan, I interviewed a doctor who couldn't do his job because he had no medicines. I knew that nothing would really change by sharing his story and that, if I ever went back to a war zone, I wanted to go back as a doctor and be able to treat people.  

I really enjoyed the transition into Medicine – people comment that it must have been difficult to adjust, but I loved studying and had a lot of fun with students who were literally half my age.

There are also some parallels between being a journalist and being a doctor, because both careers rely on your being able to communicate well. As a journalist you get a good story if people feel they can talk to you; as a doctor you get a good medical history for the same reason and that is crucial for diagnosis and treatment.”

Tell us about your decision to launch Second Sight in the year 2000.

“It surely must be every ophthalmologist’s wish to cure the blind, and the largest number of people with curable blindness lived in the country of my birth – India. It was also a well-known fact, confirmed by my first field trip for Second Sight, that millions were remaining blind simply because of the shortage of eye surgeons where they lived.

“Second Sight began by sending surgeons out to key areas in six northern states in which cataract blindness was endemic. They didn’t just operate – they trained local doctors and nurses on site and learned as much as they taught. Following an invitation from Indian ophthalmologist Dr Helen Nirmala Rao, who had dedicated her whole working life to Bihar - the poorest state in India with the highest number of people with curable blindness - we chose to focus our clinical and financial resources there and have since offered consistent and practical support that will have a lasting impact.”

What has contributed to the success of Second Sight? 

“From the very start we were deeply immersed in the daily reality of making eye services accessible to the poorest patients in India and acutely aware and appreciative of what local communities, including medics, were already doing. We have never stopped listening to them. And, as a small non-bureaucratic charity we are agile enough to change tack with their changing circumstances.

“Eye hospitals in Bihar are no longer short of eye surgeons – there has been the Reverse Brain Drain about which I dreamt at the beginning. However, no other organisation has our overview of the state. So, for a returning Bihari ophthalmologist or for clinicians deciding to stay practising in the rural areas in which they grew up, we are still the first people they contact for guidance. They consider us to be Honorary Biharis.

In addition, our success relies on the fact that we have very loyal, long-term donors who like our modus operandi - we don’t obsess over strategy and policy around conference tables; we make most of our decisions in a hospital, a patient’s home or even, quite literally, in a field. In addition, 100% of donors’ money is spent on restoring sight. We remain a volunteer-run charity.

What sort of changes could the charity sector, and other sectors, be making to ensure we are addressing inequalities? 

“Addressing inequalities needs bolder action. I get impatient when people ask those who have experienced discrimination to ‘celebrate’ their own achievements in order for others to ‘recognise’ their work. Or to keep repeating like a mantra that those in power should be ‘listening’…implying that all will be well thereafter. In fact, rather like building eye hospitals which can then do little work due to a lack of eye surgeons, I think it is missing the core problem!

“It is time to shine the spotlight on those in power and ask them to justify their own position and frankly, their continual celebration of their own achievements! In spite of no lack of talent elsewhere, most organisations in this country are still run by white, middle-aged men. I want to hear why they believe that they are the best people to hold such sway. I think we might find their justifications rather flimsy when challenged.

“So let’s start with Medicine - where over 50% of medical students are female and yet we are not seeing more female consultants in the workplace, which is unacceptable. As for the Charitable Sector – 70% of the total volunteer force is female whilst 70% of the CEOs of the 100 biggest charities are male and only around 7% are not white. I rest my case.”

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