Andrew Bastawrous, an ophthalmologist in Britain, won a Rolex Award in 2016 for his project to prevent millions of people in low-income countries from going blind from diseases that are entirely treatable in the developed world.
Nominated by Google as the best social impact app in 2017, his Peek system uses a device attached to a smartphone to screen people for vision problems. The system, which does not require specially trained people, sends data to eye clinics for assessment.
Bastawrous is scaling up his programme and developing ways to ensure sustainability. His Peek School Screening, delivered in three countries, has already screened over 100,000 children. He tells Catherine Nelson-Pollard about his plans to initiate a national programme in Botswana and Rwanda, and to build a Centre of Excellence in Kenya with funding from his Rolex Award.
You were recently in Botswana for Peek. How was that?
Excellent. Last year, we ran a pilot programme screening school children for vision problems and connecting them with treatment. After meetings with Botswana’s Ministry of Health and the Ministry of Education, we now have a plan in place to screen every child in the country by 2020.
What are the screening applications available through Peek?
We have a suite of different apps that are vision tests using a smartphone. Peek Acuity tests the sharpness of the vision, while Peek Contrast measures your ability to test between white, grey and black. If you think of a traditional vision test, it’s dark black against white, which isn’t representative of the real world. We also have Peek Colour.
How are you developing a sustainable business model?
Our motto is No Income without Impact. We want to make an impact, not profit, so every decision is based on where we can make the most positive change and only then do we ask: How do we generate an income stream to follow it?
When we look at sustainability there are two components. One is Peek – an organization delivering impact in low-income settings. Our conclusion is that governments stand to benefit a huge amount over the lifetime of those people who are sighted. We are now working to establish government contracts to ensure that we deliver a quality of service to them, resulting in us becoming sustainable through a payment mechanism.
You are involved in many projects, and you have also recently completed your PhD. What is your strategy for handling your workload?
It’s about finding the right people, investing in them and empowering them to run things. Everything in Botswana is almost completely running independently of me. There’s a team leader there who has a team of six or seven working with him and they have trained about another 50 people.
In another example, Cosmas, the project manager in Kenya, went to India to run the project and I didn’t go. He hadn’t even been on a plane before but he went and started working on the project. For me that was a real sign we are building something that can work, and it’s important that a project doesn’t require me.
You are now working with two NGOs. What are you giving to them and what are they giving to you?
We are engaged in partnerships with the Fred Hollows Foundation, an Australian NGO, and the Christophe Blinden Mission, a German-based disability organization. They have a footprint between them that covers 100 countries, so they already have programme teams all over the world. We can add value to their work and they can add scale to what we are doing.
What challenges lie ahead?
Financing for the core funding of projects. The challenge in the field is that people tend to want to fund projects. I would rather build a core team who can support multiple projects. It allows us to be more strategic to make impact-based choices.
You used your Rolex Award funding to set up a Centre of Excellence in Kenya. Tell us more about it.
We worked with a fantastic Australian-based architect team to scope the design. They spent time on the site understanding our vision. We now have designs and a budget; the next stage is trying to raise the money to start building.
When you accepted the Award, you said you were accepting it on behalf of Maria, a young Kenyan mother of three who walked miles on the rumour that you were running an eye clinic. Do you know what has happened to Maria since?
She is doing well and is now pursuing further education. Another story of patient recovery is that of Ekai, a man who took a lot of persuading to come to surgery. Most people didn’t even know he couldn’t see, and he was very isolated and withdrawn. Since his eye surgery he is now working with the hospital team as a case finder.
Do you have any advice to pass on to other young Laureates about following through with ideas? What have you learned?
There is a process I have used in everything I have done from becoming an eye surgeon, to a health doctor, to now running an organization. It always starts with “Why, What and How?” A lot of people get stuck in the “how”. If you have a vision, you know why you want to get there and why it’s important. You start to align yourself with other people who also believe in the same thing. You then start attracting good people and together you define what you are going to do to get there. By this process, you work out the how. Don’t worry about messing up because you almost certainly will. Be ready to learn when you get it wrong.
How else have the Rolex Awards helped you with your work?
The Rolex video that was produced about us is a really good four-minute articulation of what we do, why we are doing it and how we are doing it. Two-and-a-half billion people on the planet can’t see as well as they could. Most people are unaware of this. At the Rolex Awards ceremony in Los Angeles I had no idea how big an event it was until I was there. It put the subject on the radar of incredibly influential people. The chance to influence influencers around a cause that I really care about was fantastic. It’s not every day you get that kind of audience.