Street urchin makes a difference to lives

Ray Avery knows that even tiny amounts of money can save lives. Picture / Brett Phibbs

The man known in Himalayan hospitals simply as "Mr Ray" ushers me into his Mt Eden garage workshop with as much pride as any self-respecting do-it-yourselfer.

But in place of grease-smeared tools, it houses a pristine pharmaceutical production unit that makes Aids drugs in aerosol cans. It is designed to overcome the lack of child-sized doses of the medicine, an absence that often means death in Africa.

Bespectacled, dapper, charismatic, Ray Avery was one of the backroom boys who made humanitarian eye specialist Fred Hollows' work so successful.

The lens factories Avery set up in Eritrea and Nepal now make 10 per cent of the world's supply and return healthy profits, which go into blindness prevention.

Now Avery, whose first 14 years were spent in orphanages, is stepping forth as the face of Medicine Mondiale, an organisation he founded that aims to get medicines and basic equipment to those in desperate need.

As it was with Hollows, the big goal is to help developing countries become self-sufficient by building plants to make their own medicines and systems for training doctors and nurses.

At the moment it's focusing on Nepal. Avery knows the country well from his work with Hollows. Its situation is rapidly worsening because of the conflict between the King's Army and Maoist insurgents who control many rural areas.

"The net result," says Avery, "is a lot of provincial hospitals haven't received any medicines for a year."

Hospitals are using cardboard boxes as incubators for sick babies.

"For something like $300 we can change that, buy a new incubator or probably for $30, fix the old one."

Doctors are forced into a brutal means test. "You have to have 100 rupees [$3] in your pocket before you get into a hospital because that pays for a bed, then you have to pay for your drugs."

Outside hospitals people beg for the money to get inside.

"What I don't want is to be put in the same position as those doctors in Nepal," says Avery, "of having to make life-and-death decisions."

Hence Medicines Mondiale is launching its first public appeal. Avery and friends have until now done what they could from their own pockets and with help from organisations such as Rotary.

Public support is needed to make a lasting difference.

Avery's journey from backroom fixer to the dedicated frontman seems natural in hindsight. He describes key experiences of his life as pieces of a jigsaw that becomes clear only as the picture emerges.

"My life makes sense now," he says.

Early years in orphanages and living rough in London (home for a time was under a railway bridge) made him a survivor and an entrepreneur. He'd turn a quid sub-letting paper rounds and selling apples.

Taking refuge from winter in warm public libraries, he became a voracious and enthralled reader.

From a laborious after-school job cutting potatoes for a fish-and-chip shop he learned it pays to apply science to a problem. His plan to get a machine to cut the chips ran into a hiccup, oxidation turned them brown. A bit of research, the addition of nitrogen and the chips stayed good for a week. Avery had his first business and a good lesson.

"It was based on a bit of science, finding a better way of doing things."

From a chance job driving a bus of travellers from Germany to Nepal he discovered "what a ratshit, disproportionate, world it is", and that he possessed man-management skills.

During that 18-month journey (the bus often broke down) through some of the world's poorest countries, he was doctor, marriage celebrant and negotiator.

His career in pharmaceuticals (he has degrees in chemistry and biochemistry) gave him the necessary medical knowledge and experience building manufacturing plants. Then he met Hollows.

"It's like a story that's meant to be."

Avery and Hollows were introduced by a mutual friend who knew the eye doctor needed someone to set up plants to make intraocular lenses.

The meeting was classic Hollows. Terminally ill with cancer, he was staying in an Auckland hotel, here to set up a branch of his foundation but also to say goodbye to family and friends. Avery found a party in full swing with the famously gruff Hollows, a whisky and pipe in either hand, at its epicentre.

The friend introduced Avery as one of New Zealand's leading pharmaceutical scientists who had built plants all over the world.

"Fred looked at me, puffed on his pipe and said, 'yeah, but is he any bloody good?' Then turned on his heels.

"I went after him and said, 'They tell me you are dying of cancer. Well, I charge $1000 an hour in consultancy fees so neither of us has time to piss around'."

A week later, Avery was at Hollows' Sydney home planning a factory for Eritrea. Two months later he was on the ground in Africa.

Hollows was canny enough to extract deathbed commitments from key people. Avery agreed to ensure the success of the labs. "That [Fred Hollows Foundation work] occupied me for the next eight or nine years."

Hollows had no compunction about getting close to the diseased and afflicted, something that didn't come easily to Avery, who prized the order and cleanliness that his early life lacked.

That barrier was broken down by a lice-ridden Eritrean boy who fixed a pus-filled eye on Avery and reached out for him. He embraced the boy. Later in his hotel, Avery broke down.

If there's a moment a person becomes a humanitarian, Avery says that was it for him.

Another pivotal experience came near the end of Eritrea's war of independence when Avery traced the source of agonised screaming in a neighbouring hospital ward to a child who had stood on a mine.

That particular mine is designed to take a soldier's leg off to the knee, says Avery. Its effect on a 5-year-old child is more devastating. Her leg was shredded to the hip. There was no morphine for her.

"That was the beginning of Medicine Mondiale," he says.

"This girl, shaking violently in pain ... her look of absolute terror.

"I guess the catharsis is that blindness is a serious issue but there are lots of more acute things that happen to people in developing countries. More die of diarrhoeal infections than anything else, particularly babies.

"The problem is there aren't medicines designed specifically to help these people.

"When you have an outbreak of diarrhoea, which is quite common in Nepal, you don't have enough doctors so people treat themselves and that's when the deaths occur."

Some occur because the flow is inadvertently shut off on complicated IV drips. Avery, with a partner company, is producing and distributing a simple, reusable drip.

"What I'm about is finding solutions that fix problems rather than just giving away medicines."

A one-use eyedropper is another example. This was prompted by the spread of infection during treatment.

Doctors would touch an infected eye with the dropper bottle then move to the next patient and the next, spreading the infection.

"You end up with well-meaning people causing a lot of blindness because they haven't got appropriate medicines."

Another is the Aids medication in the aerosol can. The idea for that came from the practice in Africa of breaking up tablets made for adults then dissolving them in an infant's milk.

Often the mixture is left on a shelf without preservative, leading to fatal infections. An aerosol can means dosage is easily measured by the squirt (applied under the tongue).

Avery, 57, has a sense of urgency that's new to him. Twenty years ago he would have been satisfied with his contribution through the Fred Hollows Foundation.

"It's become a vocation ... to the point that I see the world in terms of what $2 or $10 can do.

"It's like a roller-coaster. When a baby [who might otherwise have died] is placed in your arms, it's a bit of magic.

"The other end of the scale is lying in bed thinking 'jeez, how am I going to get some money for these incubators'. I want to use the time I have to make a big difference."

Avery picks up a bag of clear liquid from the table at which we sit. "It's not such a complicated equation. Two or three dollars will save a child's life by getting them enough of this rehydration solution."

Setting up a small plant in Nepal to produce drugs for use in its hospitals would cut the cost of importing them from India by 90 per cent.

The potential to make a difference is huge, he says. Take the tiny Perspex lenses produced by the Hollows laboratories. A pipe dream 12 years ago, they have restored the sight of three million people.

It's the sort of impact he hopes Medicines Mondiale can make. "I want to see some real change, raise some serious money, get more people involved and make a real run at this."

New Zealand and Nepal are a good fit, he says. The Nepalese revere Kiwis because of what Sir Ed Hillary and Hollows have done for their country.

Ten hospitals rely on Medicines Mondiale. Avery says the Nepalese are naturals at public relations. On a recent trip to assess needs he was farewelled at each hospital with almost the same phrase. "We are here, Mr Ray. Please don't forget us."

Donations can be made by phoning (09) 630-7825, online at medicinemondiale.org or sent to P.O. Box 67086, Mt Eden, Auckland