We're the Himalayan Cataract Project, and we're competing in 100&Change, the MacArthur Foundation's $100 million competition to fund a single proposal aimed at solving a critical problem. Our proposal is to eliminate needless blindness in Nepa...

What is the leading cause of blindness in this region? Is there a dominant hereditary factor involved, or perhaps prolonged unprotected exposure to snow reflection is causing more permanent damage? Or other?

(HCP Co-Founder, Geoff Tabin) Cataracts are the leading cause of blindness in the developing world. Yes, there is a genetic association, although it is not well delineated; and UV light, combined with a lack of antioxidants in the diet contribute to early development of cataracts, as does smoke inhalation.
Fortunately, the loss of vision from cataracts can be completely reversed with surgery.

Aren't most people with cataracts quite elderly? The work you do is fantastic, but in comparing your efforts to some of the other 100& Change proposals you seem to be focused on an older group and hence perhaps have less of an impact on the world as a whole than projects addressing needs of younger people with more life ahead of them or of all people of all ages?

(HCP Co-Founder, Geoff Tabin) Thank you Yellow_Cherry, yes the majority of people blind from cataracts are elderly. However, in the developing world, many people go blind at an early age, including children. HCP develops overall eye care systems that provides eyecare for all ages. When we restore sight to the elderly, this allows children who have been caretakers to return to school. In addition, these elderly who have had their sight restored can now become caretakers of small children.

Beside money, what does your organization need the most right now?

(HCP Co-Founder, Geoff Tabin) Political stability and peace on earth to allow us to deliver eye care in places of great need, such as South Sudan. We also would benefit and be able to scale faster with additional Government support and an increased awareness and higher priority of blindness within government health systems. There are currently 18 M people who are blind from cataracts in the world so we also need more of the best young doctors and nurses, particularly in Africa, to choose a career in Ophthalmology.

How does curing blindness in an individual ripple out to the community?

(HCP Co-Founder, Geoff Tabin) In the developing world, there are very few services for the blind. Hence it takes people out of the workforce or a child out of school to care for that individual. Once cured, adults who were once blind from cataracts can return to the workforce. Children are able to return to school and receive an education. Elders whose sight is restored can return to care of children or homestead responsibilities. It is estimated that there’s a direct return to the economy by 400% for every dollar invested in blindness elimination. These are the direct impacts to the economy, however, the emotional impacts are greatly magnified beyond.

Hey, thanks for doing this AMA. Q's:

1) What got you guys to apply for this MacArthur grant? What was the call like when you found out you were in the running, did you feel like geniuses?

2) What do you think your chances are of actually winning? And how is yours that different from another one that also aims to cure blindness in Nigeria?

3) How do you know this solution will actually work? What if it doesn't?

(HCP Co-Founder, Geoff Tabin) The MacArthur 100&Change competition is an amazing opportunity for eye care and we don’t feel like geniuses, but we are very honored to be a part of the competition. The chances of winning are one in eight and our solution focuses on addressing overall eye care systems and all causes of blindness. Even if we do not fully eliminate needless blindness from the planet, every person who had their sight restored can return to a fully sighted life.
HCP’s model is different from the Carter Center’s superb effort to eliminate River Blindness in Nigeria, in that HCP is working to develop overall systems of eye care, rather than focusing on one disease. We are able to restore sight to people who are blind from cataracts as well as preventing blinding diseases. In addition, we also work to provide services for people who are irrevocably blind.

Who is your hero?

(HCP Co-Founder, Geoff Tabin) I have had many heroes and mentors in my life. Sir Edmond Hilary and Gaston Rebuffat for daring the impossible in the mountains and what they’ve given back to people. Sanduk Ruit, my elder brother and partner in the Himalayan Cataract Project; and Govindappa Venkataswamy, founding Chairman of the Aravind Hospital in India – for their compassion and genius at delivering the best possible medical care to the most impoverished people on the plant.

There seem to be many organizations providing vision care in low resource settings. How is your organization different from those and do you collaborate with other NGO's?

(HCP Co-Founder, Geoff Tabin) There are lots of great organizations working in the field of eye care and we collaborate with most of them. Our focus is in developing local infrastructure, training and empowering local doctors and nurses. Some of HCP's main partners include Tilganga Institute of Ophthalmology, Aravind, LV Prasad, International Council of Ophthalmology, Fred Hollows Foundation, Helen Keller International, SEVA, SEE International, ORBIS, Operation Eye Sight Universal, Sightlife, WEEMA International and others.

are there any restrictions or conflicts posed by US laws or agencies that would prevent you from directly influencing the politics in the region to help further your cause?

(HCP Co-Founder, Geoff Tabin) HCP does not directly influence politics in any region. We work with local implementing partners to develop sustainable eye care. Our hope is that the success of HCP’s model will encourage ministries of health and governments to invest further in eye care.