The Fred Hollows Foundation - Case Study

The Fred Hollows Foundation is one of the world’s leading eye health NGOs. For more than 20 years it has been helping restore the sight of people in developing nations around the globe.

When The Foundation started in 1992, its focus was on training surgeons to carry out eye operations in-country, and providing donor support to enable this vital work to continue. Today, while it is still a significant provider of eye surgery to poor communities, it has set its sights on ending avoidable blindness.

“Five years ago the organisation grappled with this,” says Nick Martin, the Foundation’s Director of Public Affairs.

“For us it was really about directing some of our efforts towards engaging with governments in the region, working with ministries of health, and working with other NGOs in the sector in partnership to make sure that we were influencing governments to dedicate funds and practices and programs into eye health – strengthening health systems in countries rather than just providing subsidised or free surgeries.

“Too often eye health is seen as a disease of ageing but it has multiple impacts, not just on individuals but families and communities, that flow through all age groups and working age populations.”

As part of this broadening focus, The Foundation has opened an office in Hong Kong. Unlike its other operations in Asia, this office is dedicated not to its practical eye health programs, but to fundraising and broader engagement.

The Foundation is now building a strong reputation in Hong Kong, China and the wider region, where it is drawing on its global expertise to show governments how best-practice eye health programs should be delivered.

Key learnings

  1. Have a clear proposition: Find your niche – if your offer is simple enough, the market will respond positively to it even if they don’t know your history.

  2. Use your Australian reputation and connections: Take advantage of any Australian links you have in your new target market, from expats to diplomats.

  3. Adapt to the local culture: Do plenty of research and ensure everything you do is culturally appropriate.

  4. Be prepared for different challenges: Moving into a new market may throw up issues and costs you do not have at home. Factor these into your planning.

  5. Take advantage of changing trends in Asia: The region’s culture of philanthropy is entering a new stage as wealth grows.

Have a clear proposition

The Foundation’s proposition is simple: it restores people’s sight. That, says Nick, is a major advantage. “We’re authentic in what we do. We receive donations from the very generous public and we dedicate those to sight-restoring work around the world.”

He says that while there are many organisations doing great work in the development and aid sphere, it’s not always clear to donors where their money is going.

“You don’t know whether they are digging a well, or providing a gender program, or providing community development or civil society advocacy. With us you know that if you give $25 you are restoring someone’s sight, or building a hospital, or training a doctor.

“That single proposition is really important. It means that there is not only authenticity but greater transparency as well for donors so that they can really understand what’s happening. I think that gives us credibility with government as well.”

And it has been crucial in building The Foundation’s brand in Asia. While in Australia the legacy of Professor Fred Hollows is highly respected, in Asia his name is unfamiliar to most potential donors.

But by reducing the emphasis on Australia when talking about their work, and instead focussing on the work done in countries including China, Vietnam, Cambodia, Laos and the Philippines, Foundation staff have potential supporters receptive.

“Through market research, but also just knowing ourselves well, we know that the helplessness of blindness, $25 surgery, and the story of hope that’s unlocked from that is a compelling message for anyone. It’s a universal human message,” says Nick.

“Even if you’ve never heard of Professor Fred Hollows, what a great story, that someone with all these skills who probably could have made a lot of money in private practice instead dedicated himself to restoring sight to the world’s poorest. He just happened to be an Australian.”

Use your Australian reputation and connections

The Foundation has been able to take advantage of its Australian connections to ease its way into new markets.

It already had strong links with the Australian Government, which is a major funder of some of its work, but it has built on this by establishing strong relationships with Australian diplomatic missions in Asia to secure top-level support for its ambition and goals.

It has also drawn on the Australian ex-pat community for support. “One of the reasons why we went to Hong Kong is there are 100,000 Australians based there,” says Nick. “These are often people who have been living in the country for a long time. They understand some of the dynamics and can help you navigate challenges.”

Mapping the activities of Australian companies in the region was crucial when deciding where to establish a base. “So often businesses have their footprint split between Hong Kong and Singapore and often when you overlay that on our footprint there’s really, really clear synergy between where we’re working and where Australian businesses want to work,” says Nick. “So we’re making sure we’ve got that alignment which then opens up a conversation on shared value around fundraising.”

The reputation The Foundation has for creating people-to-people exchange between Australia and other countries has also been a bonus. “There’s real value not just for us, but for our business partners, in The Fred Hollows Foundation being seen, genuinely, as an example of people to people exchange, between Australia and a country like China or Vietnam,” says Nick.

“The fact that we’ve been doing this work for 20 years on the ground means that we have a level of credibility that a business that’s wanting to enter a new market just doesn’t have. There’s a whole lot of cultural cachet around that that’s really important.”

This reputation helped secure an offer of support from Goodman Property in Hong Kong, which provided office space and financial backing to help The Foundation find its feet in the territory. For Goodman, being able to demonstrate to their stakeholders that they had a strong corporate social responsibility partner with a record of success and its own Chinese connections was a plus.

“A lot of countries now have a quite vibrant civil society. You can’t just be the Australian NGO wanting to move into a country where there are already active civil society organisations. You’ve got to have a really good understanding of that.” says Nick.

Adapt to the local culture

The Foundation did a lot of research before moving into the Hong Kong market, including studying competitors. “The most important part of it is understanding local NGOs,” says Nick.

“A lot of countries now have a quite vibrant civil society. You can’t just be the Australian NGO wanting to move into a country where there are already active civil society organisations. You’ve got to have a really good understanding of that.”

The Foundation market-tested its messaging and, with the help of a branding agency in Hong Kong, ensured that all its materials were culturally appropriate to the local market. It also adopted a traditional Chinese name which translates as decisive action to restore sight, a crucial step in engaging audiences unfamiliar with Professor Hollows.

The Foundation was keen to ensure that the Hong Kong office was not a ‘fly in fly out’ operation, but one which used skilled local staff and built local expertise. It recruited staff who had worked in the NGO sector and who understood Hong Kong, its people and their philanthropic behaviour.

This helped it refine its approach to suit local preferences. “With Hong Kong we were appropriately conservative to make sure that in our first year and a half of activities we didn’t go in too loudly, too brashly, and made sure that we were testing things in market before we went too big,” says Nick.

He says cultural awareness has been an ongoing learning process for everyone, adding that key staff have benefited from taking part in an Asialink Leaders program and then sharing their expertise with the organisation more widely.

It was particularly important for them to learn how to manage local staff effectively and in a culturally appropriate way.

“It’s been about understanding the role of a hierarchy but then also giving people status and access to people they need to talk to one-on-one. We’re a very flat structure normally but understanding some of those dynamics has been important as well,” he says.

In launching its Hong Kong operation, Foundation staff were actively encouraged to do things differently. Essentially, the Hong Kong office was treated like a startup. “We have given the green light to be creative, be flexible, be dynamic on the ground and not be constrained by normal internal practices but also not to distract a whole lot of other staff from our core business. By having a standalone team we were able to create a slightly different culture for how it operated,” says Nick.

Be prepared for different challenges

As a charity, The Foundation was not surprised to face resourcing issues when entering the Hong Kong market. “We’ve always had to be on the conservative side of our investment and that’s just meant that we’ve had to do more with less, we’ve had to be smarter and we’ve had to employ staff who have really good expertise and good potential to grow into roles and develop. I think we’ve done that effectively but it has been a challenge,” says Nick.

But there were other issues too. The Foundation needed expert local advice on registration requirements and business operations. “As a small not for profit in this landscape it’s very costly to actually buy in that expertise. You’re using the same lawyers that a corporate would,” says Nick.

“Those upfront costs are really, really difficult and it means you have to adjust your pace around multiple markets, for example, doing one and doing it well then looking at a second and a third rather than potentially getting the benefit of going all at once.”

The international banking system was also difficult to navigate. “We are wanting to raise funds closer to our source countries where we are doing activity and that involves us being linked to a major banking partner,” he says.

Take advantage of changing trends in Asia

The obvious rise in consumption in Asia is clear evidence that the region’s middle class is growing, and its populations becoming wealthier. However, this increase in wealth has also sparked a growing interest in philanthropy at a personal and government level.

In China, for example, the government’s latest five-year plan references the need to close the gap in terms of wealth inequality. “That’s a really important message to send out to people in the population at large,” says Nick. “That means there’s more and more discussion, more and more dedicated effort from companies, business and community leaders – and often they all overlap – around questions of poverty and development at a local level. That’s an opportunity for us to start a conversation.”

In addition, there is a definite growth in Asia’s civil society, with local organisations across all concerns from environmental and animal protection to disaster relief and medical work actively seeking expertise and then incorporating into their own work. “It’s quite a diverse space and a growing space,” says Nick. “It’s not the stereotypical view of what civil society might be like in these places.

“It’s not westerners coming in and telling people how to do it – it’s genuinely getting the best expertise, learning from it and incorporating it into NGOs on the ground. There is a genuine dialogue now between overseas and local civil society organisations.”

The future for The Fred Hollows Foundation in Asia

The Foundation is now in its second wave of engagement with the region. Countries it has worked in for decades, such as Vietnam, now have public health systems and social insurance, so there is less need for the same level of surgical support.

“Our role in those countries is changing: we’re going from direct service delivery to being a centre for expertise, a trusted partner, and also a potential funder of advanced activities like research”, says Nick.

“Hong Kong is important because it is the centre for a lot of business transactions in and around China but it is also a centre for excellence so there are universities there with some of the best clinicians, there are research facilities there.”

“We’re obviously taking an active interest an areas such as myopia and diabetes in China, so we’re able to draw upon that expertise by being positioned in the Hong Kong market whilst not weakening at all our presence in mainland China. We’re still doing the same style of work there. We’ve just got an extra level now of engagement.”

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