Another of the Australians who seem to get drawn to public health nutrition, I was born in Adelaide, the capital of the State of South Australia. When I was 5 my family moved to Mount Gambier, a fertile, farming area with coastal fishing and commercial pine plantations, effectively the provincial capital of the lower South East of South Australia and far west Victoria. My father was a GP (family doctor) and my mother was the first almoner (social worker). That background, and the fact I spent a lot of time at our cattle and sheep farm, no doubt influenced me in the direction of public health.
However it was not until I had nearly finished studying medicine at the University of Adelaide that I found out what I really wanted to do. By lucky chance I saw a small notice on the students’ notice board inviting applicants for an exchange student visit to Indonesia over our long summer holidays, visiting six different medical schools all over the country and staying with the families of medical students. I held little hope that I would be selected but maybe virtually no one else applied! So four students from the University of Adelaide, and four from the University of Queensland, set off.
It was an eye-opener for me. It made me realise that Adelaide was not the centre of the universe, and that many people in the world had little chance of adequate care and health due to poverty. (This was in 1970, but remains true now throughout the world, although less so in modern Indonesia).
In Surabaya, on a round of the paediatric wards of the general hospital, I saw a young child standing in his crib, holding the rail, who was blind. The cause was vitamin A deficiency, a condition that had more or less escaped my notice in the first five years of medical training – so much for nutrition teaching in medical schools. It seemed especially tragic when it was explained how easily his blindness could have been prevented. So maybe it was not just chance that some 10 years later, after completing an MPH at the Harvard School of Public Health, that I ended up in Bangladesh with HKI (Helen Keller International) advising on the nutritional blindness programme of the Institute of Public Health and Nutrition in Dhaka.
But that was some time in the future. After the Indonesian trip, I went back to finish my degree in medicine and surgery (MBBS in Australia). I did my houseman (internship) year at the Goroka Base General Hospital in the eastern highlands of Papua New Guinea. This was not encouraged by the medical registration people in Adelaide at the time, but a lawyer friend discovered that, from colonial days, it was an accredited hospital for training of young Australian medical officers. It was a wonderful experience and I saw many cases of new (to me) diseases and quite a lot of undernutrition (and in retrospect, stunting) due to a quite monotonous Highlands diet and high levels of infectious disease.
From there, the pressure was building to return to Mount Gambier. I quite enjoyed general practice but wanted to travel more, and headed off across Asia. I finally reached the UK where I did anaesthetics and a family planning certificate (neither of which I used much) and enjoyed being in Europe. Then back to Australia, visiting the World Health Organization on my way, where I discovered they needed, amongst other specialities, medically-trained people also trained in nutrition. Consequently I studied for a post-graduate diploma in nutrition and dietetics at the Flinders University of South Australia. Being the only medically-trained person with formal nutrition training, I was immediately employed to teach in the MPH course, and do research, at the Australian Commonwealth Department of Health School of Public Health and Tropical Medicine based at the University of Sydney as head of the nutrition subsection.
So now, some 40 years later, my work experience has been in a variety of health-related organisations and in different countries. Areas of employment have spanned public health interventions, health policy and planning, and analysis of national and other programmes, all with an emphasis on public health nutrition. Experience has included interventions for the prevention and control of micronutrient malnutrition, programmes to improve child health and reduce undernutrition, and in the prevention and control of chronic disease especially in transitional economies.
Positions have been with the UN as senior global health leadership fellow at WHO Geneva, regional advisor in nutrition for the Western Pacific Region of WHO, acting chief of the UNICEF nutrition section, and before that senior Advisor in child survival and development, and before that micronutrients; in USAID-funded cooperative agreements such as director of the OMNI Project managed by John Snow Inc.; with the non-government community, for example Helen Keller International in Bangladesh and vice-president for programs in the New York HQ office; and as an academic in Australia and the US.
I took mandatory retirement from the UN (UNICEF) in 2008, and then was asked by Ann Veneman, the executive director at the time, to represent UNICEF on the Rome-based interagency group trying to operationalise ‘REACH: Ending child hunger and undernutrition’. It demonstrated to me at least, the challenge of interagency collaboration. Even with the stated support of the heads of the agencies, the various agency nutrition sections were unable or unwilling, to give up any responsibilities, power or funds to really make it work. It is very pleasing to see it has survived, although the relationship with the UN Standing Committee on Nutrition, the Scaling Up Nutrition initiative, and the various agencies probably needs further clarification and collaboration.
After a wonderful year in Rome, I came back to New York. I was offered two professorial adjunct positions at the Friedman School of Nutrition Science and Policy at Tufts University in Boston, and at The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, at the University of Sydney. Recent consulting has been for international aid orgaanisations, UN agencies, the World Bank and others in a variety of settings: Indonesia, China, India, Canada, Fiji and Timor Leste, US, Sri Lanka, the Philippines and Afghanistan.
Other interests include being on the Board of Directors of the ‘Ma-Yi Theatre Company’, an Asian-American Off-Broadway theatre company fostering Asian-American playwrights and actors since 2003; and more recently, on the Advisory Board of Arts and Health Australia, as well as financial, advisory and creative interest in Kips Gallery for Contemporary Art, Chelsea, New York, and a new passion, gardening at my cottage at Donovan’s Landing, South Australia, where I try to spend about a third of my time).
Two of the highlights of my working life have been receiving the Asia Pacific Clinical Nutrition Society Award in 1998 (‘that person who has made an outstanding and sustained contribution to the nutritionally-related well-being and health of peoples in the Asia Pacific region’), and in 2012 becoming an Officer in the General Division of the Order of Australia (OA) (‘For distinguished service to the international community, particularly in the areas of public health and nutrition, to disease prevention and health promotion, and as a physician, academic and educator’).