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NLA News - home October 2003 Volume XIII Number 14
Changing the World: Kenneth Myer Lecture 2003. Professor Fional Stanley

Diana Giese profiles Professor Fiona Stanley, Australian of the Year, who gave the recent Kenneth Myer Lecture for the Friends of the National Library

A black and white photograph of Professor Fiona Stanley as a young girl. Courtesy of Telethon Institute for Child Health Research

Professor Fiona Stanley as a young girl
Courtesy of Telethon Institute for Child Health Research

Fiona Stanley had a golden childhood. She was free to roam and play in the bush wilderness around her south Sydney home. Every week, her parents’ friend brought her new books. She devoured the life stories of Marie Curie and Albert Schweitzer. Her father built a wooden boat and took the family out for weeks-long fishing trips beyond the Heads. In his lab, she watched him as he worked with animals in the fight against polio, then a major threat. Dr Jonas Salk visited their home. ‘In my dreams I would sail out to all the undiscovered islands and inoculate the inhabitants in a whirl-wind race to conquer disease and pestilence,’ she says.

She still wants to save the world. But she needed time to work out how. The family moved to Perth when her father took the Foundation Chair of Microbiology at the University of Western Australia. After an adolescence she remembers as difficult, she chose to study medicine, ‘a scientific subject with a human face’. She believed there was no disease science couldn’t cure. But her Professor of Paediatrics, Bill McDonald, struck a cautionary note. He told her that ‘a child lives in a family, and it lives in a community, and it lives in a political structure’.

Stanley’s first job, in the early 1970s, was in a paediatrics clinic at Perth’s Children’s Hospital. Aboriginal children, thin and sick from bouts of gastroenteritis, pneumonia or rheumatic fever would be flown in from remote settlements or Western Desert camps. ‘We would perform expensive medical “miracles” … and then dump them back into the environment that had caused their problems,’ she says. With activist colleagues, she visited ‘every mission camp, reserve and fringe-dwelling group in Western Australia … talking to the old people, talking about what life had been like, trying to get a handle on the health issues and the environmental issues’. She began to understand how life chances and living conditions produced sick children with uncertain futures. Clinical medicine on its own wasn’t enough, however well intentioned. There had to be a better way of promoting successful lives.

A black and white photograph of Fiona Stanley with early group of researchers. Courtesy of Telethon Institute for Child Health Research

Fiona Stanley with early group of researchers
Courtesy of Telethon Institute for Child Health Research

Depressed by the immensity of the problems, and not sure what to do next, Stanley took off on the backpacking trail to Europe. She answered an ad to work at the Social Medicine Unit at the London School of Hygiene and Tropical Medicine. Suddenly ‘all the lights came on’ and she could clearly see her career path. With a stellar group of colleagues and mentors, who were ‘incredibly caring about community and social issues’, she polished her skills. She also learnt the value of linking databases of basic information and trends, joining the epidemiologists who look for patterns in society. The conditions in which people live, work and play, what they do and don’t eat, how they exercise and enjoy themselves, all impinge on health. Epidemiologists describe, measure and explain diseases found in populations. Such data, she clearly recognised, could be used to improve health and social wellbeing.

The people Stanley met in London, ‘the movers and shakers of the future’, have been colleagues ever since. She and her husband, Geoffrey Shellam, then spent a year in the United States. They returned to Australia to be with his sick mother. Family continues to be important to Stanley, and she pays tribute to the constant support of her husband, who now occupies her father’s Chair at the University of Western Australia.

A colour photograph of Professor Fiona Stanley at the Kenneth Myer Lecture 2003

Professor Fiona Stanley at the Kenneth Myer Lecture 2003
Pictures Collection

 

There have been initiatives to improve child health in Australia since the end of the nineteenth century. In the years leading up to Federation and beyond, governments needed healthy young men to fight their wars. ‘At Federation, Australians had horrendously high death rates in children from infectious diseases—and particularly diarrhoea’, Stanley told ABC Radio National. In the campaigns of the time, women were educated in breast-feeding and how to be good mothers in clean environments. Between the 1900s and mid-century, there was a dramatic fall in infant mortality. Then came medical victories over infectious diseases such as measles and polio. But still, as with other indigenous people in colonised countries, the health of Australia’s Aboriginal people remained worse than everyone else’s.

From Perth, Stanley became part of the next great trend in medicine, the move from a preoccupation with curing disease to a focus on prevention and social causal pathways. As Head of Child Health in the WA Department of Health, she became part of a network of nurses and midwives whom she still consults today.  Moving on to a National Health and Medical Research Council unit at the University of Western Australia, she was also a force in setting up the WA Maternal and Child Health Research Database, which contains information collected from around the state. It is used to describe trends and the effects of preventive programs. It catalogues such things as low birth weights, pre-term births, early intervention and patterns in development. Birth cohorts are linked with the lives that follow, throughout childhood. Patterns of Indigenous maternal and child health are well represented. They provide the basis for case control studies to test hypotheses on the causes of major problems. Data collected enabled Stanley and her colleagues to explore, for instance, the connection between a lack of folic acid in diets, and spina bifida, and markedly reduce it.

By 1990, Stanley had built the reputation she needed to start to make a substantial difference. She became the Founding Director of the Telethon Institute for Child Health Research. Now 300-plus multidisciplinary workers try to find out ways of preventing major childhood diseases and disabilities. They also address problems such as youth suicide and self-harm, and Aboriginal issues. This research has been instrumental in formulating government policy.

But research is costly. In 1995, they decided, says Stanley, to sell the Institute off to the highest bidder. This was Telethon. Now every year a major telethon contributes to their work. They also receive federal and state funding, and are supported by research foundations, grants and commercial contracts.       

A colour photograph of Professor Fiona Stanley in front of the Child Health Research. Courtesy of Telethon Institute for Child Health Research
Professor Fiona Stanley in front of the Child Health Research
Reproduced from http://www.chi.uwa.edu.au/
Courtesy of Telethon Institute for Child Health Research

In July 2002, Stanley’s tireless high-profile lobbying paid off in another major initiative. Prime Minister Howard launched the Australian Research Alliance for Children and Youth with a $600 000 grant. The Alliance evolved from a meeting Stanley convened in Melbourne for childcare professionals and economists, representing 70 organisations. ‘Our kids are growing up in a toxic society. Now we’re working together across the country to make a difference,’ she told her National Library audience. In her presentation, she ran incisively through a lucid set of graphs and diagrams setting out the alarming evidence. It is ‘modernity’s paradox’ that increasing wealth and opportunity have led to greater social differences and more problems for children and youth. There have been significant increases in many childhood diseases, disabilities and problems, including asthma, obesity, diabetes, child abuse, binge drinking, drug taking and violence, as well as an ‘epidemic’ of mental health problems. Drawing on her 30 years of research and experience, she identified complex causal pathways spreading through the family, school, communities and the cultural and political environment. Unemployment, poverty, longer working hours, family breakdown and violence, and youth alienation are all part of the picture.

A colour photograph of Fiona Stanley with David Naso. Courtesy of Telethon Institute for Child Health Research
Fiona Stanley with David Naso
Courtesy of Telethon Institute for Child Health Research

Stanley pointed to the need for cross-disciplinary workers involved in ‘joined-up research’ to build community capacity. The challenge is to intervene earlier in the causal cycles. ‘We need to find out what works,’ she said. The Alliance is now framing a consensus national research agenda supported by a data network, ‘a clearing house of effective interventions, and a communication strategy for turning knowledge into action’.

New methods of community consultation and representation are also an important component of her work.  At the Institute, Aboriginal health workers are paired with epidemiologists and social researchers. The Ngunytju Tjitji Pirni project on WA’s Eastern Goldfields employs Aboriginal health workers to provide care and collect information about how they live and the challenges, such as post-natal care, that they face. In the Northern Territory, there is the Strong Women, Strong Babies, Strong Culture project. ‘It’s really exciting to see communities in control,’ says Stanley.

As a crusader for social justice, she cleverly presents her ideas in the language of politicians and decision makers. Government investment in early childhood programs will yield long-term benefits for Australia, she argues. Not only will her programs decrease the number of children, young people and families dependent on welfare, but will also deliver a thriving workforce able to compete globally. ‘The message is clear,’ she told The Weekend Australian Financial Review, ‘that if we don’t grow effective human capital, then the future of the country is in jeopardy, because we’re headed towards a higher proportion of adults who are incapable of working and are dependent.’ She calls the process of change ‘creating a learning society’.

Commitment from people at all levels, families, communities and governments is crucial if real progress is to be made. With her ideas for making things better, Stanley is the right person at the right time for Australia’s children. ‘She really is one of the most dynamic people I’ve known; she’s got an inspirational quality to her,’ Suzanne Cory, Director of the Walter and Eliza Hall Institute of Medical Research told the Bulletin. ‘I’ve rarely met anyone with such a tremendous life force.’ But with her, other Australians must take responsibility for our common future. Unless all our children, from Cape York to Busselton, Burnie to Arnhem Land, have the opportunity for healthy, happy, fulfilling lives, we can’t claim to be a successful society. As Stanley said at the Library, ‘we need to place social and environmental sustainability and population health ahead of economic growth as a national goal, and develop social policies that enhance equity, social stability and trust.’

Professor Stanley’s Kenneth Myer lecture can be found on the Library’s website

DIANA GIESE has interviewed other inspirational Australians of the Year for the National Library, including Ian Kiernan, Tony Fitzgerald, Dick Smith and John Stocker

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