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From community nursing to global health policy: Judith Sullivan’s brilliant career

By CN Content posted 05-27-2019 00:00
May 27, 2019, By: Laura Eggertson
Judith (right) with Médecins Sans Frontières (left)
Judith (right) in 2015 with a clinic nurse while working in Guinea-Bissau in West Africa with Médecins Sans Frontières.

Judith Sullivan’s transformation from a front-line community health nurse to an international consultant in health human resources began with her first posting to a desperately poor, strife-torn country.

In 1979, after earning her baccalaureate degree in nursing from the University of Toronto, Sullivan joined the non-governmental organization CUSO International. Inspired by gap-year travel to Latin America, she applied for an international nursing job there because the burden of disease from preventable health problems was so evident—and she wanted to make a difference.

Her first, six-year posting was to Colombia, then embroiled in armed conflict among multiple guerrilla factions that would not end until a peace agreement was struck in 2016. There, working alongside nuns as a nursing instructor, and at a “difficult, dirty” hospital coordinating primary care, Sullivan honed her nursing and teaching skills. She made lifelong friends and gained a deep conviction about the primacy of healthcare as a human right.

“The nuns made a point that completely coincided with our own nursing view of human rights: that patients were sacred and we had a duty of care,” Sullivan says.

But Colombia also taught Sullivan that caring and respect for human rights were not enough to meet the healthcare needs of a struggling population. She remembers one patient in particular, a victim of random, alcohol-fuelled violence, who required an urgent colostomy. The doctor and nurses could perform the surgery—but they had no colostomy bags. Despite Sullivan and her team’s best efforts to find materials, nothing worked.

“He was eventually shipped to another hospital in Bogotá, but I imagine he died for lack of the things he needed,” Sullivan says. “That was emblematic of what would happen every week—some tragedy that we couldn’t respond to with the right materials. The whole country lacked investment in health.”

Sullivan’s formative time in Colombia, along with her next four-year posting in Peru with CECI Canada, convinced her to prepare for a broad scope of health challenges. After earning a master’s degree in health administration at the Universidad Peruana Cayetano Heredia in Peru, she took specialized training in reproductive health and the management of HIV/AIDS programs. Sullivan also earned a diploma in leadership—the management of human resources—and another in tropical nursing from the UK’s Liverpool School of Tropical Medicine.

Although the courses primed Sullivan for the health conditions she encountered, little could prepare her for guerrilla encounters. In Colombia, she had to disband a regional meeting of local health committees hastily when a group of balaclava-masked guerrillas from the student-led M-19 (April 19 Movement) showed up and commandeered the stage, chanting slogans.

“To my great surprise, all the women applauded them,” says Sullivan. “[The guerrillas] were surprisingly friendly. But these were dangerous times, and I had to be really careful to avoid any future contact.”

An entirely different calibre of guerrillas was waiting for Sullivan and her husband, John, when they moved to Lima, Peru. The Shining Path terrorists were known for their brutal violence, and their campaign of bombings and murders laid siege to the city. As the country director for Save the Children Canada, Sullivan’s husband experienced security threats while travelling throughout Peru, and Sullivan had to leave communities where she was organizing vaccination and primary health campaigns for fear of Shining Path attacks.

“It was pretty dangerous out in those communities; that was a tough time,” she says.

Eventually, the violence in Peru caused the Sullivans to take up another posting, this time in Brazil. There Sullivan received her first contracts and consultant jobs with the Canadian International Development Agency (CIDA) and the World Health Organization. For the remainder of her nearly 40-year career, Sullivan shifted her focus to health policy, convinced that by leading in this arena, she could make a greater contribution to improving health outcomes.

As an adviser and consultant, Sullivan addressed questions about health systems: why they needed integral government financing and commitments, the pitfalls of international financing, and the importance of primary healthcare. She worked in Africa, Asia, and South America, evaluating programs and outcomes, planning malaria and pediatric care, and advising governments how best to deploy their human resources to get better health outcomes.

Sullivan is proudest of her success in advocating for human health resource censuses that resulted in more nurses in Argentina, Paraguay, Uruguay, and Chile. A four-year stint at the Canadian Nurses Association as international development manager taught her the important cost benefits and improved health outcomes that hiring more nurses delivers.

Canadian nurses (from L to R) Jane MacDonald, Jean Garsonnin, Judith Sullivan and Debbie Grisdale
Canadian nurses (from L to R) Jane MacDonald, Jean Garsonnin, Judith Sullivan and Debbie Grisdale first met in Colombia in 1979. Along with becoming life-long friends, each went on to pursue successful global nursing careers.

“I really became the poster girl for nursing,” Sullivan says. “I felt that expanding the supply of nursing in countries where the oversupply of physicians made no sense … was so important. I was libelled several times for defending nursing … But I used my diplomatic skills as much as possible.”

Throughout her career, Sullivan was also raising two children, Patrick and Carla, and coordinating her travel schedule with John’s. Today, her family is a “huge source of support” as she deals with ovarian cancer, which cut short a posting to Guinea-Bissau in West Africa, where she was planning malaria prevention for Médecins Sans Frontières.

Today, Sullivan advises nurses interested in global health issues to gain policy experience and hone their analytical skills for preparing briefs and arguments. She notes that given the tens of millions of people in need of humanitarian aid every year, this will continue to be the focus of most international nursing.

“Migration, trafficking, massive camps with complex disease burdens, epidemics, and disasters require highly mobile, competent health human resources,” she says.

Editor's Note: Judith Sullivan passed away earlier this month after a lengthy illness. She will be dearly missed by family, friends and colleagues.

Laura Eggertson is a freelance journalist in Wolfville, NS.