February 15, 2017
Facing Global Health Challenges – Pursuing your Passions without Losing your Family, with Dr. Jonathan and Mrs. Tina Quick
“We all need a passion – a sense of purpose – for our lives, but that no passion, job or pursuit is worth losing one’s family for.”
“Parliamentarians: Canada has played a significant role in a number of areas of research and development, Ebola vaccine and others. The people who you’ve helped don’t often get a chance to say thank you directly. But I think some of the ambassadors here can tell you what a difference your commitment has made and will make in the future.”
Jono summarized the progress in global health over the centuries, from the time of the first recorded epidemics. Smallpox was one of the most horrific, killing a half-billion people. Yet it took the WHO three meetings over 15 years to eradicate it, during which time 50 million people died.
AIDS was another entirely new disease in the 20th Century – by the year 2000, more than 30 million people were living with HIV worldwide. While it is a chronic disease in the North, it is still a death sentence in most of the Global South. However, most of the 15 million people undergoing treatment are in Africa, where treatment programs are run by nationals.
SARS was the first new pandemic pathogen of this century. Spreading from China to 26 countries, it resulted in 8000 cases and 750 deaths worldwide. At the height of the epidemic in April, 2003, it was thought that eliminating SARS was impossible, but by June the “impossible had happened” thanks to strong government and a rapid WHO response.
For such large-scale diseases, it was thought that treatments and cures were beyond reach. Yet since 2000, deaths from childhood illness, pregnancy, AIDS and malaria have been cut in half, saving more than eight million lives a year. Jono attributes this progress to leaders who “imagined the impossible, then made it happen through their vision, shared purpose and persistence.”
Global warming, ease of travel and urbanization contribute to the likelihood that we are facing a century of pandemics for which we must be prepared. We already know how to stop local outbreaks from becoming pandemics, Jono said, “but we’re not doing it.”
His career has allowed him to pursue his passions, most of which revolve around overcoming challenges for the next generation of global health. These challenges include:
- Universal health care for essential services
- Treatment and prevention of chronic illnesses like heart disease, diabetes and cancer
- Managing pandemics
Jono said that we all need a passion – a sense of purpose – for our lives, but that no passion, job or pursuit is worth losing one’s family for. His passions drove him to the point of becoming a workaholic. Tina described the impact this had on her and their three daughters: she became a single parent, the girls grew resentful and they experienced near financial ruin as Jono neglected household responsibilities. Tina said, “At one point he actually told me that he considered his job to be more important than his family.” She saw no recourse but to ask him to leave.
He stayed, but he also began to listen – especially as she implored him to speak with their pastor. This was the beginning of a three-year journey of faith where Jono grew in his relationship with God through faith in Jesus Christ. He began reading the Bible and Christian resources, including Mere Christianity by C.S. Lewis. He learned that, when God and family become one’s primary passion, other priorities fall into place.
“The most stabilizing activity for families is to eat one meal together each day, even if it requires some members to skype in.”
“It’s never too late, and things are never too bad, to mend a strained or broken relationship – if everyone is willing.”
Dr. Jonathan Quick
Dr. Quick is a family physician and health management specialist who has worked in international health since 1978. He served with the World Health Organization from 1996 to 2004 as the Director of Essential Drugs and Medicines Policy, handling assignments in more than 70 countries. He then became President and CEO of Management Sciences for Health, a non-profit organization which builds in-country capacity for stronger local health systems in Africa, Asia and Latin America.
Dr. Quick is a faculty member of Harvard Medical School in the Department of Global Health and Social Medicine. He has authored or co-authored more than 100 books, articles and chapters, including the Financial Times Guide to Executive Health and the soon to be released The End of Epidemics: The looming threat to humanity and how to stop it.
Tina Quick is a cross-cultural trainer, international speaker, author of The Global Nomad’s Guide to University Transition and founder of International Family Transitions (IFT), serving the needs of globally mobile students and their families. As a “Transitions Expert,” she has spoken at universities in China, Ecuador, Japan, Russia, Singapore, South Korea, Switzerland, the United Arab Emirates and the United States. She has moved 29 times and has raised her three children across four continents.
Tina served as the Health Officer for the International Federation of the Red Cross and Red Crescent Societies for six years while in Geneva. She has also served on the Board of Directors of Families in Global Transition and was Chair of the Program Committee for their annual conference. She is a member of the International Association of College Admission Counseling and served on the Advisory Board of TCKid, an active international community of third culture kid adults and youth.
Your Excellencies, Honorable Members of Parliament, distinguished guests, better halves that have joined today…it’s a great pleasure being here in Ottawa with you.
My first time in Ottawa was in 1985. It was my first WHO meeting and I was asked to be the rapporteur. Two things I remember about that meeting. The first one was it was day four of a five day meeting before anyone cracked a joke in the plenary session. The other thing, as rapporteur at 21h00 on Thursday night I turned in to the Ottawa Initiate Health Secretary, a mixture of dictation and written notes. I walked in the next morning at 9h00 and at each of our places was a 50 page report in French and in English, so I was really impressed.
For the last hundred years, Canada has been a source of inspiration and recreation for our family. Beginning with my great-grandfather, who was a physician. My grandfather spent his summer in Labrador, at a clinic in medical school. Our three daughters are the fifth generation of fisher-people in Canada. So it’s great to be here.
We’re going to do three things today. We’re going to share some of the successes of global health over the last generation. We’re going to talk a little bit about how my passion for global health just about cost me my family. And we’re going to say a few words about the challenges of global health going forward. So Tina can you get us started?
I’ll give you a run down of John and I and our life. We met in a hospital in Durham, North Carolina, where I was working as a nurse and he was doing his Duke Family Medicine Residency Program. It was an arranged marriage – three of our nursing friends thought we would make a great couple, so they arranged for us to meet. I guess they were right. We are still together.
Right after we got married, John wanted to do some intensive hands-on medicine before pursuing his first love of global health. So we moved to Talihina, Oklahoma – I’m sure no one has ever heard of it – population 1400. We went to work for the U.S. Government’s Indian Health Service. Together we treated snake bites, gunshot wounds and delivered babies.
After that, Jono went to work for Management Sciences for Health, a global health non-profit in Boston, Massachusetts. Now this is the second time John worked for them, the first time he had taken a year off of medical school to pursue his Master’s in Public Health. They sent him to Latin America, Africa, Asia and the Western Pacific to study drug supply systems.
Since Management Sciences for Health (MSH) is an international organization, it meant that he was travelling a lot internationally. He was gone anywhere from one to six weeks at a time. This was right about when we were starting our family. In fact, on our eldest daughter’s first birthday, I went to the calendar and counted how many days he’d been away. It turns out he had been away for exactly one year of her first year of life. After our second daughter was born, we decided it might be better for the family if we took an international posting. That way if he were to travel, it would be short trips in-country or in-region.
Our first posting was to Peshawar, Pakistan, where Jono was providing cross-border assistance to set up health services in Afghanistan. We were supposed to be there for two years, but because seven American families – including our own – received a death threat that was tied to the Gulf War, we were evacuated. I was back in the U.S. having our third daughter at the time when all American families were evacuated. But then we got a chance to go Nairobi, Kenya where Jono was working with the Kenyan government on district healthcare financing. And we spent four wonderful years there.
Then Jono was approached to work for the World Health Organization in Geneva, Switzerland. So we moved to the Geneva area and we lived just across the border in France. Jono was the Director of the Essential Medicines program there. I got to pick up my nursing again and was the Health Officer for the International Federation of Red Cross and Red Crescent Societies.
We were there for almost ten years, and then MSH approached Jono and said, “How would you like to come back and run the organization as President and CEO?” We went back to Boston. We’ve been there for thirteen years and I have completely changed careers and became a cross cultural trainer and transition consultant that works mainly with students and families.
Successes of Global Health
Humans started living together in communities about 10,000 years ago. They started farming and started using their crops to make beer. The other thing that started happening were epidemics. And one of the most horrific was smallpox, which scarred, blinded and killed billions over the decades. In the last century, smallpox killed half a billion people.
But by the late 1940s Canada, the U.S. and most of western Europe had eliminated smallpox with vaccination programs. In 1948 Canadian Surgeon General Brock Chisholm was elected the first Director General of the World Health Organization, which he had helped to create in the preceding two years. At the 1951 World Health Assembly, Dr. Chisholm challenged the world to eradicate smallpox from the entire world. He only served one term – that was his plan – and he handed over to his successor.
It took three World Health Assembly over 15 years before the world’s health leaders decided to eliminate smallpox. Guess how many people died while the world’s health leaders were talking? About 50 million people – mostly the poor and voiceless in Africa, Latin America and Asia.
Guess who the greatest opponent was? It was the Director General of the World Health Organization. A Brazilian physician, who was a great guy and did lots of good things, but he couldn’t imagine – he knew he had hundreds of thousands of indigenous people in the Amazon – he couldn’t imagine eradicating smallpox. But the decision was taken and after talking for 15 years, it only took a decade to eradicate smallpox. And it was the vision of people who would imagine the impossible and then make it happen that eradicated smallpox.
In 2003 the first new pathogen of the 21st century came out of rural China, from bats to these little delicacy bushmeat animal civets, to a Chinese physician who, staying on the 9th floor of the Metropole Hotel in Hong Kong, spread SARS virus to a dozen other people who, within a matter of weeks, spread that virus to 26 countries. As you know, Canada was one of those countries. Toronto was closed by the SARS outbreak, about a billion dollar hit to the economy. Canada suffered nearly 400 cases and 44 deaths.
In April of (2000) right at the height of SARS in Hong Kong, an official visiting from the U.S. Center for Disease Control was asked, “Do you think SARS can be eliminated in Hong Kong?” And he said, “No. It can’t be eliminated. It can be controlled.” Three months later, Hong Kong was declared SARS-free. And it’s never returned, because of good public health and people in the midst of it saying, “This is impossible, but we’ll make it happen.”
The first new pathogen of the 20th century was AIDS, which slowly simmered from the 1980s and by the year 2000, 30 million people were HIV-positive around the world. In the three years leading up to the year 2000, treatment had emptied the hospitals in the north of AIDS patients. And it had turned AIDS into a chronic disease where people who were HIV-positive lived almost as long with the virus, as they would without it. But for the people in low income countries, in Africa, AIDS was still a death sentence. Less than 1 in 100 were on treatment.
In July of that year, the director of one of the international government development agencies was asked, “Will you start a treatment program in Africa?” He said, “No, we don’t think treatment is possible in Africa. We’re going to focus on prevention.”
Others disagreed and over the next three years, a series of multi-million dollar commitments were made. And the price – which was $12,000 per year per person at that time when there was no money – that price now is $120 per year per person. 1% of the price. Three examples of imagining the impossible and then making it happen through vision and determination.
The Personal Cost of Pursuing Global Health
The year 2000 was a tipping point for global health in a good way. It was also a tipping point for our family in a not good way. I was working in the Central Drugs Program, working to get the prices down and generic competition – which a 300 billion dollar pharmaceutical company didn’t always agree with. At the same time I had been asked by Gro Brundtland, our Director-General and the former Prime Minister of Norway, to head a human resources task force with the World Health Organization. I ended up having two jobs, two offices, went into a workaholic spiral and totally lost touch with the family.
Well he more than lost touch with his family, he really alienated himself from us. Our three daughters were always saying, “Yeah, Dad stood us up again.” He would promise to come to their sporting events, their school events and he was a no-show. They really got perturbed with him when they realized that he didn’t even know the names of their best friends. These are names that are tossed around our house all the time. I had this veil over my eyes, because I thought that everybody who worked for UN organizations or WHO worked this way. So I was making excuses for him to the girls all the time…after all, he was saving the world.
The girls started telling truths to me. Things like, “You know, my friend’s dad works for a UN agency. My friend’s dad works for WHO. Their dads are home on the weekends. They do things with their families. Mom, this isn’t normal.”
It was like God lifted the veil from my eyes and I began to see what a workaholic spiral he really was in. And I mean workaholic in the truest definition. We would go on vacation, and he would try to hide the fact from us that he was working on WHO things. Even if he was home on the weekends, he was usually in his office and even though he was home he wasn’t really home.
He emotionally was not there for us. I felt very much like a single mother. And he acknowledged that. He would say things like, “I know you feel like you’re rowing the boat alone and I’ve got to change. I know what I need to do. I’ve just got to do it.”
It just never happened. If we would complain that he didn’t get home in time to have dinner with his family, or worse yet, that the girls had gone to bed by the time he got home. He used to say to me, “I’m just not smart enough to get it done in eight hours.” Well anybody who knows my husband, knows just really how ridiculous that is.
At one point he actually said to me, “My job is more important than my family.” At that point in my life, my biggest fear was that I was going to be diagnosed with a terminal illness. And I thought I was going to have to go through it alone. I would be alone and he wouldn’t be there for me.
Things hit the breaking point when he was actually in Washington D.C., doing something for his second job. I get a letter in the mail from the girls’ international school. And it says, “This is your third and final notice. If you don’t pay your school fees, we’re going to drag your children out of class and send them home.” I’m like, “What? Where was the first and the second notice? Where was the school bill?” Those were things that Jono handled.
So I’m in a complete panic, but I can’t get a hold of him in the U.S. because of the time difference. I happened to have needed to go to the Swiss bank to get some Swiss francs. I go there and all of these little accounts we have, including my own personal fund money account are dry. There’s no money. Then I go to the French account and there’s no money there. And then I looked at our U.S. dollar account and there’s no money anywhere.
Now I am beside myself. Jono finally gets in touch with me that night and I said, “Jono, they’re going to pull the girls out of school. You haven’t paid their school fees. There’s no money anywhere. Either you are having a complete and total nervous breakdown, or you are having an affair. Which one is it?”
It turns out he had been so busy that he hadn’t been filling in his travel expenses for which he would get reimbursed. By the time he sat down and filled them all out WHO owed us something like 30,000 Swiss francs. At the time, that was close to 30,000 U.S. dollars.
Well you would think that maybe this would kind of wake him up, but it didn’t. And things just got worse. Finally I said, “I think you should consider moving out and getting your own place. That you can tell us when would be a good time to come visit you and we’ll do that. So we won’t be disappointed by you.” He refused to leave, so now I had to figure out something else.
I have always been a person of strong faith, even as a small child. And I knew the power of prayer. I prayed all the time, but I never let Jono see the depth of faith that I had, because even though he was a church goer, I knew he was not a strong believer. And I felt like I couldn’t talk to him about those things. Finally one day I said to him, “You need to go see Jim, our pastor. And he needs to fix you. Jono, you need to learn to give these things over to God.”
Learn how to give it over to God. That sounded like a really good idea. The British Christian writer C.S. Lewis says that, “believing sitting in a church will turn into a Christian, is like believing that sitting in a garage will turn you into a car.”
But for fifty years I had been going to church, sort of thinking I was a Christian. I was going to communicants class in high school. I was a worship leader, played drums in church and sang the hymns. But when I really hit this bottom […] of being alone, I realized I didn’t know how to read the Bible. I didn’t know how to pray. And when I really thought of it, I didn’t believe.
I remember vividly the first meeting with Jim. […] He starts drawing this cavern and this bridge of faith and all that. I said, “Jim I don’t want to talk about faith. I just want to talk about how to give it up to God.” […]
That started a three year journey of conversations, of reading. And I had talked myself out of the logic of God and of the immortality of Jesus in high school logically. I became, at the end of this three year period, convinced by the evidence. By answered prayer. By the existence of an absolute moral law.
It took a year after I started this journey before I could put my arm around our oldest daughter without her cringing and grimacing. She was fourteen at the time and she was really the one who was most traumatized. She understood how much guilt I felt. So when she was in college, I’d get these 22h00 emails asking me to review her essay […]. We worked together. I helped her get her first job. And we slowly rebuilt the relationship.
In 2010, a decade after all of this started, we did a co-presentation together about chronic diseases and faith. And we went for a run and just reflected on what had happened. At one point she said, “I hated you.”
I hadn’t realized that it had been that deep, but we clearly loved each other. And that gave me the passion […] and the sense of family that let me continue to follow my passions in global health and not at all jeopardize my family again. […]
The Future of Global Health: Three Challenges
One is the challenge of universal health coverage. Thirty countries are there and another thirty are on the way. It is a matter of human rights […].
Second challenge is chronic diseases. Many people don’t realize that in low and middle income countries heart disease, cancer and diabetes is already killing more people than AIDS, TB, malaria and other tropical diseases combined. Two cancers alone – cervical cancer and breast cancer – kill more women in poor countries than pregnancy and childbirth […].
Finally, epidemics like SARS, Zika and pandemic flu. We’re headed toward a century of pandemics if we don’t really fight back and do what we know should be done. Only one out of three countries worldwide are able to do that.
Stepping back from this experience, what I became completely convinced of is that we all need a passion in life, but no job is worth losing your family for. No matter how damaged or strained a relationship is, how long it’s been going on, it’s never too bad or too late to repair it. I firmly believe that if Jono had not come to Christ when he did, our family would not be together today.
I know that in this room there are probably – maybe the majority of you in your professional lives over the last fifteen years – have been part of the effort that has achieved these great accomplishments in global health. To the point where we’ve got 15 million people on treatment a day.
I just want to say – particularly for the parliamentarians, because Canada has played a significant role in a number of areas of research and development, Ebola vaccine and others – the people who you’ve helped don’t often get a chance to say thank you directly. But I think some of the ambassadors here can tell you what a difference your commitment has made and will make in the future.