Julie Bowen: supporting the transformation of the health system in Tonga

A self-described ‘continuous learner’, Julie Bowen has a diverse academic and professional background.

“I enjoy learning,” she says. “When I came to the Pacific I decided that I would do an online postgraduate course in hospital management via Fiji National University just to see what they were teaching in the region, as this would give me a better understanding of how and why systems operate as they do.”

Julie’s love of learning also extends to learning about and working within other cultures. So when a PACTAM2 role came up in Palau focusing on workforce development in the health sector, she jumped at the chance to work with a partner organisation in the Pacific.

She was placed in the Ministry of Health in Palau for four years, working initially on their HR systems and then on their strategic plan. On completion of this assignment she applied for another PACTAM2 position, this time in Tonga as a Health Systems and Planning Adviser with the Tongan Ministry of Health.

She has now been in the position for more than three years, focusing on systems strengthening, leading the development of a package of essential health services and carrying out an administrative services review.

“The ministry didn’t have any senior administrative roles that were comparable to roles in other ministries or government bodies so attracting and retaining the right staff was difficult,’ she says. ‘This was problematic as strong corporate governance is an essential component of any health service. A review of the structure, systems processes and bottlenecks was undertaken, and a series of recommendations were made.”

The minister endorsed the changes, one of which was the formation of a new directorate and the establishment of several new positions, bringing a new set of skills and competencies into Corporate Services to help them improve their performance.

There have also been some challenges in the role, especially in relation to the pace at which things happen in an agency that does not always have the autonomy they need to make key decisions in a timely manner.

“You’re working in the Pacific and things move at a different rate,” Julie says. “However, you are also reporting back to funding bodies in Australia where people may have different timelines and agendas. Working between the expectations of the two cultures can be difficult.”

Natural disasters, such as cyclones, can also bring things to a standstill. Earlier this year Tonga was hit by Cyclone Gita, a devastating storm that wreaked havoc throughout the island nation.

“We had a lot of people living in emergency housing and tents. There was a three or four-month period when we were cancelling non-essential technical assistance coming into the country, so we could bring the more important things in,” she says.

But it’s been during the times of difficulty that Julie has seen the true resilience of the community.

“The main thing I’ve learnt from my counterparts and colleagues is from their attitude and the approach to life,” she says.

“For example, during the cyclone, people were very negatively impacted, but the optimism and the support people have for each other goes beyond what we would normally see back in Australia.”

“The belief that it’s all going to be ok, that we can work this out … just the whole approach to adversity is admirable,” she says.

Julie believes the PACTAM2 program has benefits that extend beyond each individual country into the Pacific region as a whole.

“For example, the package of essential health services that we’ve developed is now being looked at with interest by other Pacific islands. Pacific islands see themselves as a large community sharing many common challenges, so there is lots of work done that can be shared between advisers and Pacific Island countries.”

Julie began her career as a teacher, then moved into working with high risk adolescents before joining the health sector where she worked in alcohol and other drugs (AOD) treatment and education. She eventually became a director of a drug treatment service where her responsibilities included new projects, innovation, tendering and workforce development. A component of her work was managing a training organisation that provided competency-based training throughout Australia.

Her qualifications include degrees in teaching and community development, a Postgraduate Certificate in Education, a Diploma of Business, a Master of Educational Management and further postgraduate studies in public health (addiction studies) and health service management.