KEY POINTS:
1. Susan Morton
Principal investigator and senior lecturer in Epidemiology, School of Population Health, University of Auckland
Professor Peter Gluckman calls her a rarity; "Maybe there is no other doctor in the world like her."
Dr Susan Morton, he says, has the ability to look at a life history - the pathways that start before birth and lead to adulthood - and translate it into meaningful social policy.
"This is the new biology", says Gluckman, the director of the Liggins Institute. "We can do things in test tubes, or on animals, but Susan has the unique skill of understanding how to relate data across the life course and complete the bridge to public health. It's a marriage of skills that's a needed step in today's world."
For the past three years, Morton has led a team of researchers developing a longitudinal study, which, if granted final Government approval, will start this year and follow the wellbeing of 8000 children and their families in Auckland and Waikato for at least 25 years.
The study will examine how influences such as family structure, school and new technology can affect children's health, education, behaviour and social adjustment. Findings from the study, which is to be funded by the Ministry of Social Development and the Health Research Council of New Zealand, will help shape new social policy.
It follows on from the world-acclaimed longitudinal studies in Dunedin and Christchurch of the 1970s.
"New Zealand has changed so much in three decades. Especially in our demographic profile - the huge influx of Asian population, and the higher fertility rate among Maori and Polynesian people," Morton says.
"It will help us to understand how everything interacts to create a particular outcome at any point in life. It helps answer questions like how do you get in there early and lessen the burden of obesity?
"I feel like I'm trying to keep people healthy, rather than parking an ambulance at the bottom of a cliff."
Morton and a group of researchers throughout the country, including Professor Peter Davis at Auckland University, are waiting for the Government green light within the next two months.
"The communities are really excited about it - women are asking when they need to get pregnant so they can be part of it", she says.
"It's been a long three years - times when I felt I was banging my head against a brick wall. But the potential of what it could achieve drives me through."
The reward for 46-year-old Morton would be making a difference to families again something she thrived on as a paediatrician.
"Back then, every day felt like a privilege to be helping families with children - it was a real buzz. Research can be isolating. So being involved with families and children again through this study would bring back some of that buzz."
Morton is using skills she developed doing her PhD in London - studying three generations of Scottish women to find if a baby's weight was influenced by the mother's birth and development.
This new study could envelop Morton for the rest of her working life, but she hopes it will soak up only half of her time. She is also working with Gluckman on a global study modelling the economic costs of a poor start to life.
It's a long way from the Catholic girls school in Taranaki, where she was encouraged to find a job that would be "a stop-gap until I had children."
She became a maths teacher, and continued teaching after having two of her children. But when she helped set up a voluntary group in Wellington providing new mothers with support, she felt impotent to make a difference. So at 28, she went to medical school.
"At times, when it was all too hard, my husband [Grant] and my family said, you can do this. Even when I became pregnant in my third year", she laughs.
"I was following a dream, and that's incredibly important. I hope the one thing my three daughters have learned - to follow their dreams. You never want to live with regret."
So far, they've listened. Morton's eldest daughter is about to graduate from Harvard University, another is studying science at Victoria University, and the youngest is interested in design.
Although she has the chance to make a difference to a whole new generation of New Zealanders, Morton's first priorities lie with her own children.
I'm a mum first. That's what's most important to me, she says. I would give it all up for them.
2. Avid Herd
Paediatric Emergency Medicine Fellow, Starship Childrens Hospital, Auckland
It's 11am, rush-hour at the children's emergency clinic at Starship - a stream of accidents and illness that will stretch until 6am the next day.
Dr David Herd pushes through the double doors wearing a shirt leaping with kaleidoscopic monkeys, and a yellow smiley-face stethoscope.
He is a curly-haired bear of a man, softly spoken, gentle and calm. He keeps a set of juggling balls in his top drawer to cheer up frightened patients.
Herd's speciality is not only making children well, but making them happy.
For the past two years, the 41-year-old father of two, has been the paediatric emergency medicine fellow at Starship Children's Hospital. It is, he says, the perfect job - 28 hours a week on the floor at the hospital, and 20 hours research.
The main focus of his study is reducing the stress of procedures on children in the hospital to ensure they are not in pain or scared.
"Distress can come simply from the sight of a needle. With children it's not only pain, but the new added psyche of what are you doing to me?" Herd says.
"As doctors, we need to have a range of skills and techniques that make the whole visit nicer for children. For a lot of the doctors here it's innate - they get on well with kids and know how to communicate with their parents.
"Children love to play and a lot of what we do is interacting play."
Starship is the only hospital in the country with an emergency paediatric clinic. It's a speciality that has found its feet in New Zealand only in the last 10 years.
"They are important; they bring a child-friendly perspective to caring for a child with an acute injury. We have to remind doctors a child is not a little adult. I think we do a good job here taking away the pain", Herd says.
This wasn't his life vision. Herd initially saw himself as a neuro-physiologist, then went down the road of psychology.
"But doing a science degree, I [missed] spending time interacting with people", he says. He began a bachelor of medicine, but became disillusioned and quit, spending three years as a computer consultant. But once again he was drawn back to medicine by people in particular, little fragile people.
Herd, whose iwi is Te Atiawa (Taranaki), spent 10 years working in Taranaki and Waikato hospitals before moving to Auckland to take up the fellowship.
His first study determined effective doses of ketamine, an anaesthetic and painkiller for children in emergency. Other published research has investigated using sucrose on the tongue as pain relief in babies, and which paracetamol syrup tastes best to kids.
"One of the things I'm most proud of is becoming a published author during my fellowship. I went from having one research study published in five years, to having five in a year", he says.
"Another thing I'm proud of is when you see a procedure now done with little distress."
Herd credits paediatric intensive care specialist Dr Brian Anderson with encouraging him in his research efforts, but Anderson insists Herd drives himself.
"He's such a strong researcher, doing a lot of good studies on reducing children's pain when most people at his level don't bother. Research can be a pain in the butt, and a lot of his colleagues would rather go fishing. But he's so enthusiastic", Anderson says. "He will be one of our professors one day, I'm sure."
When the position at Starship ends next month, Herd plans to go back to school and finish his Doctor of Medicine degree.
"I would love to stay in this job for the rest of my career. But I still have things to learn."
3. Swee Tan
Plastic and Cranio-Maxillofacial Surgeon and Director of Surgery, Hutt Valley DHB
"We were very, very poor. In my dreams as a child, I wanted to be somebody."
Growing up in the fishing village of Senggarang in southern Malaysia, Swee Tan knew his ticket out was education.
At 19, his parents sent him to Singapore, where he learned English. "I read the English newspaper from front page to back every day, including the birth notices. I thought every English word I needed would be in there."
He grasped enough to get a scholarship at Melbourne University's medical school. When he graduated, he came to Waikato Hospital as a house surgeon.
Today Tan, 48, holds down three jobs as a plastic surgeon, a world-renowned researcher, and, from this year, Director of Surgery for the Hutt Valley District Health Board. His dreams to be somebody have been realised, tenfold, to the immeasurable and ongoing benefit of the New Zealand medical community.
"I believe in human capital investment - I'm not old, but I'm always thinking about the next generation", he says. He believes in giving young doctors opportunities, as he was once given.
As a young medic in New Zealand, he was drawn to plastic surgery work that was very innovative and life-changing, helping people less fortunate.
His first opportunity came at the Burwood Unit in Christchurch in 1990, before he headed to Britain and the United States to gain more experience. He almost stayed at Oxford, but was headhunted by Dr Max Lovie, then director of the Wellington Regional Plastic, Maxillofacial & Burns Unit.
He returned to New Zealand in 1996, to work as a consultant at Hutt Hospital, and set up a private practice as well.
Four years later, Lovie, Tan's mentor and friend, died suddenly. The unit was in danger of imploding. But after some soul-searching, Tan quit his successful practice to take on the directorship, despite misgivings about the public health system.
"It had become so frustrating, I thought maybe there was no place for me in public medicine. But the crisis created opportunity, and got me thinking where I really wanted to be", he says.
"My heart is in training people. I have one pair of hands, but I can achieve more training one hundred pairs."
Tans areas of interest have been in head and neck medicine, and investigating haemangioma (strawberry birthmarks) - the subject of his PhD.
"Few people have looked at the curious phenomenon of why a strawberry birthmark grows so rapidly a year after birth, and then begins to regress and disappear."
But Tan discovered a gene which switched on in the tumour and led to the cells committing suicide. He hopes this breakthrough can one day be applied to shrinking other solid tumours, such as cancer.
His latest ambition is a research institute, with the Hutt Valley DHB, focusing on basic science. Fundraising for $10 million is about to begin.
"Basic science research looking at molecules that cause cancer, birthmarks or birth defects is so exciting", Tan says. Although most of the technology advances in plastic surgery have been made, he believes the future is in making tissue, nerves, heart muscles and cartilages.
Dr Colin Calcinai, president of the New Zealand Association of Plastic Surgeons, says Tan has the foresight to see what is best for not only reconstructive surgery but broader medicine.
"He's an innovative surgeon, a very good researcher and a lovely man", he says. "If he has a fault, it's that he tries to take on too much but that's common in people who are good."
Tan not only juggles three professions, but makes time for his family - his wife, Sanchia, and their three children, aged 8 to 14. At Easter, he completed a tree-house in leafy Ngaio that he had been promising them for eight years.
"In the Lord of the Rings, when Frodo doesn't want the ring, Gandalf says, 'it's not for you to decide. You must decide what to do with the time given to you'", Tan says. "I have to make use of the time given to me, and build a platform for the future."
4. Cliona Ni Mhurchu
Nutritionist Programme director, Clinical Trials Research Unit, University of Auckland
It's a cruel twist of fate, she says. As Dr Cliona Ni Mhurchu leads a world-first study trying to get people to shop healthily, she wages a daily battle to get her two toddlers to eat vegetables.
"You'll see me going through the supermarket with two contrary kids hanging out the trolley, demanding Bart Bars and Fruit Loops", she laments.
"Isn't it funny that I have possibly the fussiest children in New Zealand? I was so determined my children would eat family meals and a wide range of tastes and textures. So I can totally empathise."
Work dishes up surprises, too. Ni Mhurchu (pronounced Nee Wurku) has been stunned by the early findings in her study encouraging people to buy healthier foods at supermarkets.
Although the general perception is healthier options are more expensive, a pilot study led by Ni Mhurchu, through the University of Auckland's Clinical Trials Research Unit last year, revealed an average family of four could be fed on healthier food choices for just $7 more a week.
"Finding out the price difference wasn't that big was a really big shock to a lot of people, including me", she says.
The $1.8 million Supermarket Healthy Options Project (SHOP) is the biggest project in 37-year-old's Ni Mhurchu's research career.
"It feels like SHOP is my other baby, and this one's just learning to walk."
The new study discounts healthier foods by 12.5 per cent, to see if removing GST would change eating habits, scanning the trolleys of 1200 Wellington shoppers.
"We're trying to replace like with like, we're not suggesting they buy new complicated foods. If we can't find cheaper equivalents, we can show people how to balance it by using less - cooking lean meat with more veges", she says.
Ni Mhurchu grew up in Dublin on typical Irish fare - meat, potatoes and vegetables. She says she's lucky she knows how to shop healthily. "Money is not such an issue for me as it is for some other people", she says.
She studied nutrition and dietetics at Dublin's Trinity College, working as a clinical dietitian in English hospitals, before realising it wasn't for her.
"It was quite frustrating trying to get an individual to change their behaviour. It became clear they were driven by the environment they lived in, so I went back to get my PhD and look at the bigger picture."
Ni Mhurchu met her New Zealand husband, Pieter Rodenburg (also a health professional) in England and came here in 1998, for what was initially a year's stay.
She took on research at Auckland University, and it has evolved into her passion - working on obesity prevention, dietary behaviour change, diabetes and the heart.
"When I first came here no one was doing nutritional research. Now the political will is behind it and a lot of this research actually has a chance of being converted into policy - especially if it's simple and can make a difference."
There's a real advantage being in New Zealand, she says, because there's less bureaucracy and policymakers are willing to take a risk.
Ni Mhurchu's next goal is to improve nutritional labelling on food, letting shoppers know at a glance whether the sugar, salt or fat content is high.
Her peers have no doubt she will make it happen. Professor Anthony Rodgers, director of the Clinical Trials Research Unit, says one of Ni Mhurchus great strengths is her ability to relate to all people - academics, nutritionists and shoppers alike.
"She can talk the talk with them all. She has it in spades", he says. "We can tend towards making expert committee recommendations in medical-speak, but she makes it more digestible."
5. Stephen Robertson
Geneticist Chair in Child Health Research, University of Otago
The triumphs that keep Professor Stephen Robertson going are simple - sitting down with a family and helping solve their mystery. "Finding some sort of Holy Grail, some prize-winning epoch-making study, doesn't hang in my mind", he says.
As a paediatrician and geneticist, Robertson's quest is to unravel the genetic enigma of congenital malformations to understand why abnormal hearts, bones and kidneys are passed on through families.
"The highlights", 41-year-old Robertson says, "are not so much the moments of discovery in the laboratory, but when you get to tell a family what it all means, to answer questions that have often hung over them like a pall for generations."
It was one such case that drove Robertson across the world, to solve a terrible problem for a Maori family, and led him to become a world authority in paediatric genetics.
As a junior doctor at Starship, Robertson met the Miru Tito family from West Auckland who had lost seven baby boys with congenital malformations. His determination to piece together their genetic puzzle led him to a scholarship at Oxford University in 2000.
"This opportunity came to pursue a mystery I'd been wrestling with for a few years, and I was able to put my nose to the grindstone and push myself. There were big ups and downs - there were many periods of time when it looked as if it was going to defeat us", he says.
But at Oxford, with the help of Professor Andrew Wilkie, Robertson discovered a new family of genes responsible for congenital malformations of the skeleton, brain and internal organs. The genes encode proteins called filamins that are part of the scaffolding of cells. He was finally able to fill the gaps for the Miru Tito family.
If only it were always that rewarding.
"It's terribly disappointing when you have a desire to deliver answers to a family, and you can't. That frustration for people who want to have children now, who want to know the risk they run, but you can't help them with an answer", he says.
Now back at the University of Otago, from where he graduated from medical school first in his class, Robertson continues trying to unlock the secrets of rare genetic disorders, to help understand the more simple abnormalities such as dislocated hips, cleft palate, a hole in the heart. Families throughout the world send him genetic samples, hoping he can crack the code of their conditions.
"I have some international stature, but it's in my own little niche", says the man who won the national secondary school science fair as a sixth former. "But I know it's making a difference for families around the world whom I will never meet."
Robertson could have stayed at Oxford, but he was compelled to return to Dunedin, with his wife, Robyn Blake, a GP, and their three young children.
"There is a paucity of genetic specialists in New Zealand. I received my training here and I had a desire to come back and help," he says.
The Cure Kids charity created a place for him - a permanent chair in Child Health Research at the University of Otago. "It's my intention to be here for a long time", he says.
"I want to be part of delivering world-class genetic services for New Zealanders, with our limited resources and personnel. New Zealand has the capacity - there's brilliant work in genetics happening here, we have the talent. But it's an expensive and fast-moving science."
Joanne Dixon, the clinical leader of the Central and Southern Regional Genetic Service at Wellington Hospital, has known Robertson since he was a med student and values his "knowledge of syndromes, his international contacts and the academic rigour he brings to our discussions.
"As a scientist working in a small centre he has to have tremendous focus and drive. He's recognised as the world expert in his field, and I personally admire anyone who can specialise in just one molecule. I always give him a hard time, that he needs to become a two-molecule man before he retires to which he responds I'm working on it."
"We are the ones who keep his feet firmly on the ground."
