When J’Belle began her PhD research she nev­er antic­i­pat­ed the evi­dence for improve­ments she would unearth close to home or the out­comes it has achieved.

Already well estab­lished as an expert in tuber­cu­lo­sis (TB) with over­seas work in Nepal and North­ern India, J’Belle was sent to the Tor­res Strait, first to work on an Active TB Case Find­ing project, fol­lowed by a fed­er­al­ly-fund­ed TB project to ensure the safe and eth­i­cal trans­fer of Papua New Guinea TB patients from the Tor­res Strait back to the Papua New Guinea health system.

“Liv­ing and work­ing in the com­mu­ni­ty I was study­ing allowed me to under­stand nuanced social dynam­ics, like the per­ceived threats of cross-bor­der TB trans­mis­sion,” says J’Belle.

“This embed­ded under­stand­ing informed the research and also influ­enced my clin­i­cal prac­tice. Liv­ing and work­ing on loca­tion made sure the evi­dence I gath­ered was trans­lat­ed into actions that were cul­tur­al­ly and con­tex­tu­al­ly relevant.”

Her research result­ed in tan­gi­ble changes such as updat­ed TB screen­ing pro­ce­dures, new train­ing for clin­i­cians, and bet­ter col­lab­o­ra­tion between health­care ser­vices at the Aus­tralia – Papua New Guinea border.

Her expe­ri­ence has made her a strong advo­cate for the ben­e­fits gained from research under­tak­en on the ground, and also for the focus on trans­la­tion­al research – trans­lat­ing the aca­d­e­m­ic work into prac­ti­cal action.

How­ev­er, she points out that there is work still to be done. ​“My work iden­ti­fied sig­nif­i­cant pol­i­cy and prac­tice gaps, such as the inad­e­qua­cies in cur­rent ear­ly warn­ing tools for detect­ing clin­i­cal dete­ri­o­ra­tion in TB patients.

“We need mech­a­nisms that are fit-for-pur­pose, par­tic­u­lar­ly for vul­ner­a­ble pop­u­la­tions like chil­dren suf­fer­ing from TB and mal­nu­tri­tion. I’ve advo­cat­ed for changes to clin­i­cal tools that could save lives by bet­ter iden­ti­fy­ing crit­i­cal cases.”

Empha­sis­ing the ben­e­fits of trans­la­tion­al research, J’Belle says: ​“Ulti­mate­ly, the goal is not only to high­light these issues in aca­d­e­m­ic papers etc, but to ensure they lead to last­ing, pos­i­tive changes in actu­al health care deliv­ery and governance.”

J’Belle pub­licly shared her exten­sive work in the field of TB at the 2023 CRANAplus con­fer­ence. ​“The response I received was over­whelm­ing­ly pos­i­tive and sup­port­ive, which was incred­i­bly val­i­dat­ing and inspir­ing,” she says. 

“One of the cen­tral themes of my research is the call for nurs­es and oth­er health­care pro­fes­sion­als to be brave and to advo­cate fierce­ly for patient safe­ty. We must chal­lenge prac­tices that have become nor­malised but that com­pro­mise patient wel­fare, par­tic­u­lar­ly in remote and cross-bor­der set­tings where patients are vulnerable.

“I want to inspire nurs­es to resist becom­ing com­pla­cent or feel­ing pow­er­less in the face of ​‘nor­malised’ sys­temic issues. We must con­front these assump­tions and pri­ori­tise eth­i­cal health care, even when it feels daunt­ing. We must ques­tion and speak out when patient safe­ty is at risk, espe­cial­ly when deal­ing with endem­ic dis­eases, where the con­se­quences can be fatal.”

J’Belle says her research rais­es crit­i­cal eth­i­cal ques­tions about the respon­si­bil­i­ties fac­ing clin­i­cians. ​“How do we bal­ance resource con­straints with our duty to pro­vide care that does not dis­crim­i­nate based on nation­al­i­ty or geog­ra­phy, and how are we sup­port­ed in this incred­i­bly dif­fi­cult envi­ron­ment?” she asks. ​“My research aims to keep these moral dilem­mas at the fore­front of pol­i­cy discussions.”

J’Belle says: ​“I am deeply hon­oured and grate­ful to have received the CRANAplus award this year, and I extend my heart­felt thanks to all who have sup­port­ed and believed in the impact of this work, espe­cial­ly those who inspire me in our shared mis­sion to improve health care in remote communities.

“Win­ning the CRANAplus award is a tes­ta­ment to the impact we can make when we work coura­geous­ly and col­lab­o­ra­tive­ly for the greater good.”

J’Belle says she always knew she want­ed to work in low-and-mid­dle-income set­tings with peo­ple who were most under­served. After nurs­ing and research stints in Chi­na and Viet­nam, she spent some time in the foothills of the Himalayas in Dharam­sala, main­ly with Tibetan chil­dren brought over the bor­der and housed in monas­ter­ies and board­ing schools.

This is where, she says ​“I fell in love with work­ing with TB patients. It is a cur­able dis­ease but also dead­ly. I want­ed to help peo­ple deal with the fear and stig­ma attached to TB, under­stand­able feel­ings as many have seen their loved ones die.

The nom­i­na­tion that secured the CRANAplus award for J’Belle states in part: J’Belle has made a sig­nif­i­cant con­tri­bu­tion to the field of pub­lic health by lead­ing a fed­er­al­ly fund­ed TB project across the Tor­res Strait Islands and Papua New Guinea bor­der. J’Belle iden­ti­fied gaps in TB ser­vice deliv­ery, which pro­pelled her to write a busi­ness pro­pos­al and suc­cess­ful­ly secure fund­ing to estab­lish Aus­trali­a’s first TB Con­trol Unit sit­u­at­ed with­in an Indige­nous community.

“When I ini­tial­ly estab­lished the TB Unit,” says J’Belle, ​“there were no exist­ing poli­cies or pro­ce­dures to effec­tive­ly man­age TB con­trol at the Aus­tralia- Papua New Guinea bor­der. The pri­ma­ry aim of my PhD was to gen­er­ate the nec­es­sary evi­dence to sup­port patients and devel­op a com­pre­hen­sive TB pro­gram in this high-risk region. I could nev­er have antic­i­pat­ed the extent of our suc­cess­es dur­ing the imple­men­ta­tion phas­es of this trans­la­tion­al research, out­comes that I have since doc­u­ment­ed and mea­sured in my research publications.”

Since sub­mit­ting her PhD the­sis, J’Belle has spo­ken at numer­ous nation­al and inter­na­tion­al con­fer­ences and forums, includ­ing the TB Cen­tre for Research Excel­lence Sym­po­sium and WON­CA World Con­fer­ence in Syd­ney, and the TB Research Advance­ment Cen­ter Sem­i­nar Series at Johns Hop­kins Uni­ver­si­ty Cen­ter for TB Research. She also pre­sent­ed at the Nation­al TB Coali­tion of Amer­i­ca, and most recent­ly, was invit­ed by the Aus­tralian Res­pi­ra­to­ry Coun­cil and Glob­al TB Cen­ter to train nurs­es and out­reach work­ers on the pro­vi­sion of TB care at the Pacif­ic Islands TB Con­trollers Asso­ci­a­tion (PIT­CA) Con­fer­ence in Pohn­pei, Fed­er­at­ed States of Micronesia.

She is cur­rent­ly a Research Fel­low in the Sur­veil­lance and Eval­u­a­tion Research Pro­gram at The Kir­by Insti­tute, UNSW Syd­ney. ​“I am priv­i­leged to be part of an incred­i­ble team ded­i­cat­ed to address­ing sig­nif­i­cant health­care chal­lenges in remote and under­served com­mu­ni­ties. Our work focus­es on rapid point-of-care test­ing in remote First Nations com­mu­ni­ties, ensur­ing time­ly diag­no­sis, pre­ven­tion and treat­ment of infec­tious dis­eases where it is need­ed most.

“This work isn’t just about gen­er­at­ing sci­en­tif­ic knowl­edge, but also about empow­er­ing com­mu­ni­ties and health­care providers with the tools and infor­ma­tion they need to act swift­ly and effec­tive­ly, with cul­tur­al safe­ty at the fore­front of every decision.

“This kind of work demon­strates impact­ful career path­ways that are avail­able to nurse researchers. Trans­la­tion­al research offers oppor­tu­ni­ties to con­tribute mean­ing­ful­ly to pub­lic health while stay­ing deeply con­nect­ed to patient care and com­mu­ni­ty engagement.”