Midway through my lunch with Kate Dolan, a ship appears on the stretch of ocean we can see from our table in a café in Sydney, Australia. The ship, looking something like a table turned upside down, seems to be carrying four enormous, inexplicable pillars out to sea. When we return to our conversation, Dolan tells me she used to live on a boat once. It was the mid-1980s, and a formative moment in her career, when she was helping establish Sydney's pioneering needle-exchange programme near the city's red light district. The needle-exchange programme, the brainchild of Alex Wodak from St Vincent's Hospital, was a great success, and is credited with helping limit the city's HIV epidemic. Dolan volunteered to work in the programme fresh from earning a degree in psychology at the University of New South Wales. As the HIV pandemic gathered pace, needle-exchange programmes would become a focal point for activism, but Dolan says she saw herself as being at a coalface of public health. “I didn't see myself as an activist”, she says. “It was really exciting; almost an honour to be involved so early.” In the years since, Dolan continued to work in related fields, lobbying governments to provide treatments for drug users in prisons in Australia, the UK, and Asia, helping found the Australian Prostitutes' Collective, and the country's AIDS Drugs Information Collective. Now based at the National Drug and Alcohol Research Centre, University of New South Wales, she has established the Program of International Research and Training to build capacity among the treatment and research sectors in developing countries. In 2003, at a harm reduction conference in Slovenia, Dolan met a public-health physician from Iran in a chance encounter that led to her latest focus. Later that year, she went on a tour of about a dozen Iranian prisons. Since then, Dolan has secured funding to establish drug treatment research for women in Iran's prisons and has opened a community sexual health clinic for female sex workers and drug injectors in Tehran. “I think we have made a difference for those women”, she says. “Before we started there was nothing for them; since then other clinics have started.” Now in her 40s, Dolan has two small children and has not lived on a boat for many years, preferring a beachside community south of Sydney. However, she is now wondering whether it will be possible next year to work more intensely with the women in Iran. We finish our lunch of soup and grilled fish and look out into the bay, where the ship seems to have lowered its towering cargo into the ocean. As Dolan looks over the deserted beach, she says “I go to these challenging places sometimes, and think this is heaven”.