A CEO’s lesson in the meaning of happiness: Less status and wealth, more purpose and simplicity

Wednesday, 11 March 2026

Cushla Smyth is the chief executive of the Medical Technology Association of NZ (MTANZ).

What was your most formative life experience?

I began travelling solo when I was 19. The first place I went was Thailand, and that experience fundamentally reshaped how I see the world.

At that age, I was exposed for the first time to Buddhism and to a culture that approached life very differently from the Western framework I had grown up in. The contrast was stark. In Bangkok I stayed with a Thai family who later sent me to visit relatives in the north-east of Thailand, in Isaan. Although they had a house in the town, they would take me to villages where people lived in bamboo huts and cooked outside over open fires.

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At the time, I instinctively categorised what I saw as poverty. But what unsettled and ultimately changed me was that the people I met were genuinely happy, not in a superficial way, but in a grounded, contented way. They had strong family ties, deep cultural and spiritual roots, fresh food, and a clear sense of belonging. Their joy did not seem dependent on possessions or status.

That experience forced me to rethink what “happiness” actually means. In Western culture, we are often conditioned to strive for the best car, the best house, the highest-paying job as if accumulation equates to fulfilment. What I witnessed in Thailand suggested something very different ‒ that contentment can come from connection, purpose and simplicity.

Who is your most inspirational figure, and why?

I don’t have a single most inspirational figure ‒ I’m constantly inspired by women.

The scale of what women contribute to society, both at home and at work, often goes unrecognised. The ability to hold professional responsibility, family life, community obligations and still show up with competence and care is extraordinary. The amount women manage, and get done, in a single day is quite remarkable.

More recently, I’ve been inspired by [MP] Barbara Edmonds. She’s a highly accomplished tax lawyer, deputy leader of the Labour Party, and a mother of eight. That combination of intellectual rigour, public leadership and family commitment is impressive by any standard.

Favourite book?

I was a prolific reader as a child, so choosing one feels like I’m cheating on all the other books I’ve adored. My favourite author growing up was Maurice Gee. His fantasy novels transported me to completely different worlds, I loved the escapism and the sense of adventure. Then as a teenager, I discovered his adult fiction and appreciated an entirely different layer of his storytelling.

I’m forever grateful to my mum for nurturing that love of reading. She was constantly buying me books, and when that became expensive, we discovered the local book exchange ‒ a much more economical way to keep me supplied.

As a leader, how would you address a toxic work culture?

Earlier in my career, I learned this lesson the hard way. I was too slow to address problematic behaviour because I didn’t want to be seen as heavy-handed. What I’ve learned since is that avoidance is far more damaging than decisiveness.

If culture is off, you deal with it early and directly. Be clear about expectations. Be objective about behaviour. Have the hard conversations quickly. Protect the team.

I believe in being fair, but I no longer believe in being “too nice” at the expense of performance and psychological safety. Strong culture requires courage.

Hardest decision ever?

The early days of Covid-19.

As national manager for Onelink (part of NZX-listed Ebos Group), my teams and I were responsible for distributing PPE to hospitals and later RAT tests to testing stations. In those first months, it felt like every decision carried enormous weight. We were working 14-hour days, often without a break for weeks, trying to manage global supply shortages in real time.

What made it hardest was the uncertainty. I remember seeing international news stories about doctors and nurses dying after re-using PPE and genuinely not knowing whether we would have enough to protect our own health workforce. At the same time, members of my own team were getting Covid. You’re worried about their wellbeing but you’re also responsible for keeping the supply chain moving so hospitals can function.

There wasn’t the luxury of perfect information. You made the best call you could with what you knew at the time, knowing the stakes were high.

That period taught me resilience, calm under pressure, and the importance of clear, decisive leadership when there is no easy answer.

Should billionaires exist?

I tend to take a live-and-let-live approach. I’m not inherently against people building extraordinary wealth, particularly where it comes from innovation, value creation or entrepreneurship.

That said, I don’t believe the level of inequity we see globally is fair or sustainable. The real issue isn’t whether billionaires should exist, it’s whether systems ensure opportunity, dignity and access for everyone.

If I was a billionaire, I would …

I would focus on strengthening global systems that ensure opportunity, dignity and access for everyone.

Philanthropy is important, but I’m more interested in structural change, investing in health, education and institutions that create lasting equity rather than temporary relief. Real impact comes from fixing systems, not just funding symptoms.

What is the one thing that could happen in New Zealand tomorrow that would make life better for the most people?

Policy stability and long-term thinking in health.

If we stopped redesigning the system every electoral cycle and instead committed to stable, evidence-based reform with cross-party support, outcomes would improve. Certainty allows clinicians to focus on patients, agencies to focus on delivery, and industry to invest in innovation and access.