Achieving Wellbeing with Pacific Peoples, Families and Communities Considerations of Gender, Culture

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Achieving Wellbeing with Pacific Peoples,
Families and Communities Considerations of
Gender, Culture and Socio-Economic Contexts
22-25 September 2008Cairns, Australia

• Taimalieutu Kiwi Tamasese
• The Family Centre
• Aotearoa New Zealand

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Objectivity is for uncommitted Gods. My
commitment will not allow me to confine myself to
so narrow a vision. So vast, so fabulously
varied a scatter of Islands, Nations, Cultures,
Mythologies and Myths. So dazzling a creature,
Oceania deserves more than an attempt at mundane
fact only the imagination in free flight can
hope if not to contain her - to grasp some of
her plumage and pain. (Albert Wendt,1982 )
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Atu Vasa
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Pasefika Peoples in Aotearoa New Zealand
Population

• Six highest Pacific Peoples populations now
  resident in New Zealand1. These are
• Samoan 131,103
• Cook Islands (Maori) 58,011
• Tongan 50,478
• Niuean 22,476
• Fijian 9,864
• Tokelauan 6,822
• 1 All Pacific Peoples population figures are
  drawn from www.stats.govt.nz/census/2006-census-da
  ta/quickstats-about-pacific-peoples

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Historical Context

• 1848-1914 The growing of the New Zealand empire
  into the Pacific and the consequent colonisation
  of Pacific nations such as Samoa, Niue, Tokelau
  and Cook Island
• Early 1900s Australia and New Zealanders
  involvement in Phosphate Mining in the Pacific
  specifically in Banabas and Nauru
• Australia and New Zealand economic, social and
  political influence in the Pacific region that
  continues to the present.
• Source One a Half Pacific Island, Stories
  the Banaban People Tell of Themselves, Jennifer
  Shennan Makin Corrie Tekenimatang
• Source The Pacific Plan, 2005

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• Migration from 1950s
• Pacific people form 7 of NZ population
• Samoan community half of this group, concentrated
  in urban north island cities
• Samoan and other Pacific people tend not to turn
  up to Palagi (western) services, especially
  mental health

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Pacific Conceptions of WellbeingA Qualitative
Study intoPacific Perspectives on Cultural
Obligations and Volunteering
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• Wellbeing as Experienced by the Self
• Wellbeing, Relationship and Belonging
• The Spiritual Nature of Connections and Therefore
  of Wellbeing
• Wellbeing is the Fulfillment of Roles,
  Responsibilities and Heritage
• Wellbeing is the Responsibility to Guard and
  Protect
• Wellbeing as Rooted in Reciprocity and Mutuality
• Wellbeing is Experienced When Life is in Balance
  or in Harmony
• Wellbeing is Experienced When Ones Aiga or
  Aiga-like Formations are Well

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• Wellbeing is Experienced in Actions of Support
  and Alofa
• Wellbeing is a Good Education
• Wellbeing is Having a Job
• Wellbeing is Owning a Home
• Wellbeing is the Ability to Provide
• Wellbeing is Having a Place in the Community
• Wellbeing for the Elder Generation is Being
  Involved in Collectives
• Wellbeing is Helping our Children Reach their
  Goals
• Wellbeing is Living Safely
• Wellbeing is Acknowledgement

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The Contexts

• Gender
• The Impact of Western Gender Arrangements on
  Indigenous Cultures
• Excavating liberative gender arrangements.
• Culture
• The coherence of rationality, mentality,
  physicality and spirituality.
• Colonisation
• The restoration of Culture.
• Economic Context
• The subsistence of affluence
• The Economics of Migration
• Taking our Place on the Economic Table

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Social Wellbeing for Pacific Peoples
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Research Contribution to Achieving Wellbeing
On the Matter of Pacific Governance

• Pacific governance of Pacific Research
• Leadership of research projects
• Institutionalise cultural and gender
  accountability approaches.

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Research Achieves Pacific Wellbeing by Restoring
Pacific Cultures and Concepts
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OLE TAEAO AFUAThe New MorningA Qualitative
Investigation into Samoan Perspectives on Mental
Health and Culturally Appropriate Services
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UPU TOMUA - THE FIRST WORD
The last testament of Tapuitea to her brother
was I shall make good the harm Ive done by
rising to the heavens and appearing in the West
as the morning star. I shall guide you to the
fishing, to sailing and to a new morning. In
Samoan Culture there are three perspectives. The
perspective of the person at the top of the
mountain, the perspective of the person at the
top of the tree, and the perspective of the
person in the canoe who is close to the school of
fish. In any problem the three perspectives are
equally necessary. The person fishing in the
canoe may not have the long view of the person on
the mountain or the person at the top of the
tree, but they are closer to the school of fish.
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This research represents the culmination of all
three perspectives, as it sought a range of views
both long and short, from women and men and from
the Elders and those who work in the health
field. In launching on a sea journey, timing is
of the essence. So we say, Ua faapopo ni aso ua
ae le tuua aso folau In assessing timing, The
Morning Star - Tapuitea - is indicative of the
currents and the winds May the perspectives of
the fishermen and the insights into the winds and
currents lead the Faafaletui to a new
morning. Tuiatua Tupua Tamasese Efi 28 May 1997
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ACKNOWLEDGMENTS
Our thanks to the Elders and those who work with
clients of the mental health system.
Specifically we acknowledge Talolua Toa Afele,
Salasala Vaelupe Aluni, the late Leao Walter
Brown, Palepa Aleipata Brown, Folole Iaeli Esera,
Soonafai Aivaea Malieituia Fata, Fepuleai Seuao
Faamanutaeao, Faauliuli To Faiumu, Finau Fiaui,
Ulatifa Imoana Godinet, Anealeise Emi Patu Laban,
Mesepa Tanielu Laban, Thomas Laban, Silipa Mamea,
Fuiono Manua, Toleafoa Tomanu Masinaanamua, Ale
Palelei, Loudeen Parsons, Johnny Pauu, Lefao
Paniani Saena, Mafuie Saena, Toleafoa Iumai
Saivaiese, Ifopo Soo, Papalii, Faasisila,
Sua, Time Utumataiona Tafea, Taanoa Taiti, Sina
Taanoa Taiti, Faalelei Teo, Emi Tuiavii, Mele
Ahfani Tuilepa, Leapi Tuitaalili, Leaupepe Uili
and Iunita Vaofusi. Without your contributions,
this research would have no wisdom.
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AIMS OF THE RESEARCH
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• To identify and establish the perceptions of
  Samoan people of mental health by
• Inquiring as to their conceptions, descriptions
  and explanations of mental health
• Seeking their responses to current statistical
  data on Pacific Island mental health
• Seeking information on Samoan peoples
  experiences of mental health services in New
  Zealand
• Identifying Samoan cultural practices and beliefs
  of mental health and well-being
• Seeking information on the changes in conceptions
  and understanding of mental health with the
  introduction of Western models of mental health
  care.

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METHOD
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DEVELOPING AN APPROPRIATE METHODOLOGY

• Methods which exclude
• Research methods, which hold values intrinsic to
  western cultures when applied to non-western
  communities, contribute directly to exclusions.

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• Exclusions, as put succinctly by Trinh, underline
  one way discourses,
• ..a conversation of us about them, of the
  white man with the white man about the
  primitive-native mana conversation in which
  them is silenced. Them always stands on the
  other side of the hill, naked and speechless,
  barely present in its absence.
• The issues of who produces knowledge, and the
  role of the researcher (team) in the production
  of knowledge, need to be recognised in the
  context of being inclusive.

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RESEARCH METHOD AND COMMUNITIES IN CRISIS

• Constructs of method should
• emerge from, and faithfully reflect, the
  intrinsic source of its participants needs and
  knowledge bases.
• The information provided in this study, by the
  Samoan participants, reveals that
• urgent responses are needed to create structures
  of change within the Public Mental Health
  Service
• the call for legislative and social relief,
  reflects a community which recognises that it is
  in crisis and
• serious questions for the research community
  regarding
• their ability to address their own roles, and
• appropriate processes of research within
  communities in crisis.

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CHOICE AND JUSTIFICATION OF METHOD

• The choice to use a focus group method for this
  study arose out of three primary reasons.
• 1. Collective discussion is the natural forum for
  discourse concerning issues of import within the
  Samoan context.
• 2. Focus groups allowed for discussion at a more
  in-depth level than what most research techniques
  allow.
• 3. The focus group method facilitated systematic
  comparisons of an individuals experience with
  those in their group.
• The focus groups were facilitated by Samoan
  researchers using questions developed by the
  researchers.

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FAAFALETUI A METHODOLOGY OF WEAVING TOGETHER
KNOWLEDGE FROM WITHIN THE HOUSES OF RELATIONAL
ARRANGEMENTS
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• The term faafaletui was the concept brought to
  the notice of researchers by the Elder Men and
  Womens focus group participants, to explain the
  process in which they viewed themselves to be a
  part of.
• Essentially, faafaletui languages a method which
  facilitates the gathering and critical validation
  of Samoan knowledge.
• There are two appropriate approaches to the way
  in which Samoan people may best be grouped for
  research interviews.
• These are by gender, and
• by relative status within the cultural community.

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• Each group represents a house (fale).
• Delegations from each of the houses would meet
  with each other, to
• share the same process of making known the
  knowledge frames from each of their parent
  houses.
• The information is threaded and re-threaded
  amongst these realtional houses until all are
  agreed that
• the specified knowledge pieces are valid, and
• give truth to the collective experiences.

• Faafaletui, is
• the critical process of weaving (tui) together
  all the different levels of knowledge frames from
  within the houses of collective representation,
  in order that the Samoan world view is
  substantially enhanced, and added to.

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A SAMOAN REPORT AND A PALAGI (ENGLISH) REPORT

• In order to overcome the problems raised with
  translation of material
• the transcription, in the Samoan language, were
  the base from which all ongoing work began.
• a primary report in Samoan was undertaken, so
  that the essence of the participant material
  remained intact.
• Copies of the draft Samoan report were given to
  authoritative participant members from each of
  the groups to check for
• coherency
• appropriate languaging of terms and concepts and
• an appropriate observance of written protocols
  and etiquette.
• The English report is based on the Samoan report,
  and is written and prepared in a format
  accessible to English speaking health
  professionals.

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The Samoan Self
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• The Samoan self draws its sense of sacredness and
  uniqueness from a deep sense of belonging to its
  genealogy, place of identity, language and
  culture. The self also draws worth from carrying
  out appropriate roles and responsibilities.
• The relational person exists in identity with
  others from specific locations of belonging as in
  their villages, districts and country
  faasinomaga that they are born into
  genealogical continuums tupuaga and that during
  their lifetimes, they undertake positions and
  roles of responsibility tofiga.

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• The Samoan conception of persona, of self, is as
  a total being - comprising the Spiritual, Mental
  (psychological) and Physical.
• It is the person in their totalityI cannot
  separate the person if I become mentally unwell,
  everything else is not well. If I become
  physically unwell, everything is not well. I
  cannot say, I will leave my spirituality while I
  go and get on with my physical function, or I
  will put aside my mental function while I
  undertake my spiritual duty. The whole person is
  all parts. The person cannot be divided
  vaevaeina by anyone.

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• The state of mental wellness for a Samoan person
  is a state of relational harmony, where the
  elements of spiritual, mental and physical are in
  balance.
• We can view ourselves as whole beings. In other
  words, the spirit, the body, the will loto.
  When I say, you and me, I am talking about the
  whole person. There is a physical side, mental
  and spiritual (sides). I include the spiritual
  because there is no Samoan person who exists
  outside of a spiritual existence.

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• Treating individuals, apart from their
  communities, is likely to deny them the meaning
  and support that is basic to their process of
  healing. Healing processes that do not address
  the spiritual aspect as a part of the therapeutic
  process are likely to fail.
• if both (physical and spiritual) natures are not
  in balance, well-being cannot be in balance

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SACRED AND FORBIDDEN RELATIONSHIPS
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• Relational arrangements within the Samoan Social
  Constructs are Tapu or Sacred.
• These include relationships between parents and
  their children alii (titular heads of families
  and villages), and tulafale (titular orators)
  matai (generic term of alii and tulafale) and
  families matai and village brothers and
  sisters taulasea (traditional healers) and those
  under their care people and their God/s.
• Within each particular relational group, there
  are prescribed protocols which define how one
  appropriately relates to the other. The
  integrity of relational arrangements lies in the
  nature of their being sacred.

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• Mental ill-health among Samoan people is often
  understood as being the result of breaches of
  forbidden or sacred relationships.
• it was known that the tapu had been put in place
  after much deliberation and with vision. (It was
  known) that desecration of the tapu was
  forbidden, yet he/she went ahead and desecrated
  it.
• Then it will be said, if anything your curse
  will be (the result) of your (stupidity/senseless
  act). He or she is faavalevalea because the
  sacredness of parents, protocols and etiquette,
  traditional nobility have been desecrated.

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ADDITIONAL PRESSURES IN NEW ZEALAND
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• The economic constraints on Samoan families in
  New Zealand are a significant cause of mental
  ill-health for Samoan people in New Zealand.
• there is not enough money to budget for the
  lifestyle in this countryremember our people
  will never forget their families in Samoa. A
  benefit of 300.00 a fortnight (single elderly
  rate with no accommodation supplement), will not
  be enough if there is a family need in Samoa.
  Another expense is the education of children and
  the care of family needs.

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• There are significant economic pressures on
  Samoan people to fulfill roles and
  responsibilities, both to families in New Zealand
  and to families in Samoa. The low income levels
  of many in Samoan communities are a critical
  factor behind the increase in mental ill health
  for Samoan people in New Zealand.
• this is one area which causes mental unwellness
  within our elder people. There is not enough
  financially to meet obligations and fulfill
  responsibilities. It is not surprising that the
  mind becomes unwell when one has love for their
  family, parents and the need to provide for
  family.

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• The marginalisation of Samoan cultural norms,
  values and language in New Zealand, is also a
  contributing factor in mental ill-health.
• At a personal level, the loss of belonging to
  language, identity and culture leads to a loss of
  relational harmony and self worth. The continual
  adjustment to the dominant culture is a powerful
  destabiliser of mental health for Samoan people.
• For younger people the push to succeed in a
  palagi environment at school, where they are seen
  as different, and often from a low income family,
  can lead to the development of psychological
  problems.
• There are conflicts of cultural identity causing
  shock and trauma. (Whether the child) was born
  in New Zealand or brought up in Samoa, there are
  conflicts with cultures within schools.

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A SAMOAN MENTAL HEALTH SERVICE
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Strengthening of critical cultural concepts and
structures is important to preventing mental ill
health. Strengthening spirituality and
relational arrangements within the family is
particularly important. The family is the first
place of relational harmony, belonging and
identity, education and nurturance. The churches
also can provide this support and role. Clients
should not be individualised away from their
extended families. Churches could also be looked
to as partners in the healing process.
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• A successful Samoan mental health service
  requires hospital and community based services
  designed and largely staffed by Samoan people.
  People would be treated with regard to the
  elements of spirituality, mentality and
  physicality. Key cultural factors, such as
  relational arrangements, would be central to
  service delivery. Personnel for such a service
  would include currently recognised mental health
  professionals and traditional healers.
• Traditional Samoan medicine and healing
  knowledge should be valued in the treatment of
  Samoan peopletaulasea (Samoan healer), should be
  recognised because there are illnesses which can
  only be treated by fofo Samoa (Samoan healing
  methods) there are also illnesses which can only
  be treated by Western medicine

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• There is a need for further culturally safe
  research. There is also a need for ongoing
  consultation between clients, mental health
  professionals, traditional healers and families.
• .. you also need consultation with the clients
  themselves because they are the most important
  people in this concept. What do they want, how
  do they want it done. Secondly, lets look at the
  perceptions of our fofo and taulasea (Samoan
  healers). These are the people who we need to
  talk with. Thirdly, consultation with the
  families of the clients. How do they (want
  services provided) - (for example), our family
  person is ill, we want this done and that done.

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• Development of Samoan workforce in the Mental
  Health Area.
• There needs to be education of Samoan
  psychiatrists and Samoan cultural consultants.
• There should be government scholarships offered
  to Samoans to study in medicine and to be trained
  in clinical medicine. We should then use our own
  doctors who also understand us.
• There are important parallels between what
  participants called for, and recent Maori mental
  health initiatives.

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A REVIEW OF LOTTERY RESPONSIVENESS TO PACIFIC
COMMUNITY GROUPSA Cultural Audit of the
Lottery Grants Board
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Summary of Findings and Recommendations
The Literature Review The literature review
outlined certain key aspects of the historical
background to the settlement of Pacific people in
New Zealand and the demographic characteristics
of the Pacific population here. The context of
networks of colonial, political and economic
relationships between New Zealand and the Pacific
nations which extend back to the middle of the
nineteenth century were noted.
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The Lottery Grants Board Strategic Direction and
Priorities document in its Mission Statements and
Guiding Principles offers the basis of a
framework for equitable and responsive cultural
relationships with the Pacific community.
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Legislation as it Relates to Pacific People and
the Lottery Grants Board
The Gaming and Lotteries Act 1977 is derived from
earlier legislation, and embodies former
assumptions about the nature of New Zealand
society and its culture such as, that the New
Zealand society was homogenous and moral. The
present legislation is now required to address
the needs of a pluralistic society, a society
that privileges the Treaty of Waitangi and a
society that should honour its obligations to the
people of the Pacific.
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• Under the following Acts
• Human Rights Act 1993
• New Zealand Bill of Rights Act 1990
• the Lottery Grants Board must ensure that it is
  not discriminating against, precluding or
  inhibiting the Pacific people in any of the
  facets of its structure, policies, funding
  allocations and distributions as well as its
  administration.
• These findings strongly suggest that the Pacific
  People should receive lottery funding on an
  equitable basis with other New Zealanders.

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Developing Policy Responses

• Strategic responsiveness plan
• The development of this plan is based upon the
  results of the
• Review of Lottery Grants Board funding for
  1997 and 1998
• the focus groups and
• the internal cultural audit.
• the key findings from those audit processes are
  outlined below.

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• Review of Lottery Grants Board funding for the
  years 1996 to1998
• Pacific people in New Zealand are considerably
  under-represented among those receiving funding
  from the Lottery Grants Board. In comparison
  with the general population they
• make fewer applications
• apply for smaller amounts of money
• apply to a smaller range of distribution
  committees
• receive a much smaller proportion of the funds
  they apply for
• receive 2.7 times less than their proportion in
  the New Zealand population and
• receive proportionately less in every
  distribution committee.

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• It was clear that these key factors would need
  to be addressed in order for Pacific people to
  benefit from lottery funding on an equal basis
  with the general population. The key
  recommendations developed from this review of
  funding are
• the implementation of a strategy to ensure that
  funding to Pacific people is at least consistent
  with their representation in the population, but
• with the goal of funding them at a higher level
  in order to provide for the particularly high
  level of deprivation they experience and allow
  for past under-funding.

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• A key feature in this strategy is
• the establishment of a specific Provider
  Development Fund designed to
• increase the capacity of Pacific groups to access
  lottery funds and
• fund the direct provision of services by Pacific
  groups to their people.

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Focus groups

• Analysis of the focus group discussions showed
  clearly that the under-representation of Pacific
  people among applicants was due, largely, to
• an unduly complicated application process
• length of the application form
• difficult English language used in the
  application form
• lack of information about the application process
  and funding available in Pacific languages.

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• These problems were compounded by the
• lack of personal contact between Lottery Grants
  Board Pacific staff members and Pacific
  applicants
• low representation of Pacific people on the
  staff, Board and Committees of the Lottery Grants
  Board
• incompatibility of Pacific cultural frameworks
  and the dominant Palagi cultural framework
  informing the work and functioning of the Lottery
  Grants Board
• incompatibility of some Lottery Grants Board
  funding criteria and the funding needs of Pacific
  communities
• the lottery committees low levels of
  understanding of the needs and values of Pacific
  people in New Zealand
• the disproportionately low level of lottery
  funding going to Pacific groups.

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• The aspects of lottery funding processes that
  participants considered were working well were
• the Pacific funding clinics set up by Pacific
  workers
• regional successes such as Christchurch and
  Wellington, where Pacific groups had been more
  successful in gaining funds than Pacific groups
  elsewhere
• well trained and motivated Pacific lottery staff
  members who had a high level of personal contact
  with Pacific groups,
• Pakeha staff who went out of their way to help
  Pacific groups.

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• The following were identified as essential
  elements in any plan for overcoming the
  difficulties noted above
• modifying the application process and providing
  research and administrative support for Pacific
  applicants
• increasing the level of Pacific representation at
  all levels of the Lottery Network. This was
  considered to be crucial to improving
  communication between Pacific groups and the
  Board, committees and staff
• active involvement of Pacific grass roots groups
  in defining their funding needs and priorities
• funding developmental education and capacity
  building for Pacific groups
• funding the development of administrative skills
  and physical facilities

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• the committees develop a holistic approach to
  support services based upon the whole self
• developing an ongoing process of accountability
• funding services based upon Pacific cultural
  frameworks,
• funding equitably.

62

• Internal Cultural Audit
• Specifically, the interviews indicated that
• the Lottery Grants Board has no overall policy
  regarding its responsiveness to Pacific people
• the individual lottery funding committees, with
  the exception of the Lottery Community Facilities
  Committee, have no specific policies relating to
  Pacific people
• much policy making is carried out on an ad hoc
  basis
• policy is made by funding committees and their
  composition is crucial to outcomes
• Pacific input into policy formulation and
  analysis is very limited.

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• In terms of what they felt was not working
  well for Pacific applicants, Community
  Development Group staff considered that
• Pacific applicants were doing badly out of the
  Lottery Grants Board
• the Lottery Grants Board was culturally and
  philosophically unhelpful to Pacific people
• the application process was daunting for them
• Pacific people needed information provided in
  appropriate languages and formats and
• that the process of making political appointments
  to funding committees had excluded Pacific
  participation and representation at that crucial
  policy making level.
• Pacific people were under-represented on regional
  and national decision-making bodies.

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• In terms of what they felt was working in
  favour of Pacific applicants, Community
  Development Group staff considered positive
  developments to have been
• allowing funding up to 5,000 without legal
  status
• the establishment of the Pacific Island
  Consultation and Advisory Group
• employment of effective Pacific workers in key
  regions.

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MY MOTHER DANCES
Through the shadows cast by the moon tonight the
memory of my mother dances like the flame-red cap
I watched in the black waters of the lake of the
Golden Pavilion in Kyoto. Such burning
grace. Though I am ill with my future and want to
confess it to her I wont. Not tonight. For my
mother dances in the Golden Pavilion of my
heart. How she can dance. Even the moon is
spellbound with her grace.