Pacific Health at Otago
Pacific Virtual Case
Overview
The Pacific virtual case is an educational tool for future health workers, aiding in their understanding of Pacific individuals and their cultural nuances. It emphasizes the significance of family in engaging with Pacific patients and highlights the fluidity of Pacific peoples between New Zealand and the Pacific islands.
This understanding encourages health professionals to explore innovative, family-oriented solutions for Pacific health issues within a system that typically treats patients as individuals.
Given that Pacific peoples often function as collective family entities, the conventional approach of treating patients as individuals may feel foreign.
The Pacific Virtual Case, aligned with the Fonofale Model of Health, illustrates the model's components, combating negative stereotypes perpetuated in media and public narratives about Pacific peoples. The objective is to shift focus towards the strengths of Pacific cultures, providing insight into Pacific individuals while addressing their often challenging health statuses.
This approach allows a concentrated effort on the strengths of Pacific peoples amid health inequities, fostering a nuanced understanding of their health.
Meet the Family
The Family tree below shows how each family unit relates to the wider family entity. Scroll down to read about the various family units. We ask you to use the Fonofale Model of Health to help you put a Pacific lens on how things present. Allow it to help you identify potential Pacific strengths that will help you engage meaningfully with Pacific peoples, and to understand the context of how and why they present the way they do.
At the same time, we encourage you to keep reflecting back to the relationships between Aotearoa and the different Pacific Island nations in the region, as these relationships lay the foundation for the relationships that exist today.
Our Pacific virtual case has a young Pacific family at its core with the father figure, Chris as the main case.
Meet Chris and Fiona. Chris is a Samoan male in his early to mid-twenties. He was born and grew up in Auckland. Fiona is also in her early to mid-twenties and was born in the Cook Islands and moved to NZ when she was 12 to attend secondary school.
Fiona came over from the Cook Islands, with her family, and they settled in Auckland. She met Chris at a school sporting event and they had been courting for several years before getting married. They both work, are both active in their church/youth community events, and they are saving to buy a house.
Chris has asthma and eczema which he has been managing well with inhalers and appropriate creams. He has had this since he was a child and although a challenging start in navigating his medications, he now has these conditions under control. Fiona is fit and well.
They have a two-year old son, Ioane.
Meet Sina. Sina migrated to New Zealand in the late 1960’s after encouragement and advertisements inviting Samoans (and other Pacific peoples) to come to New Zealand (the land of milk and honey) for better work and education opportunities.
She met Ioane at a church community event in the late 1960’s and they married and had children in early to mid-1970’s. Ioane came from Samoa around the same time as Sina and started working and continued working until he passed away a few years ago after a cardiovascular event. .
Sina lives with her daughter and son-in-law and three of their children, one of which is married with a young child. She loves her grandchildren and having them around her every day. She is particularly fond of her great grandchild, Ioane, whom she looks after during the day when his parents are at work.
She has high blood pressure and is on medication for this. She does not smoke and is not overweight. She worked for most of her life since migrating to New Zealand, retiring when she turned 65years. She misses working as she had a close community of friends at work. She is closely involved with her church and looks forward to the weekly “matua” get together with other older members of the church.
Meet Tala and Lua, Chris’s parents. Tala was born in New Zealand and is Chris’s mother and Sina’s daughter. She met Lua in church 28years ago, he had come over from Samoa to find work to help support his family back in Samoa.
They are both in their late 40’s early 50’s and are still working, and have been, for coming up to 25years. They both work long hours and have encouraged their children to study hard and think about university. They are both active in their community and in their church. It is the same church they met in 28 years ago and Lua is now a deacon. They have a good GP and belong to a Pacific Island Health provider.
They live with Tala’s mother Sina in a house Tala’s parents bought when they were young. Their son Zak, and daughter Christina, who is a doctor at the hospital lives with them, as does Chris and his wife and son. They are very proud of all their children, especially Christina. However, they are concerned about how hard she works. She is getting ‘old’ and does not have a boyfriend yet and this is a concern for them also.
Meet Christina. She is Chris’s older sister and a young professional. She is a medical registrar working at Middlemore hospital.
She did her medical training at Otago Medical School. It was a struggle going through her medical education journey and she is aware of the challenges Pacific peoples face and how it is reflected in health status in New Zealand. She wants to make a positive change impacting health outcomes for Pacific people in New Zealand.
She did her elective in Samoa and had an opportunity to meet and live with her parents’ families. Most special for her was spending time with her paternal grandparents and she would like to connect with Samoa and give back to the health systems and services in Samoa. She would also love to have a family of her own but is getting tired of her family/ extended family giving her the third degree about not being married and not having children yet. She just wants to finish her exams.
She is thinking about moving to Australia to finish her training but is not sure how to share this to her parents who she knows love having her home and sharing to others her successes. She has been saving up and is thinking about buying her own place soon but needs to decide about Australia.
Talofa & malo ni! Meet Lupe and Don. Lupe is another of Chris’s older sisters. She is married to Don who is Tokelauan and they both live in Wellington.
They are both in their mid-thirties. Lupe is a lawyer and Don works in IT. Don came over to New Zealand when he was very young. His family migrated almost thirty years ago. His grandparents are still in Tokelau, and he has been several times. They have two children in high school.
Don’s family are all in Wellington where there is a large Tokelauan community. They are active in their community particularly in their church but also in their sporting community where they both still compete in waka ama. They met at touch rugby nationals several years ago when they were both playing touch in their early .
They are conscious of their health and are mindful of what they eat and attend a local CrossFit gym.
Talofa! Meet Zak. He is 17 years old and at high school. He is doing well at school and is thinking about going to university.
He has not got a girlfriend and is aware all his friends are getting girlfriends. In fact, he is feeling confused as he is not sure about his sexuality. He is a prefect at school and while doing well in his studies, he is a little bored with school and is eager to start working and make some money.
He knows his parents want him to be a doctor or a lawyer like his older sisters, but he is not really interested, and those jobs look to hard. Also, none of his close friends at school are talking about university. His mate Siaosi is talking about trialling for an opportunity to go play rugby league professionally in Australia.
Talofa & malo e lelei! Meet Michael (Mikaele) and Lola. Michael is Chris’s uncle, Tala’s brother. He too was born in New Zealand and was named Mikaele at birth after an uncle back in Samoa. However, after many years of navigating school and work in New Zealand he has adopted the english translation of his name.
Michael was made rendundant from his work a couple of years ago and has not worked since. His wife Lola still works but is looking to retire soon. They have six children, two of which are still living at home with them and both work. The other four are living with their own immediate families and all are working.
Although Michael is not working formally, he is a deacon at church and involved in church community activities. He also holds a Matai (Chief) title from his mothers family in Samoa and plays an active role in family and village activities in Samoa.
Meet Teuila and Tomasi. Teuila is Another of Chris’s aunty’s. She is an older sister to Tala and is married to Tomasi who is in his late 50’s.
Tomasi is a Faifeau (Church Minister) and pastors at a Samoan church in a rural community in the South Island where there is a growing Pacific community.
They moved to the South Island five years ago with their 2 youngest children. The older 2 remained in Auckland as they are both at Auckland University.
Pacific peoples are often intricately connected to their family living in the Pacific Islands. Families living in the Pacific Islands can be large and even more connected than what is seen in Aotearoa, New Zealand.
In some Pacific cultures, family living in the Pacific Islands may be decision makers for health issues for family living in Aotearoa, New Zealand. The commitment to families in the Pacific Islands may be financial and impact on the livelihoods of family in Aotearoa.
Penina is Chris’s aunt. Penina came over to New Zealand when she was young and grew up with Tala and her siblings. Her birth mother is Ioane’s sister and she is still alive living in Samoa with the rest of their family.
Penina was sent by her family to attend school in New Zealand in search of better educational and work opportunities. She is married to Iosefa and they live just out of Wellington. They have three children all grown and with their own partners.
Sefo is Chris’s uncle and he too came over from Samoa when he was in his late teens, sent to look for work to help support family back home in Samoa. His father is Sina’s older brother back in Samoa.
When he came over, he lived with Sina and Ioane who helped find him work and then have been his parents while living in New Zealand. He is now married and is living in Timaru with his wife Susan, whom he met at work in Auckland. She is from Timaru and when their work place in Auckland shut down in the eighties she encouraged him to join her in Timaru where they found work and built a life.
He has since supported many more family members from Samoa to come to Timaru to work and is active in the community in sport and church.
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Please return to MedMoodle to complete an activity based on what you have learned so far.
Pacific Virtual Case & the Fonofale Model of Health
With the brief introductions to the various units that make up this Pacific virtual case, reflect on each of the nine components of the Fonofale Model of Health, applying it to the Pacific virtual case to help you identify potential strengths for discussion in your lecture and small group sessions.
We will meet the virtual case in its entirety, and as individual units, over the next few years as we start applying the Fonofale Model of Health in clinical scenarios and as we transition across from ELM to ALM.
What is the
Pacific Virtual Case?
The Pacific virtual case serves as a tool to depict a fictional Pacific family, aiding in understanding the contextual factors influencing how and why Pacific individuals present certain health issues. Rooted in oral traditions, Pacific cultures transmit knowledge through stories, songs, and chants, showcasing shared characteristics among Pacific island ethnicities. This case underscores the strengths and learning opportunities inherent in Pacific cultures, emphasizing the importance of comprehending the context of Pacific patients for future healthcare professionals.
While acknowledging that the virtual case doesn't represent all Pacific families, it mirrors the reality for many disproportionately represented in health statistics, particularly those in high deprivation areas. The core family is central, encompassing extended family members and close friends, reflecting the intergenerational nature of Pacific families in Aotearoa, often multiethnic - more and more young Pacific peoples have connections to more than one Pacific ethnicity including Maori.
Despite negative health statistics presented in Pacific health lectures, the Pacific virtual case urges learners to adopt the Fonofale Model of Health. This model helps identify strengths within Pacific families and communities, aiding in better engagement with Pacific patients. The narrative encourages a pause before interpreting through a Western lens and promotes recognizing Pacific strengths first.
Throughout your learning journey, various elements of the virtual case will be unpacked, gradually filling your "kete/ato" (basket) of knowledge in Pacific health. The real-world encounter with the Pacific case awaits in ALM 4 and the Pacific Immersion program at the Dunedin campus.