Call for health boost to Pacific community from next government

Pacific health professionals in New Zealand are calling on the next government to better empower them to improve health outcomes for the community.

There are promising signs with Pacific immunisation rates the highest in the country and the 22,000 people tested for Covid-19 in South Auckland recently showing the community's commitment to health.

But high rates of non-communicable disease, smoking and chronic conditions continue to stymie progress in improving health statistics. Also, there are high rates of rheumatic fever and people not collecting prescriptions due to cost.

Lee Pearce had spent 11 years away from New Zealand working as director of health for Tokelau and health advisor for Nauru.

After returning recently, she realised that the Pacific community in Aotearoa had been left behind by the health sector.

"Coming back to New Zealand I'm shocked and I haven't been vocal about it but I've said it, our communities have become silent in the shadows, their voices have gone," she said.

"Everything's become siloed and reactive rather than proactive."

Pearce is the director of Pacific services at Porirua-based Pacific Health Plus, one of the new providers established to address Pacific specific health issues and obstacles to accessing primary and hospital level care.

The intensive-care trained nurse is not sure if the problem "is just a hospital issue, or a DHB (District Health Board) issue or a PHO (Primary Health Organisation) issue", but she said government health policy was being written by those who didn't have experience at the coal face with Pacific people, which needed to change.

The Samoan-New Zealander said more Pacific people were needed in all areas of health.

"Be it through the ambulance service, be it through home-help, be it through health-care assistance, be it through nursing, be it through medical school, be it through counselling," she said.

"There are lots of opportunities. It's just, how can the government make those opportunities happen?"

One of the new generation of Pacific health professionals intent on making a difference is Toni Anitele'a, who is one of 20 Pasifika in their final year at Otago Medical School with "one of the biggest Pacific graduating year groups" ever.

"So we've come through the ranks being very aware that there is a deficit of Pacific health workers throughout the country."

Based at the Wellington campus, the soon to be Dr Anitele'a will spend the next two years with the region's four hospitals where she looks forward to serving the community.

"You definitely notice when you walk into a room [and] you've got your Pacific name badge - whether you're Samoan, Tongan, Niuean, Cook Island, whatever you may be, from whichever Pacific country you may be - as soon as you walk into the room and your Pacific patient sees that, it just lights up the room," she said.

That connection breaks down barriers for Pacific people where health is often a culturally tapu topic, said the 23-year-old. When Pacific people see themselves reflected in the health system, added Anitele'a, "it's one step closer to achieving equity" where systemic barriers have existed for years.

However, Pasifika have allies throughout the health sector where she is intent on working with all of them to see and create change.

Like Lee Pearce, Anitele'a would like to see greater Pasifika input into policy setting and creation where she noted Pacific equity often came as an afterthought when putting forward new strategy.

"It's only at maybe the last one or two sign-offs that someone raises their hand and goes 'Hey, has this actually had a Pacific lens over it? Has anyone from a Pacific provider or someone high up in the Pacific community had a look at this new framework?' so that we can make sure it actually relates to our communities and can achieve healthy outcomes."

For the chair of the Pacific chapter of the Royal New Zealand College of General Practitioners, Api Talemaitoga, more empowerment of Pacific health providers is required.

The South Auckland GP said Pasifika respond best to those who were culturally competent and had the most empathy.

"The Pacific community really listens to the voice of people that look like them, speak like them and that they trust."

This is evidenced by the massive community response to Pacific health providers calling on the community to get tested for Covid, said Dr Talemaitoga, who has been involved in the development of a New Zealand network of Pacific health and social providers over the last 20 years.

"They know that these are people who can explain it in their language, who can reassure them with what they're feeling and who will not treat them as if they're just another number."

Pacific providers were key to arresting the poor health of the community, he said.

"But I look forward to a government committing funding into our Pacific providers who will go above and beyond for their people to make a difference."

For Talemaitoga, "health is no longer a transaction" and an improved quality of interraction is what will help move Pacific rates in rheumatic fever, non-communicable diseases and chronic conditions in the right direction.