‘Window’ on Pacific peoples’ health calls for urgent system change
- This media release is available in the following formats:
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- Tongan
- Fijian
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A new report paints a stark picture of the health care challenges faced by Pacific peoples in New Zealand and calls for ambitious changes to the system to be made urgently.
Bula Sautu: A window on quality 2021: Pacific health in the year of COVID-19 was launched today in Parliament by Minister for Pacific Peoples Hon Aupito William Sio. The report is the latest in a series of ‘window’ publications from the Health Quality & Safety Commission (the Commission). It considers the health of Pacific peoples and provides a snapshot view of how the health system is working (or not working) for them.
The report is the product of a partnership and co-development process between the Commission and Drs Corina Grey, Api Talemaitoga, and Debbie Ryan. It includes contributions from many Pacific health and community leaders, clinicians and health workers. The Commission convened a consumer advisory group comprised of Pacific consumers on 27 May 2021 to respond to the findings of Bula Sautu. This group has developed a set of practical recommendations to further advance the report’s findings.
Bula Sautu highlights some of the worst health care inequities in New Zealand affecting Pacific peoples and the lack of discussion of these inequities in the ongoing health system reforms. The report also profiles providers, communities and individuals responding creatively and effectively within the constraints imposed upon them. This was particularly evident during the COVID-19 response, when innovation flourished.
Associate Professor of Public Health Collin Tukuitonga, Associate Dean Pacific at the University of Auckland and a Commission board member, says Pacific peoples who call Aotearoa New Zealand home have been denied their right to health and wellbeing for decades despite clear evidence that inequities exist in almost all health conditions reported.
‘Pacific peoples are expected to navigate through a health system that has not been designed with or for them. Many have to effectively look after themselves, as it is impossible for them to overcome the many barriers to accessing health care. These shortcomings reflect systematic bias and racism in the New Zealand health and disability system and the lack of diversity in the health workforce.
‘We need a health system that enables Pacific peoples to identify and design Pacific solutions. Leaders and decision-makers in our training establishments and professions must take decisive action to support and grow the Pacific workforce required at all levels of the system. And we need to turn around the unacceptable racism of our system; it drives inequitable health care processes and outcomes, and is enabled by the structure of the system.’
Dr Corina Grey, Pacific Health Data and Insights Lead at Auckland District Health Board, and co-author of the report, says within the health sector there are a number of key actions organisations and individual services can take, many of them within existing resources. These actions are presented in the report as a framework to improve Pacific health.
‘These key actions focus on knowing the data; delivering holistic and integrated care; improving access to health services; respectful and authentic engagement with Pacific consumers and communities; simple, clear communication; and support of the Pacific workforce,’ she says.
'The strengths of Pacific providers and communities were highlighted during the response to COVID-19. Pacific health and social service providers worked together with church and other community leaders to rapidly set up testing services, tailor support for contact tracing, and deliver food packages and masks to communities, working collaboratively with community leaders and other agencies to provide holistic and integrated models of care.’
Dr Api Talemaitoga, a general practitioner, chair of the Pacific General Practitioners’ Network and co-author of the report, says initiatives such as this show change is possible.
‘However, improvements in Pacific health and a reduction in health inequities will not happen without an ambitious change and transformation agenda.
‘A strategy based on “business as usual” will not give us the change required.’
Pacific innovation
Below are snapshots of other innovative approaches showcased in this report.
Dr Maryann Heather – GP, South Seas Healthcare, Otara, Auckland; senior lecturer Pacific health, School of Population Health, University of Auckland
‘In terms of our high rates of immunisations for children, I give credit to our practice nurses because they’re the ones that make sure that all our kids get the immunisations. They do the recalls. They’ll call, they’ll send people around. That comes down to relationships. Our parents and our grandparents know the benefit of vaccinations. Often, a lot of the time when we ask them, we tell them why it’s important, and they really listen.’
Sinia Saafi, community health worker, Alliance Health Plus Primary Health Organisation
‘The key for me was working through the churches. You need that time for the health worker to go in there and work with the community from the inside out. People are hungry for personal connection, because the personal connection with a health worker gives them confidence.’
Dr Api Talemaitoga, GP, chair of the Pacific General Practitioners’ Network
‘Rates of vaccination for human papillomavirus (HPV) in Pacific peoples improved when the Ministry of Health and the Health Promotion Agency worked to ensure the messages were culturally appropriate.
‘A campaign tailored for Pacific peoples was developed with pictures of Pacific families. The message was reframed from appealing to the individual teenager to one about future protection and health of Pacific families.
“Messages were delivered in Samoan, Tongan and Fijian languages. Immunisation messaging focused on families worked.’
Manogi Eiao, pre-dialysis nurse specialist, renal services, Counties Manukau DHB
‘Money is a big problem. That’s what holds a lot of people back – they have no time off work, or they don’t have any sick leave. They need to go to work to get that money, to pay the bills, to feed the family and they “neglect” their health. They “neglect” their appointments.
‘We’re open 8:00am to 4:30pm, but if I recognise a family is struggling, I’ll go out and do a home visit at 6:00pm.
‘Our nurse practitioner does Saturday clinics. She’ll see a lot of patients who can’t make it during the week. It’s trying to work with our patients and fit in with their lives.’
Examples of inequities facing Pacific peoples
- Pacific peoples live, on average, six fewer years than non-Māori non-Pacific.
- Less than half (47 percent) of pregnant Pacific women were registered with a lead maternity carer (LMC) in 2018, compared with 81 percent of non-Māori, non-Pacific women.
- Pacific women subsequently experience more complications during pregnancy, more intensive interventions during and after birth, and worse outcomes for both mother and baby than other ethnicities.
- Only 59 percent of Pacific families of infants in their first year of life received all their Well Child/Tamariki Ora core contacts, compared with 81 percent of non-Māori, non-Pacific families.
- Pacific children subsequently experience a higher incidence of a range of conditions, including asthma, dental problems, and ear and skin infections, than children from other ethnic groups. Only 36 percent of five-year-old Pacific children are free of caries (tooth decay) compared with 69 percent of non-Māori, non-Pacific children.
- There is a lack of national data on the health of Pacific youth but survey data suggests rising rates of depressive symptoms and attempted suicide in Pacific youth, and barriers to accessing health care.
- For Pacific peoples some aspects of preventative health care, like flu immunisations, seem to perform well, but Pacific peoples bear a disproportionate burden of long-term conditions including gout, cardiovascular disease, kidney disease, cancer and asthma, and, in particular, diabetes. Those with diabetes experience a trifecta of issues:
- earlier onset leading to earlier and worse complications
- inadequate management and control of diabetes
- worse hospitalisation rates relative to other ethnic groups.
- Pacific peoples are significantly under-represented across the entire health workforce.
Ua faailoa mai e se lipoti fou tulaga faaletonu e tusa ma luitau tau soifua maloloina o loo feagai ma tagata Pasifika i totonu o Niu Sila ma ua faaalia ai e tagata le moomia ona faatino loa o suiga tetele i le faiga faavae.
Bula Sautu: A window on quality 2021: Pacific health in the year of COVID-19 o le lipoti lea na faalauiloa ananei i le Palemene e le Minisita o le Pacific Peoples, Afioga Aupito William Sio. O lenei lipoti o se tasi o galuega tele lata mai nei i 'avanoa' ua faasalalauina e le Health Quality & Safety Commission (le Commission). O loo faamamafa i le lipoti tulaga tau soifua maloloina o tagata Pasifika ma saunia se vaaiga i tulaga o loo aogā (pe le o aogā) ai le faiga faavae tau soifua maloloina mo i latou nei.
O lenei lipoti o se taumafaiga faapaaga ma tusia faatasi e le Commission ma Drs Corina Grey, Api Talemaitoga, ma Debbie Ryan. O loo aofia ai finagalo ma manatu o le toatele o taitai Pasifika i le soifua maloloina ma taitai o afioaga, fomai ma aufaigaluega a le soifua maloloina. Na faafoe e le Commission se fonotaga a le komiti faufautua e aofia ai tagata Pasifika o loo faaaogāina auaunaga i le aso 27 Me 2021 e auiliili se tali atu i iuga na maua mai i le lipoti na tuufaatasia e Bula Sautu. Na saunia e le komiti lenei fautuaga talafeagai e mafai ai ona laasia le isi vaega o iuga o loo ta'ua i le lipoti.
Na faamamafa e Bula Sautu nisi o faiga e lē tutusa ma lē sa'o ua matuai sili atu ona faaletonu i totonu o Niu Sila o loo afaina ai tagata Pasifika atoa ai ma le lē faatalanoaina o nei faiga lē tutusa ma lē sa'o i polokalame o loo faaauau pea ona toefuatai ai le faiga faavae tau soifua maloloina. O loo faamatala manino foi i le lipoti auaunaga, afioaga ma tagata taitoatasi o loo lelei le tali atu i manaoga e ui i tulaga o loo faalavelavea ai le faatinoga o a latou galuega faatino. Na molimauina lava le tulaga lea i le vaitaimi o le faatinoga o galuega e tali atu ai i le COVID-19, na faamanuiaina ai le tele oatinae ma faiga fou.
Na saunoa le Associate Professor a le Public Health Collin Tukuitonga, Associate Dean Pacific i le Iunivesite o Aukilani ma o le sui a le komiti faatonu a le Commission, o tagata Pasifika o faaigoaina Aotearoa Niu Sila o lo latou aiga o tagata nei ua savalia le fia sefulu tausaga o faafitia lo latou aiatatau i tulaga tau soifua maloloina ma le soifua manuia, e ui i faamaoniga o loo aliae faiga e lē tutusa ma lē sa'o i le tele o vaega uma tau soifua maloloina na lipotia.
‘E iai le manatu e mafai e tagata Pasifika ona faaaogā le faiga faavae tau soifua maloloina lenei e ui lava na faavae e aunoa ma so latou sao pe lei faavaeina foi mo i latou. O le toatele o i latou nei o loo faatino le tausiga mo i latou lava, talu ai e lē o faigofie ona latou sopoia le tele o luitau e maua ai tausiga tau soifua maloloina. O faaletonu nei o loo atagia mai ai faiga faaituau ma le faailogalanu ua masani ai le faiga faavae tau soifua maloloina ma auaunaga mo i latou e lē atoatoa le malosi o le tino ma le mafaufau i totonu o Niu Sila, atoa ai ma le lē lava o ituaiga tagata faigaluega eseese a le soifua maloloina.
‘Tatou te moomia se faiga faavae tau soifua maloloina e mafai ai e tagata Pasifika ona iloa ma faavae faiga Faa-Pasifika e tali atu ai. E tatau i taitai ma ē faia faaiuga i totonu o matātā o loo a'oa'o ai tomai ma galuega ona faatino ma le mautinoa faiga e lagolagoina ma faatuputeleina ai tagata faigaluega Pasifika o loo moomia i totonu o vaega uma o le faiga faavae. Ma e moomia ona tatou fuli atoa faiga faailogalanu o loo aliali i totonu o la tatou faiga faavae; ua mafua ai ona aliae faiga lē tutusa ma lē sa'o i tausiga tau soifua maloloina ma taunuuga, ma ua faateteleina e le auivi o le faiga faavae.'
Na saunoa Dr Corina Grey, Pacific Health Data and Insights Lead i le Auckland District Health Board, ma o se tasi o tusitala o le lipoti, e tele galuega faatino autu i totonu o le matātā tau soifua maloloina e mafai e faalapotopotoga ma auaunaga taitoatasi ona latou faatinoa, ma o le tele o nei galuega faatino e mafai lava ona faatino i punaoa o loo iai i le taimi nei. O galuega faatino nei o loo folasia i totonu o le lipoti o se auivi e faaleleia ai le soifua maloloina o tagata Pasifika.
Na ta'ua e Dr Grey ‘o loo faamamafa i galuega faatino autu nei le malamalama i faamaumauga; faataunuuina o tausiga atoatoa toe fesootai; faaleleia o auala e maua ai auaunaga tau soifua maloloina; fesootaiga talafeagai ma e moni ma tagata Pasifika o loo faaaogāina auaunaga ma afioaga; fesootaiga faigofie ma manino; ma lagolagosua mo tagata faigaluega Pasifika.
'Na iloga lelei malosiaga o auaunaga mo tagata Pasifika i le vaitaimi na faatino ai galuega e tali atu ai i le COVID-19. Na galulue faatasi auaunaga tau soifua maloloina mo tagata Pasifika ma auaunaga tau agafesootai faatasi ma ekalesia ma taitai o afioaga ia vave ona faatino nofoaga e fai ai siaki, faamaoti lagolagosua e iloa ai fesootaiga vavalalata, ma faataunuu le tuuina atu o pusa meaai ma ufi fofoga i afioaga, galulue soosoo tauau ma taitai o afioaga ma isi faalapotopotoga e saunia tausiga e atoatoa ma fesootai.'
Saunoa se tasi o fomai Dr Api Talemaitoga, o le taitaifono foi lea a le Pacific General Practitioners’ Network ma o se tasi foi o tusitala o le lipoti, o taumafaiga nei ua iloa ai e mafai ona faia suiga.
‘Peitai, e lē mafai ona tupu suiga lelei i le soifua maloloina o tagata Pasifika ma tuuitiitia faiga lē tutusa ma le lē sa'o i tulaga tau soifua maloloina e aunoa ma ni suiga tetele ma suiga i mataupu o loo tuliloaina.
‘O le iai o se taiala faataatia e fua i “tulaga masani” o se faiga lea tatou te lē maua ai le suiga o moomia.’
Faiga fou Faa-Pasifika
O nisi nei o fausaga fou o loo folasia i totonu o le lipoti lenei.
Dr Maryann Heather – GP, South Seas Healthcare, Otara, Auckland; faiaoga sinia Pacific health, School of Population Health, University of Auckland
‘E tusa ai ma le maualuga o le faitau o tatou tamaiti ua fai tuipuipui, ou te fia faailoa le sao a tausimai auā o i latou nei o loo taumafai ia fai tuipuipui uma a tatou fanau. Latou te toe faamanatu. E faafesootai, ma asiasi i aiga. Ona o le lelei o sootaga ma tagata. Ua lau silafia e o tatou mātua ma tuaa le aogā o tuipuipui. O le tele o taimi, pe a matou talosagaina tagata, matou te faailoa i ai le tāua o le tuipuipui, ma latou taliaina fautuaga.’
Sinia Saafi, galue mo le soifua maloloina o tagata lautele, Alliance Health Plus Primary Health Organisation
‘O le faiga sili i la'u galuega e auala atu lea i ekalesia. E moomia le avanoa e mafai ai e se tagata faigaluega a le soifua maloloina ona faatino sa'o galuega i nofoaga e maua ai tagata. E fia maua e tagata fesootaiga mafana, auā e mafai e fesootaiga mafana ma le tagata faigaluega a le soifua maloloina ona maua ai le talitonuga ia te ia lava.’
Dr Api Talemaitoga, GP, taitaifono o le Pacific General Practitioners’ Network
‘Ua siitia le faitau o tagata Pasifika ua faia tuipuipui o le human papillomavirus (HPV) i le vaitaimi na galulue faatasi ai le Matagaluega o Soifua Maloloina ma le Health Promotion Agency e faamautinoa o loo talafeagai feau o loo faailoa i tagata.
‘Na saunia se polokalame faalauiloa e patino lava mo tagata Pasifika ma o loo faalauiloa ai ma ata o aiga Pasifika. Na suia le feau mai le taumafai e faatosina mai tupulaga talavou taitasi i se faiga o loo faatatau i le puipuiga ma le soifua maloloina o aiga Pasifika.
“Na faataunuuina feau i gagana Samoa, Toga ma Fiti. Na aogā le faiga na patino ai feau i tuipuipui mo aiga.’
Manogi Eiao, tausimai faapitoa pre-dialysis, renal services, Counties Manukau DHB
‘O le faafitauli tele lava o le seleni. O se itu lea e taotaomia ai le toatele o tagata – e leai se avanoa e malolo ai mai galuega, po o le leai foi o ni aso ma'i. E moomia e tagata le faigaluega e maua ai le tupe, e totogi ai pili, fafaga ai le aiga ma "faatalalē" ai lava i lo latou soifua maloloina. E “faatalalē” e vaai le fomai.
‘E tatala a matou auaunaga mai le 8:00 i le taeao e oo i le 4:30 i le afiafi, ae a iai se aiga ou te iloa o loo i se tulaga faigata, ona ou alu lea vaai i le fale i le 6 i le afiafi.
‘O Aso Toonai e tatala ai auaunaga tau soifua maloloina e vaai e le tausimai. O le avanoa lea e vaai ai tagata e lē mafai ona saili se fesoasoani i aso o le vaiaso. O taumafaiga lava ia fetaui ma tagata ma a latou fuafuaga.’
Faataitaiga o faiga e lē tutusa ma lē sa'o o loo feagai ma tagata Pasifika
- I se fua faatatau, e ono tausaga e itiiti ai le umi e soifua ai tagata Pasifika faatusa i tagata e lē o ni Māori poo Pasifika.
- E itiiti ifo ma le 'afa (47 pasene) o tamaitai Pasifika ua ma'itaga na lesitala e avea ma lead maternity carer (LMC) i le 2018, e faatusatusa i le 81 pasene o tamaitai e lē o ni Māori, poo Pasifika.
- E tele atu faaletonu e feagai ma tamaitai Pasifika i le vaitaimi o ma'itaga ai, ma e sili atu ona moomia le tele o le fesoasoani i le vaitaimi o ma'itaga ai ma le taimi ua fanau ai, ma e sili atu ona faaletonu taunuuga mo le tina ma le pepe faatusa i isi ituaiga tagata.
- Na o le 59 pasene o aiga Pasifika o pepe na maua uma fesootaiga autu i le tausaga muamua mai le Well Child/Tamariki Ora, faatusa i le 81 pasene o i latou e lē o ni Māori, poo aiga Pasifika.
- E tele isi faaletonu o feagai ma tamaiti Pasifika, e aofia ai le ma'i sela, leaga o nifo, ma'i o taliga ma pa'u o le tino, faatusa i tamaiti e tupuga mai isi ituaiga tagata. Na o le 36 pasene o tamaiti Pasifika ua lima tausaga e leai ma ni faaletonu i nifo (nifo mama'i) faatusa i le 69 pasene o tamaiti e lē o ni Māori poo tamaiti Pasifika.
- E lē o atoatoa foi faamaumauga aoao i le soifua maloloina o tupulaga Pasifika ae o loo faailoa mai faamaumauga i suesuega na fai le faatuputupulaia o āuga i tulaga o mafatia ai ma le taumafai o tupulaga Pasifika e pule i ola, ma tulaga o loo taotaomia ai le maua o tausiga tau soifua maloloina.
- E iai tulaga o loo aogā mo tagata Pasifika e foia ai le maua i faama'i, e pei o le faia o tuipuipui o le fulū, ae e sili atu ona maualuga ma umi le feagai ai o tagata Pasifika ma faaletonu e aofia ai faama'i o le gugu, faama'i o le fatu, faama'i o le fatugao, kanesa ma le ma'i sela, aemaise lava le ma'i suka. E tolu lava faaletonu o loo feagai ma tagata ua maua i le ma'i suka:
- vave ona maua i le faama'i ma faateteleina aafiaga e maua ai
- e lē o atoatoa faiga e tausi ma pulea ai le ma'i suka
- sili atu ona maualuga le toatele o tagata ua faataotolia i le falemai faatusa i isi ituaiga tagata.
- E matuā lē lava le toatele o tagata Pasifika o loo galulue i galuega i le faiga faavae atoa tau le soifua maloloina.
Kuo 'omi 'e ha lipooti fo'ou ha fakatātā 'ao'aofia fekau'aki mo e ngaahi pole 'oku fehangahangai mo hono tokangaekina 'o e tu'unga mo'ui lelei 'a e kakai Pasifikí 'i Nu'u Silá pea ne kalanga ai ke fakahoko ha liliu lahi fakavavevave ki he sisitemí.
Bula Sautu: Ko ha vakai (window) ki he tu'unga leleí 2021: Tu'unga 'o e mo'ui lelei 'a e Pasifikí 'i he ta'u 'o e COVID-19 na'e tuku atu ia 'i he 'aho ni 'i Fale Alea 'e he Ministā ki he Kakai Pasifikí Hon Aupito William Sio. Ko e lipootí ko e fakamuimui taha ia 'i he ngaahi fakatotolo 'vakai' kuo pulusi meí he Health Quality & Safety Commission (Komisoni ki he Tu'unga Lelei & Malu 'a e Mo'ui Leleí - ko e Komisoní). 'Okú ne vakai'i 'a e tu'unga 'o e mo'ui lelei 'a e kakai Pasifikí pea mo e founga 'oku ngāue (pe 'ikai ngāue) ai 'a e sisitemi ki he mo'ui leleí kiate kinautolú.
Ko e lipootí ko e ola ia 'o ha hoangāue mo e founga fokotu'u'u fakataha na'e fakahoko 'i he vaha'a 'o e Komisoní mo e kau Toketā ko Corina Grey, Api Talemaitoga, mo Debbie Ryan. 'Oku kau ki ai 'a e ngaahi tānaki meí he tokolahi 'o e kau taki Pasifiki 'i he tu'unga mo'ui lelei mo e komiunitií, kau toketā mo e kau ngāue Pasifiki ki he mo'ui leleí. Na'e fokotu'u 'e he Komisoní ha kulupu fale'i ki hono faka'aonga'i 'o e ngaahi sēvesí meí he kakai Pasifiki 'oku nau faka'aonga'i 'a e ngaahi sēvesí 'i he 'aho 27 'o Meé 2021 ke nau fakahoko ha tali ki he ngaahi ola 'o e fekumi 'a e Bula Sautu. Kuo fokotu'u 'e he kulupú ni ha ngaahi fakakaukau 'e ala fakahoko faingofua ke fakaloloto 'aki 'a e ngaahi ola meí he fekumi 'a e lipootí.
'Oku hulu'i mahino 'e he Bula Sautu 'a e ni'ihi 'o e ngaahi tō nounou kovi taha 'i he vahevahe taaú fekau'aki mo hono tokangaekina 'o e mo'ui leleí 'i Nu'u Silá 'okú ne uesia ai 'a e kakai Pasifikí pea mo e si'isi'i hono tālanga'i 'o e ngaahi tō nounou ko 'eni 'i he vahevahe taaú 'i he ngaahi fakalelei ko ia 'oku lolotonga fakahoko ki he sisitemi mo'ui leleí. 'Oku toe fakahā foki 'i he lipootí 'a e ngaahi kautaha fakahoko ngāue, ngaahi komiunitī mo e ni'ihi fakafo'ituitui kuo nau fakahoko ha ngaahi ngāue mohu founga mo ola lelei 'i he funga 'o e ngaahi fakangatangata 'oku hilifaki atu kiate kinautolú. Na'e hā mahino eni lolotonga 'o e ngāue ki hono fakafepaki'i 'o e COVID-19 'a ia na'e mapuna hake ai 'a e ngaahi 'ilo mo e founga fo'ou.
'Oku pehē 'e Colin Tukuitonga ko e Tokoni Palōfesa 'o e Mo'ui Lelei 'a e Kakaí (Associate Professor of Public Health), Tokoni Pule 'i he Va'a Pasifiki 'o e 'Univēsiti 'o 'Okalaní (Associate Dean Pacific at the University of Auckland) mo ha mēmipa poate 'o e Komisoní, kuo tāpalasia 'a e totonu 'a e kakai Pasifiki kuo nau ui 'a 'Aotearoa Nu'u Sila ko honau 'apí ke nau a'usia 'a e tu'unga mo'ui leleí mo e mo'ui ola leleí 'i ha laui ta'u lahi neongo hono fakamo'oni'i mahino 'a e tō nounou 'i he vahevahe taaú 'i he meimei tu'unga kotoa 'o e mo'ui leleí 'oku lipootí.
"'Oku 'amanaki atu ki he kakai Pasifikí ke nau ngāue'aki ha sisitemi ki he mo'ui leleí na'e 'ikai ke kaungā-fa'u fakataha mo kinautolu pe fa'u ma'a kinautolu. Kuo pau ai ke meimei tokangaʻi lelei ʻe ha tokolahi 'a kinautolu pē, he ʻoku ʻikai malava ke nau ikunaʻi ʻa e ngaahi ʻā vahevahe lahi ki hono ma'u atu 'o e tokangaekina 'o e moʻui leleí. 'Oku ho'ata mai meí he ngaahi tō nounou ko 'ení 'a e filifilimānako mo e laulanu kuo takaloto 'i he sisitemi 'a Nu'u Sila ki hono tokangaekina 'o e mo'ui leleí mo e faingata'a'ia fakaesinó pea mo e 'ikai potupotu tatau hono fakafofonga'i 'o e tu'unga kehekehe 'o e kakaí 'i he kau ngāue ki he mo'ui leleí.
'Oku tau fiema'u ha sisitemi ki he mo'ui leleí 'okú ne fakaivia 'a e kakai Pasifikí ke nau 'omai mo fa'u ha ngaahi tali 'oku tuha mo e kakai Pasifikí. Kuo pau ke fai ʻe he kau takí mo e ni'ihi faituʻutuʻuni ʻi heʻetau ngaahi kautaha fakaakó mo e ngāué ha ngāue fakapatonu ke poupouʻi mo fakatupulaki ʻa e kau ngāue Pasifikí 'a ē ʻoku fiemaʻu ʻi he ngaahi tuʻunga hono kotoa 'o e sisitemí. Pea ʻoku fiemaʻu ke tau fulihi ʻa e laulanu ta'efiema'ua 'i he'etau sisitemí; ʻokú ne teke 'a e fakapalataha 'i he ngaahi founga mo e ola meí hono tokangaekina 'o e mo'ui leleí, 'a ia 'oku fakaivia 'e he fa'unga 'o e sisitemí."
ʻOku pehe ʻe Dr Corina Grey, ko e Taki 'i he Va'a Fakamatala mo e 'Ilo Lolotó ki he Mo'ui Lelei 'a e Pasifikí 'i he Poate Fakavahe 'a 'Okalani ki he Mo'ui Leleí, mo e tokotaha na'e kau atu ki hono faʻu ʻo e lipootí, ʻoku ʻi ai ha ngaahi ngāue tefito 'e ala fakahoko 'e he ngaahi kautahá mo kinautolu 'oku nau fakahoko sēvesi fakafo'ituitui 'i loto 'i he sekitoa ki he mo'ui leleí, pea ko e lahi 'o kinautolu 'oku tō loto pē 'i he nāunau 'oku lolotonga ma'ú. 'Oku 'oatu 'a e ngaahi ngāué ni 'i he lipootí ke ne faka'esia hono fakalelei'i 'o e tu'unga mo'ui lelei 'a e kakai Pasifikí.
'ʻOku fakamama'u ʻa e ngaahi ngāue mahuʻinga ko ʻení ʻi hono ʻiloʻi ʻo e fakamatalá; tuku atu ʻo ha founga tauhi 'oku kānokato mo fakalūkufua (holistic and integrated); fakalelei'i hono ma'u atu 'o e ngaahi sēvesi ki he mo'ui leleí; fakafehokotaki mo e komiunitī Pasifikí pehē kiate kinautolu 'oku nau faka'aonga'i 'a e sēvesí 'i ha founga fakaʻapaʻapa mo mo'oni; founga fetuʻutaki faingofua mo mahino; mo ma'u 'a e poupou 'a e kau ngāue Pasifikí', 'a 'ene laú.
ʻKo e ngaahi mālohinga ʻo e ngaahi kautaha fakahoko ngāue mo e komiunitī Pasifikí na'e hā mahino ia lolotonga 'o e ngāue ki hono fakafepaki'i 'o e COVID-19. Naʻe ngāue fakataha ʻa e ngaahi kautaha fakahoko ngāue ki he moʻui leleí mo e tu'unga fakasōsiale Pasifikí mo e ngaahi siasí mo e kau taki kehe ʻo e komiunitií ke fokotuʻu fakavavevave ʻa e ngaahi fai'anga sivi, fakapatonu 'a e tokoní ki hono muimui'i 'o e fetu'utaki mo kinautolu na'e feohi vā ofí, mo fetuku atu 'a e me'atokoni mo e ngaahi me'a 'ufi'ufi ki he matá ki he ngaahi komiunitií, ngāue fakataha mo e kau taki 'i he komiunitií mo e ngaahi potungāue kehé ki hono tuku atu 'o ha founga tauhi 'oku kānokato mo fakalūkufua.'
'Oku pehē 'e Dr Api Talemaitoga, ko ha toketā fakafāmili, sea 'o e Netiueka 'a e kau Toketā Fakafāmili Pasifikí mo kau atu ki hono fa'u 'oe lipootí, 'oku fakae'a mai 'i he ngaahi ngāué ni 'oku malava ke fakahoko 'a e liliú.
‘Neongo ení, 'e 'ikai malava ke hoko 'a e ngaahi fakalelei ki he tu'unga 'o e mo'ui lelei 'a e kakai Pasifikí mo holoki 'a e tō nounou 'i he vahevahe taau 'i he tu'unga 'o e mo'ui leleí kae'oua kuo fakakau ki ai ha 'asenita ki ha liliu mo ha fakalelei ma'ongo'onga.
'E ʻikai ʻomi ʻe ha founga ia ʻoku fakatefito ʻi he "ngāue angamahení" ʻa e liliu ʻoku fiemaʻú.'
'Ilo fo'ou 'a e Pasifikí
ʻOku ʻoatu ʻi lalo hano fakamā'opo'opo 'o ha ngaahi founga fo'ou 'oku fakaʻaliʻali atu ʻi he lipooti ko ʻení.
Dr Maryann Heather – GP, South Seas Healthcare, Otara, 'Okalani; faiako mā'olunga 'i he tu'unga 'o e mo'ui lelei 'a e kakai Pasifikí, Ako'anga ki he Mo'ui lelei 'a e Kakaí, 'Univēsiti 'o 'Okalaní
ʻFekau'aki mo tu'unga mā'olunga 'oku 'i ai 'etau ngaahi huhu malu'i ki he fānaú, ʻoku ou fakamālō'ia'i ai 'etau kau neesi hokó he ko kinautolu ʻoku nau fakapapauʻi ʻoku maʻu atu ʻe heʻetau fānaú kotoa ʻa e ngaahi huhu maluí. 'Oku nau fakahoko hono toe ui mai kinautolú. Te nau telefoni, te nau fekauʻi ha kakai ke nau takai atu. 'Oku makatu'unga eni 'i he tu'unga 'o e tauhi vaá. ʻOku ʻiloʻi ʻe heʻetau mātuʻá mo ʻetau ngaahi kuí ʻa e lelei ʻo e ngaahi huhu maluʻí. 'I he taimi lahi, 'i he taimi ʻoku mau kole ange ai kiate kinautolú, ʻoku mau talaange 'a e ʻuhinga ʻoku mahuʻinga aí, pea nau fakafanongo fakamātoato.'
Sinia Saafi, tokotaha ngāue ki he mo'ui leleí 'i he komiunitií, Alliance Health Plus Primary Health Organisation
ʻKo e kií kiate au, 'a e ngāue 'o fou atu ʻi he ngaahi siasí. 'Oku fiema'u ha taimi ki he tokotaha ngāue ki he mo'ui leleí ke 'alu ki ai 'o ngāue mo e komiunitií mei loto ki tu'a. ʻOku fiema'ua 'e he kakaí 'a e fehokotaki fakafo'ituituí, he ʻoku ʻoange ʻe he fehokotaki fakafo'ituitui mo ha tokotaha ngāue ki he moʻui leleí kiate kinautolu ha ongo'i malu.'
Dr Api Talemaitoga, GP, sea 'o e Netiueka o e kau Toketā Fakafāmili Pasifikí
ʻNaʻe lelei ange 'a e tu'unga 'o e tokolahi ʻo e huhu maluʻi human papillomavirus (HPV) ʻi he kakai Pasifiki ʻi he taimi naʻe ngāue ai ʻa e Ministry of Health mo e Health Promotion Agency ke fakapapauʻi 'oku fenāpasi 'a e ngaahi fekau 'oku tu'uaki atú mo e 'ulungaanga fakafonuá.
ʻNaʻe faʻufaʻu ai ha polokalama faka'ai'ai ma'á e kakai Pasifikí 'aki hano fakakau ki ai ha ngaahi 'īmisi 'o ha ngaahi fāmili Pasifiki. Na'e fulihi ai 'a e kaveinga 'o e fekaú 'a ia na'e fakataumu'a ki he to'utupú fakafo'ituitui 'o fakafekau'aki mo e ‘malu mo hao 'i he kaha'ú mo e mo'ui lelei 'a e ngaahi fāmili Pasifikí.
"Naʻe tu'uaki atu ai 'a e ngaahi fekaú ʻi he ngaahi lea faka-Haʻamoá, faka-Tongá mo e faka-Fisí. Na'e ola lelei 'a e ngaahi fekau fekau'aki mo e huhu malu'í 'a ia na'e tu'uaki atu 'o fakakaveinga 'aki 'a e ngaahi fāmilí.’
Manogi Eiao, neesi mataotao ki he teuteu 'o e taialasisí, ngaahi sēvesi ki he kofuuá, DHB Counties Manukau
ʻ'Oku hoko 'a e paʻangá ko ha palopalema lahi. 'Okú ne uesia ai ha kakai tokolahi – 'oku 'ikai ke 'i ai ha taimi ke nau nofo ai meí he ngāué, pe 'oku 'ikai ke 'i ai ha'anau ngaahi 'aho 'oku fakangofua ke nau nofo ai meí he ngāué kapau 'oku nau puke. 'Oku fiemaʻu ke nau ngāue ke maʻu ha paʻanga, ke totongi e ngaahi mo'uá, fafanga e fāmilí pea nau "taʻetokanga'i" ai 'enau moʻui leleí. ʻOku nau "tukunoa'i" ʻenau ngaahi ʻapoinimení.
ʻʻOku mau kamata ngāue 'i he 8:00 pongipingi ki he 4:30 efiafi, ka ʻo kapau te u fakatokanga'i ha fāmili ʻoku faingataʻaʻia, te u ʻaʻahi leva ki honau 'apí ʻi he 6:00 efiafi.
ʻʻOku fakahoko ʻe heʻemau neesi hokó ʻa e kiliniki ʻi he ngaahi ʻaho Tokonakí. 'E sio ai ki ha kau mahaki tokolahi na'e ʻikai ke nau lava ange 'i he lolotonga 'o e uiké. Ko e feingá ke ngāue fakataha mo ʻemau kau mahakí 'i ha founga 'oku tuha mo ʻenau moʻuí.'
Ngaahi fakatātā ʻo e ngaahi tō nounou 'i he vahevahe taaú ʻoku fehangahangai mo e kakai Pasifikí
- Ko e lōloa 'o e moʻui ʻa e kakai Pasifikí, ʻoku nounou 'aki ia 'a e ʻavalisi ko e taʻu ʻe ono ʻi hono fakahoa ki he kakai 'oku ʻikai ko ha Mauli pe Pasifikí.
- 'Oku si'isi'i hifo 'i he vaeua (pēseti 'e 47) 'o e kakai fefine Pasifiki 'oku feitamá 'oku lēsisita mo ha mā'uli takimu'a (lead maternity carer - LMC) 'i he 2018, fakahoa atu ki he pēseti 'e 81 ki he kakai fefine 'oku 'ikai ko ha Mauli, pe Pasifikí.
- 'Oku aʻusia ai ʻe he kakai fefine Pasifikí ha ola 'oku palopalema'ia lahi ange lolotonga 'enau feitamá, 'o fiema'u ai ha ngaahi faito'o lahi ange ʻi he lolotonga mo e hili 'a e fā'elé, pea ola kovi ange mo e tu'unga 'oku 'i ai 'a e faʻeé mo e pēpeé ʻi hono fakahoa ki he ngaahi matakali kehé.
- Ko e pēseti pē 'e 59 'o e ngaahi fāmili Pasifiki 'oku 'i ai 'enau fānau iiki 'oku nau ma'u atu 'a e ngaahi tokoni Well Child/Tamariki Ora, 'i hono fakahoa atu ki he pēseti 'e 81 'o e ngaahi fāmili 'oku 'ikai ko ha Mauli pe Pasifikí.
- 'Oku iku ai ke aʻusia ʻe he fānau Pasifikí ha ngaahi palopalema kehekehe lahi ange, kau ai ʻa e mahaki hela, ngaahi palopalema fakaenifo, mo e mahaki'ia 'o e telingá mo e kilí, ʻi hono fakahoa atu ki he fānau mei he ngaahi matakali kehé. Ko e peseti pē ʻe 36 ʻo e fānau Pasifiki taʻu nimá ʻoku hao meí he nifo koví ('au'aunga 'a e nifó) ʻi hono fakahoa atu ki he peseti ʻe 69 ʻo e fānau ʻoku ʻikai ko ha Mauli, pe Pasifikí.
- ʻOku siʻisiʻi ʻa e fakamatala fakafonua ki he moʻui lelei ʻa e toʻutupu Pasifikí ka koe fakafuofua 'oku ma'u mei hono savea'i 'o e fakamatalá 'oku fakautuutu ange 'a e ngaahi fakaʻilonga 'o e mahaki'ia fakae'atamaí mo e feinga taonakita ʻi he toʻutupu Pasifikí, mo e ngaahi ʻā vahevahe ki hono maʻu atu 'o e tokangaekina 'o e moʻui leleí.
- Ki he kakai Pasifikí ʻoku ʻi ai ha ngaahi tafaʻaki ʻo e moʻui faka'ehi'ehi ki he mo'ui leleí, hangē ko e huhu malu'i fuluú, ʻoku hā ngali lelei, ka ʻoku uesia lahi ange 'a e kakai Pasifikí 'e he ngaahi mahaki tauhi kau ai ʻa e kauti, mahaki mafu, mahaki'ia 'o e kofuuá, kanisā mo e mahaki hela, kae tautautefito ki he mahaki suká. ʻOku aʻusia ʻe kinautolu ʻoku mo'ua 'i he mahaki suká ha ngaahi palopalema 'oku matatolu:
- kamata vave ange 'o iku ai ke a'usia vave ange 'a e ngaahi nunu'a kovi ange hono ngaahi faingata'a'iá
- ʻikai feʻunga hono tokanga'i mo hono mapuleʻi ʻo e mahaki suká
- kovi ange 'a e tu'unga 'o e nofo falemahakí 'i hono fakahoa atu ki he ngaahi matakali kehé.
- ʻOku mātu'aki tokosi'i 'aupito 'a e kakai Pasifiki ʻi he tokolahi fakakātoa 'o e kau ngāue ki he moʻui leleí 'i hono fakahoa atu ki he tokolahi 'o e kakai Pasifikí.
E sega ni vinaka sara na i tukutuku vou me baleta na qaravi ni veika e bolei kina na nodra bula na lewe ni Wasa Pasifika e Niu Siladi, ka gadrevi me veisautaki sara vakatotolo na i vakarau ni nodra qaravi
Bula Sautu: Na i vakatagedegede ni veiqaravi ni yabaki 2021: Na nodra bula na lewe ni Wasa Pasifika e na yabaki e basika kina na mate na COVID 19, e a tekivu kaburaka edaidai e na bose ni Palimedi na Minisita ni lewe ni Vanua ni Wasa Pasifika (Minister for Pacific Peoples], ko Hon Aupito William Sio. Oqo na i kuri ni i vola tukutuku era sa tabaki oti mai na Health Quality & Safety Commission (vakalekalekataki me Commission). E dau dikeva na nodra bula na lewe ni Wasa Pasifika, ka vakaraitaka ni sa toso tiko vakavinaka (se sega) na veiqaravi me baleti ira.
Na i vola tukutuku oqo, e rau vakarautaka vata na kena matabose (Commission), kei ratou e tolu na vuniwai, ko Corina Grey, Api Talemaitoga, kei Debbie Ryan. E okati tale ga kina na nodra cau e vuqa na lewe ni Wasa Pasifika era cakacaka e na tabana ni bula, se veiliutaki e na kedra maliwa na veiuma tamata ni Wasa Pasifika. E na i ka 27 ni Me 2021, era a sureti kina e so na lewe ni Wasa Pasifika me ra lewe ni matabose ni soli i vakasala, me ra vakasamataka na veika e tabaki e na Bula Sautu, ka vakaraitaka na nodra nanuma e na veika e tabaki. E ratou sa vakatura kina e so na ka me tomana na veika e na i vola tabaki.
E vakaraitaki e na Bula Sautu ni toka sara e ra e so na i vakatagedegede kei na duidui ni veiqaravi me baleta na bula ka ra sotava tiko na lewe ni Wasa Pasifika, ka sega ni bau basika oqo e na veivosaki e caka tiko me baleta na veiveisau me na vakayacori me baleta na qaravi ni bula. E tabaki tale ga kina na i tukutuku me baleti ira era veiqaravi vakaisoqosoqo, se lewe ni vanua yadua, ka ra vakaraitaka vakadodonu na nodra rai, e na lomanibai ni veika era rawa ni vosa kina. E vakavatukana sara vakavinaka oqo e na veika e caka e na vuku ni mate na COVID 19, ni basika vakalevu kina na veiveisau.
Ko Collin Tukuitonga, na Associate Professor ni Public Health, ka Associate Dean Pacific e na koronivuli ni vuli torocake na Iunivesiti e Okaladi, ka lewe ni Matabose (Commission), e tukuna ni ko ira na lewe ni Wasa Pasifika era sa wili vakalewe ni vanua tudei e Niu Siladi, e sega ni soli vei ira e na dua na gauna balavu sara na nodra dodonu me ra vakayagataka na veiqaravi ni tabana ni bula e dodonu me soli vei ira.. E vakaraitaki, ka tu na kena i vakadinadina, ni yaco tiko na veivakaduiduitaki e na qaravi ni nodra bula.
E namaki vei ira na lewe ni Wasa Pasifika, me ra vakamuria na veika e tu me ra cakava ni bera ni qai soli vei ira na veiqaravi me baleta na nodra bula. Era a sega ni vakaitavi e na kena vakarautaki, se a caka me baleti ira. E lewe levu sara era dui sagai ira ga vakataki ira, e na veika me baleta na nodra bula, baleta na vereverea ni veika me ra cakava ni bera ni qai soli vei ira na veiqaravi me baleta na bula. Na vereverea ni veika e sotavi, e dusia tiko ni bula vinaka tiko e Niu Siladi na veivakaduiduitaki vakauma tamata e na tabana ni bula kei na qaravi ni vakaleqai ni i tuvaki ni yago, vata kei ira era vakacakacakataki e na tabana ni bula.
E gadrevi me dua na sala ni qaravi bula, me rawa kina vei ira na lewe ni Wasa Pasifika me ra kila ka navuca na i wali ni leqa me ganiti ira. Ko ira era veiliutaki kei ira era vakatulewa e na veivanua ni veituberi e na tabana ni bula, e dodonu me ra tokona ka vukea na kena vakalevutaki cake na nodra vakacakacakataki na lewe ni Wasa Pasifika e na i vakatagedegede taucoko ni veiqaravi. E dodonu me da veisautaki na i tovo tawa kilikili ni veivakaduiduitaki vakauma tamata ka vaka me usutu tiko ni tabana ni qaravi bula. E la’ki basika e na veiqaravi e caka, kei na vua ni veiqaravi, baleta ni vu sara tiko ga mai na i tuvatuva ni veiqaravi.
Ko vuniwai Corina Grey, e lewe ni matabose ni bula e Okaladi (Pacific Health Data and Insights Lead e na Auckland District Health Board), ka dua vei rau ka vola na i vola tukutuku. E tukuna ko koya ni tiko e na tabana ni qaravi ni bula, na veika e so era rawa ni cakava na veisoqosoqo se lewe ni vanua yadua, me vakayagataki kina na veivuke sa tu rawa. E tabaki e na i vola tukutuku na veika e rawa ni caka me vukea na nodra bula na lewe ni Wasa Pasifika.
E tukuna ko Vuniwai Corina Grey, ni veika e rawa ni caka oqo, e vakabibitaki kina na kena kilai vinaka na veitukutuku e tu; na raraba kei na taucoko ni veiqaravi; vakavinakataki cake na sala me rawa kina ni vakayagataki na veiqaravi ni bula e tu; na nodra rokovi ko ira era vakayagataka na veiqaravi kei ira na lewe ni Wasa Pasifika; me matata ka vakarawarawataki na veitaratara; kei na nodra tokoni ko ira era vakacakacakataki.
E laurai vinaka na nodra duavata ka cakacaka vata na lewe ni Wasa Pasifika e na veika era cakava e na gauna e tekivu veitauvi kina na mate na COVID 19. Ko ira na lewe ni Wasa Pasifika era cakacaka e na tabana ni bula kei na veiqaravi raraba, era cakacaka vakavoleka sara kei ira na i liuliu ni veivavakoso lotu, kei ira na i liuliu ni veisoqosoqo vakauma tamata e na kena vakaduri vakatotolo na veivanua me dikevi kina na veitauvi ni mate; veitokoni e na vakamuri ni veitaratara me baleta na Covid-19; veisoliyaki ni kakana kei na matavulo vei ira na lewe ni vanua; cakacaka vakavoleka sara kei ira na i liuliu ni veisoqosoqo vakauma tamata kei ira era veiqaravi raraba, era vakaraitaka na mataqali veiqaravi e veiganiti dina.
Ko Vuniwai Api Talemaitoga e vuniwai ni veiqaravi raraba, ka liutaka tiko na nodra i soqosoqo na vuniwai ni Wasa Pasifika era veiqaravi raraba (Pacific General Practitioners’ Network), ka dua vei rau na vola na i tukutuku oqo. E tukuna ko koya ni veika e dau basika vakaoqo, e vakaraitaka tiko ni rawa ni yaco na veisau
‘Ia, na vakatorocaketaki ni nodra bula na lewe ni Wasa Pasifika, kei na vakalailaitaki ni leqa ni veivakaduiduitaki, e na rawa ni yaco kevaka e vakarautaki vakavinaka sara e dua na i tuvatuva ni veiveisau e gadrevi me caka.
Na i tuvatuva e tiko kina na vakasama “toso ga na qaravi bisinisi”, e na sega ni rawa kina na veisau e gadrevi me yaco’
Na Veika era vakatekivuna na lewe ni Wasa Pasifika
Oqo na i tukutuku matailelevu ni veisala vovou ni veiqaravi.e na i tukutuku oqo.
Ko Vuniwai Maryann Heather – e vuniwai ni bula raraba (GP), e na South Seas Healthcare e Otara, Okaladi; e veivakavulici e na veika me baleta na nodra bula na lewe ni Wasa Pasifika, e na Iunivesiti e Okaladi.
‘E na veika me baleta na nodra cula vakalewe levu na gone e na i cula ni sasabai me tarova na mate, au vakacaucautaki ira na nasi era veiqaravi kina, e na nodra sasaga me ra cula taucoko na noda gone e na i cula me tarova na mate. Era lesuvi ira na gone me ra cula tale.
Era qiri e na talevoni, talai ira e so me ra la’ki veicula e na veivale. Oqo na i vakaraitaki ni veimaliwai vinaka. Era kila na i tubutubu kei ira na bu kei na tukai, na yaga ni i cula me tarova na mate. Era dau vakarorogo vinaka sara ni vakamacalataki na yaga ni i cula me tarova na mate.
Ko Sinia Saafi, e cakacaka e na tabana ni bula e na veivanua vakaitikotiko, e na ruku ni Alliance Health Plus Primary Health Organisation
E usutu ni noqu veiqaravi na i sema ki na veivale ni lotu. E gadrevi me lako kina ko koya e veiqaravi e na veika me baleta na bula, me la’ki maliwai ira kina na lewe ni lotu.ka cakacaka vata kei ira. Era gadreva tu na veitaratara vakavoleka kei ira era veiqaravi, me vakadeitaka na yalodra’.
Ko Vuniwai Api Talemaitoga e vuniwai ni veiqaravi raraba (GP), ka i liuliu ni nodra i soqosoqo na vuniwai ni Wasa Pasifika era veiqaravi raraba
‘E toro cake sarana kena tosona veicula me tarova na mate na ‘human papillomavirus’ (HPV), e na kedra maliwa na lewe ni Wasa Pasifika, e na gauna e rau vakatorocaketaka kina na Minisitiri ni Bula kei na tabana e qarava na kena vakatetei na i tukutuku e vakadewataki (Health Promotion Agency), me veiganiti kei na nodra i vakarau vakavanua na lewe ni Wasa Pasifika.
E qai bucini e dua na sala me vukea na sasaga me ra ciqoma na lewe ni Wasa Pasifika na i tukutuku ni veicula. E vakayagataki kina e so na i taba ni vuvale ni lewe ni Wasa Pasifika. E veisautaki na i vakamacala me kua ni vakatabakiduataki vei ira na cauravou kei na gone yalewa, ka me vakabibitaki kina na nodra taqomaki kei na nodra bula na lewe ni vuvale vaka Wasa Pasifika e na veigauna mai muri.
E vakadewataki ki na vosa vaka -Samoa, vaka -Toga, vaka - Viti, na i tukutuku taucoko me baleta na veicula. E toso vakavinaka sara na kena qaravi na veicula ni vakabibitaki kina na bula ni vuvale’.
Ko Manogi Eiao, e cakacaka vakanasi e na Counties Manukau DHB, ka kena dau e na veiqaravi me e na veika me baleta na ivi
E leqa bibi na veika vakailvo. E dau vakataotaka na sasaga - e sega ni rawa na cegu mai na cakacaka, se sega na gauna ni gade me baleta na tauvimate. E vinakati na cakacaka me rawa na i lavo me saumi kina na veika e tu me saumi - na bili, na nodra kana na vuvale, ka vaka me “guileca” kina na qaravi ni bula. E “guileca” vaka kina na veika e lokuci me caka.
E dau tekivu na neitou veiqaravi mai na 8 na kaloko e na mataka ki na 4 na kaloko e na yakavi. Kevaka au siqema rawa na dredre e sotava tiko na vuvale, au na qai la’ki raici ratou e na 6 na kaloko e na yakavi.
E dau veiqaravi na neitou nasi e na vei Siga Vakarauwai, me qaravi ira kina ko ira era sega ni rawa ni la’ki laurai e na loma ni macawa. E tovolei tiko me caka na veiqaravi me sota vata kei na gauna e donu vei ira me ra qaravi’
Na i vakaraitaki ni duidui era sotava tiko na lewe ni Wasa pasifika
- E lailai sobu mai na ono na yabaki na balavu ni nodra bula na lewe ni Wasa Pasifika ni vakatautauvatani kei na balavu ni nodra yabaki ni bula ko ira era sega ni Maori se lewe ni Wasa Paifika’
- E na yabaki 2018, e lailai mai na veimama (47 na pasede) na kedra i wiliwili na marama lewe ni Wasa Pasifika era tiko bibi, e tabaki na yacadra e na dua na vale ni bula ni veiqaravi vei ira na tiko bibi (lead maternity carer - LMC), ni vakatautauvatataki kei na 81 na pasede vei ira era sega ni Maori se lewe ni Wasa Pasifika.
- E laurai ni lewe levu vei ira na marama ni Wasa Pasifika, era sotava na veileqa e vuqa e na gauna ni nodra tiko bibi, ka levu cake na veiqaravi me caka vei ira e na gauna ni vakasucu kei na gauna sa sucu oti kina na gone, ka levu na leqa e basika vei ira na gone kei na tinadra ni oti na vakasucu, ni vakatautauvatani kei ira na marama ni veivanua tale e so.
- E rauta e 59 ga na pasede vei ira na veivuvale ni Wasa Pasifika era tiko kina na gone dramidrami, era taura taucoko na veivuke e tu mai na Well Child/Tamariki Ora, e na i matai ni nodra yabaki ni bula. Ia, e 81 na pasede vei ira era sega ni Maori se lewe ni Wasa Pasifika, era vakayagataka na veivuke oqo.
- Era sotava kina e levu sara na gone ni Wasa Paifika e so na leqa ni bula me vaka na ceno, tola ni bati, mate ni daliga kei na kuli, ni vakatautauvatani kei ira na gone ni veivanua tale eso. E rauta e 36 ga na pasede na levu ni gone ni Wasa Pasifika e sega ni tola na batidra, ni vakatautauvani kei na 69 na pasede na gone era sega ni Maori ka sega ni gone ni Wasa Pasifika.
- E sega ni tiko e dua na i tukutuku ni vanua raraba e dua na ka me baleta na nodra bula na i taba gone ni Wasa Pasifika. Ia, e laurai e na vakadidike e caka, ni toso cake tiko ga na kedra i wiliwili na i taba gone ni Wasa Pasifika era dau yalobibi, ka ra dau tovolea me ra vakamatei ira; ka tu na veika e vakalatia na qarai ni veivuke me baleta na nodra bula.
- E so na veiqaravi me baleta na tarovi ni mate, me vaka na i cula me tarova na matetaka, era vakayagataka vinaka na lewe ni Wasa Pasifika. Ia, era lewe levu sara ga e tauvi ira na veimate me vaka na vuvuce kei na vutu ni i sema ni yago, mate ni uto kei na iivi, kenesa, ceguleka, ka vakabibi na mate ni suka. E tolu na ka e laurai vei ira na lewe ni Wasa Pasifika me baleta na mate ni suka:
- ni veitauvi totolo, e vakavuna na kena basika tale ga vakatotolo e so na leqa e sala vata kaya
- e sega ni taucoko na veiqaravi e caka me vakalailaitaka na kedra i wiliwili ko ira e tauvi ira na mate ni suka
- e levu taudua na kedra i wiliwili na lewe ni Wasa Pasifika era curu ki valenibula ni vakatautauvatani kei na vo ni veiuma tamata tale e so.
- E lailai dina ga na kedra i wiliwili na lewe ni Wasa Pasifika, era cakacaka e na tabana ni qaravi bula raraba.
Te `akaāri mai nei tetai ripōti `ōu, i tetai `ākara`anga taukore tikāi, no runga i te au manatā i roto i te turanga rapakau, e tomo nei te iti tangata no te Moana-nui-o-Kiva i Aotearoa ki roto, e te `umuumu`ia nei, kia tauī viviki ia teia turanga.
Kua `o`ora`ia ki roto i te Paramani, te Bula Sautu: A window on quality 2021: Pacific health in the year of COVID-19 e te Minita o Te Manatū mō ngā iwi ō te Moana-nui-ā-Kiwa, te Hon Aupito William Sio. Ko te ripōti `ōu rava atu teia, no roto i te au ‘`ākara`anga’ a te Health Quality & Safety Commission (te Commission). Te `ākara nei teia i te turanga ora`anga o te iti tangata no te Moana-nui-o-Kiva, e te turama mai nei i te rāvenga a te turanga rapakau (me kore ra, te rāvenga-kore) no ratou.
No roto mai teia ripōti i te `anga`anga taokotai`anga i te `akatupu`ia`anga, i rotopu i te Commission e, te au Taote, ia Corina Grey, Api Talemaitoga, e Debbie Ryan.
Tei roto i teia, te au mānakonako`anga no roto mai i te ma`ata`anga o te au turanga rapakau no te Moana-nui-o-Kiva, e te au arataki `oire, te aronga `ākono i te maki, e te aronga rapakau. Kua `akako`u te Commission i tetai pupu arataki no te Moana-nui-o-Kiva, i te ra 27 o Mē i te mata`iti 2021, kia `ākara i te ripōti i roto i te Bula Sautu. Kua `anga teia pupu, i tetai au tāmanako`anga, i te tā`anga`anga atu i teia au `ākakitekite`anga.
Kua turama mai te Bula Sautu, i tetai au mea taukore rava atu i roto i te rapakau`anga i te iti tangata no te Moana-nui-o-Kiva, i roto i Aotearoa, e te anoano kia `uri`uri`ia teia au mea taukore, ki roto i te au `akatanotano`anga i te turanga rapakau e tupu nei. Te `akaāri katoa mai nei te ripōti i te au `oire tangata, e te aronga e tautā pakari nei i roto i teia pū`ere`ere. Kua kite meitaki ia teia kimi`anga rāvenga, i te tuātau COVID-19.
Te karanga nei te Associate Professor o te Public Health, a Collin Tukuitonga, Associate Dean Pacific o te `Āpi`i Tuatoru o Tāmaki Makaurau, e mēma no te Commission board e, e karanga ana te `iti tangata no te Moana-nui-o-Kiva ia Aotearoa e, e kainga no ratou, e kua tere atu ki te au nga`uru`anga mata`iti te pāruru`ia`anga ratou mei to ratou tika`anga ki te rapakau`anga e te ora`anga meitaki, noātu e, te takataka ua mai ra te tumu i roto i te au manatā e ripoti`ia ana.
‘Te `irinaki`ia nei te `iti tangata no te Moana-nui-o-Kiva, kia kimi i to ratou kaveinga na roto i tetai turanga rapakau, kare na ratou i `akapapa, e kare i `akapapa`ia no ratou. Ma`ata ua atu, te `ākono meitaki ra ia ratou uā`orāi, i te mea e, kare e rauka ia ratou i te `akatu`era i te au pāruru`anga ki te rapakau`anga. Te `akaāri mai nei teia au manamanatā, i te tū pāpākitai, e te kai pākiri tangata i roto i te turanga rapakau, e te turanga pakipakitai, o Aotearoa, e te ravakore i te au rāvenga tūkētūkē i roto i te aronga rapakau.
‘Te anoano`ia nei tetai turanga rapakau, te ka `akamana i te `iti tangata no te Moana-nui-o-Kiva, i te `akakite mai, e te `akapapa i te au mea tau no te `iti tangata no te Moana-nui-o-Kiva. Ka `inangaro`ia te au arataki, e te aronga `akateretere i roto i to tatou au ngā`i terēni`anga, e te au ngā`i `anga`anga, kia turu kia tupu te aronga `anga`anga no te Moana-nui-o-Kiva, e `inangaro`ia nei ki roto i te au taka`i`anga, i roto i te turanga rapakau. Te anoano`ia nei tatou kia tauī i te ravenga taukore o te kai pākiri tangata o ta tatou turanga rapakau; te `ōpara nei i te au ravenga `ākono i te maki, e te au mea e tupu nei, e `akatupu`ia nei e te `akapapa`ia`anga te turanga rapakau.
Te karanga nei a Dr Corina Grey, te Pacific Health Data e te Insights Lead, i ko i te District Health Board o Tāmaki Makaurau, e te co-author o te ripōti e, tei roto i te turanga rapakau, tetai au rāvenga pu`apinga rava atu e tau kia rave te au putuputu`anga, e te au turanga tauturu tātakitai, te ma`ata`anga, tei roto takere i te au rāvenga e vai nei. Tei roto teia au rāvenga i te ripōti, ei `akapapa`anga no te `akapu`apinga`anga i te ora`anga meitaki no te Moana-nui-o-Kiva.
‘Te tāto`u nei teia au rāvenga pu`apinga rava atu ki runga i te au kite tei tātā`ia; te `ākono`anga i te katoa`anga o te tangata maki, e te `anga`anga taokotai i roto i te `ākono`anga i te tangata maki; te `akapu`apinga`anga i te tomo`anga ki roto i te au turanga rapakau; te tomo`anga ki roto i aronga maki e te au `oire tangata no te Moana-nui-o-Kiva i raro ake i te ngakau kauraro; te komakoma`anga māmā e te takataka; e te turu`anga i te aronga `anga`anga,’ i nāna ei.
‘Kua turama`ia mai te mātūtū o te aronga tauturu, e te au `oire tangata no te Moana-nui-o-Kiva, i te tuātau COVID-19. Kua `anga`anga taokotai te turanga rapakau no te Moana-nui-o-Kiva, e te au turanga tauturu i te ora`anga, ki roto i te au `ākono`anga pure, e tetai atu au arataki `oire, i te akatū viviki i te au ngā`i vāito`anga, `akatanotano`anga i te āru`anga tangata, e te kave`anga i te au ko`u kai e te au tāpokimata ki roto i te au `oire tangata, te `anga`anga taokotai`anga ki roto i te au arataki `oire, e tetai atu au tipātimani, i te `ōronga i te `ākono`anga i te katoa`anga o te tangata maki, e te `anga`anga taokotai i roto i te `ākono`anga i te tangata maki.’
Te karanga nei a Dr Api Talemaitoga, e taote, e `aka`aere no te Pacific General Practitioners’ Network, e te co-author o te ripōti e, te `akaāri mai nei teia au rāvenga `ōu e, ka rauka te tauī`anga.
‘Inārā, kare e tupu teia au `akapu`apinga`anga i roto i te rapakau`anga no te Moana-nui-o-Kiva, e te `akatopa`anga mai i te au mea taukore, me kare e tauī`anga pakari.
‘Kare te kaveinga tei tango`ia ki runga i te “mei tei mātau`ia” e `akatupu i te tauī`anga e `inangaro`ia nei.’
'Akatanotano`anga no te Moana-nui-o-Kiva
Tei raro ake nei, tetai au rāvenga `akatanotano`anga tei `akaāri`ia mai i roto i teia ripōti.
Dr Maryann Heather – GP, South Seas Healthcare, Otara, Auckland; senior lecturer Pacific health, School of Population Health, University of Auckland
‘I raro ake i te tārē`anga ma`ata i ta tatou tamariki tei pātia`ia ki te vairākau pāruru, te `akameitaki nei au i to tatou au neti, no te mea, na ratou e `akapāpū ana kia pātia`ia ta tatou au tamariki katoatoa, ki te vairākau pāruru. Ka tāniuniu `āka`ōu ua rāi ratou. Ka tāniuniu ratou, ka tono`ia tetai tangata. Tei runga te reira i te au tū piri`anga. Kua kite to tatou au metua, e to tatou au metua pakari i te pu`apinga o te pātia`anga vairākau-pāruru. I te ma`ata`anga o te taime, me pati atu matou, e `akakite atu ana matou i te pu`apinga kia ratou, e, e `akarongo tikāi ana ratou.’
Sinia Saafi, community health worker, Alliance Health Plus Primary Health Organisation
‘Ko te `anga`anga na roto i te au `ākono`anga pure, te mea pu`apinga rava atu kiāku. Ka anoano koe i te reira taime, no te tangata rapakau i te aere atu ki te `anga`anga ki roto i te `oire tangata, mei roto mai ki va`o. Te `inangaro nei te tangata i te `ātui`anga tetai ki tetai, no te mea, ka rauka ia ratou i te `irinaki i te tangata rapakau kua mātau ratou.’
Dr Api Talemaitoga, GP, `aka`aere no te Pacific General Practitioners’ Network
‘Kua pu`apinga mai te tārē i te pātia`anga vairākau pāruru no te human papillomavirus (HPV) ki roto i te `iti tangata no te Moana-nui-o-Kiva, i te `akapāpū`anga te Marae Ora, e te Health Promotion Agency, i te au rāvenga komakoma`anga na roto i te peu/`ākono`anga.
‘Kua `akatanotano`ia ki te au tūtū o te au kopu tangata no te Moana-nui-o-Kiva, tetai `o`ora`anga ki va`o no te `iti tangata no te Moana-nui-o-Kiva. Kua `akapapa `aka`ōu`ia te tuatua `akakite, mei te `akakoro`anga ki te māpū tamariki okotai, ki tetai no runga i te pāruru`anga no te tuātau ki mua, e te ora`anga meitaki o te au kōpū tangata no te Moana-nui-o-Kiva.
“Kua tātā`ia te au `akakitekite`anga ki roto i te reo Samoa, Tonga e te Vītī. Kua pu`apinga te au `ākakitekite`anga, e tāto`u ra i te au kōpū tangata.”
Manogi Eiao, pre-dialysis nurse specialist, renal services, Counties Manukau DHB
‘E āka manatā tikāi te moni. Na te reira e tāpū ana i te tangata ki muri – kare o ratou taime no te `akaruke i te `anga`anga, me kore ra, kare o ratou rā no te no`o ki te kainga, me maki. Ka anoano`ia ratou kia aere ki te `anga`anga no te moni, i te tutaki kaio`u, te `āngai i te kōpū tangata, e ‘’kare e ma`ara`ia atu’’ to ratou ora`anga kopapa. Kare e ‘’ma`ara`ia atu’’ to ratou au `āravei`anga tei tātuātau`ia.
‘E tu`era ana matou mei te ora 8:00 i te popongi ki te `āpa no te ora 4:00 i te a`ia`i, māri ra, me kite au e, te putaka`iti ra tetai kōpū tangata, ka aere atu au ki te ngutu`are i te ora 6:00 i te a`ia`i.
‘E `anga`anga ana to matou nēti i te Ma`anākai. Ka tauturu i te ma`ata`anga o te aronga maki, kare e rauka ana i te aere mai i roto i te epetoma. Ko te tautā`anga teia i te `anga`anga taokotai ki roto i ta matou aronga maki, kia tau ki to ratou ora`anga.’
Au `ākara`anga i te au mea taukore i roto i te `iti tangata no te Moana-nui-o-Kiva
- Poto ake te ora`anga o te `iti tangata no te Moana-nui-o-Kiva, mei te ono mata`iti, me `aka`aite`ia ki tetai, kare e te Māori, e kare e no te Moana-nui-o-Kiva.
- Tei raro ake i te `āpa (47 pātene) vaine nui no te Moana-nui-o-Kiva tei rētita`ia ki ko i tetai pū `aka`ānau (LMC) i roto i te mata`iti 2018, me `aka`āite`ia ki te 81 pātene o te vaine kare e te Māori, e kare e no te Moana-nui-o-Kiva.
- Ka tomo te vaine no te Moana-nui-o-Kiva na roto i te au manatā ma`ata atu i te tuātau e nui ra, ka inangaro tauturu i te tuātau nui, e i muri ake i te `ānau`anga, e ka kino atu te ka tupu ki te māmā, e te pēpe, me `aka`āite`ia ki tetai atu `iti tangata.
- E 59 pātene ua rāi o te tamariki no roto i te au kōpū tangata no te Moana-nui-o-Kiva,i roto i to ratou mata`iti mua, tei tū i to ratou au puka Well Child/Tamariki, me `aka`āite`ia ki te 81 pātene kōpū tangata, kare e, te Māori, e kare e no te Moana-nui-o-Kiva.
- Ma`ata atu te tamariki no te Moana-nui-o-Kiva te ka tū`ia e te au tū maki, mei te potopoto a`o, manatā ni`o, e te taringa e te maki pākiri, me `aka`āite`ia ki te tamariki o tetai atu iti tangata. E 64 pātene tamariki e rima mata`iti no te Moana-nui-o-Kiva, kare e caries (ni`o pē) me `aka`āite`ia ki te 31 pātene kare e te Māori, e kare e no te Moana-nui-o-Kiva.
- Kare e tātā`anga basileia no runga i te ora`anga kopapa o te māpū no te Moana-nui-o-Kiva, māri ra, te karanga nei te kimikimi`anga kite e, te kake nei te tārē i te au `akairo-maki depressive, e te tautā`anga `akakore i te ora`anga i roto i te māpū no te Moana-nui-o-Kiva, e te au pāruru ki te tomo`anga ki roto i te turanga rapakau.
- Te tāmanako`ia nei e, te pu`apinga nei tetai tu`anga `ākono maki no te iti tangata no te Moana-nui-o-Kiva, mei te au pātia`anga vairākau pāruru flu, māri ra, te taomi`ia nei te iti tangata no te Moana-nui-o-Kiva e te au maki roa, mei te gout,maki puku`atu, maki katu i`i, cancer, e te potopoto a`o, e ko te mea kino rava atu, te toto-vene. E toru manatā i raro ake i te maki toto-vene:
- ko te `akamata`anga teia, e ka kino atu
- maringakore i te `aka`aere`anga, e te `akatanotano`anga i te maki toto-vene
- ma`ata atu te tare no te no`o ki roto i `aremaki, me `aka`aite`ia ki tetai atu `iti tangata,
- Kare te iti tangata no te Moana-nui-o-Kiva e manako`ia ana i raro ake i te katoa`anga o te turanga rapakau.
He pikitia kōhure te kī a tētahi pūrongo hou mō ngā mātātaki maimoa hauora ki ngā iwi o te Pasifika kei Aotearoa nei, ā, ka kī hoki kia kaha, kia tere hoki te tini i te pūnaha.
I whakamānutia te pūrongo Bula Sautu: A window on quality 2021: Pacific health in the year of COVID-19 i te Whare Paremata i tēnei rā e te Minita mō ngā Iwi Pasifika, e te Hōnore Aupito Wiremu Sio. Ko te pūrongo nei he pūrongo hou o ngā putanga ‘window’ nā te Kupu Taurangi Hauora o Aotearoa (te Komihana). Ka tirohia te hauora o ngā iwi Pasifika me tētahi tirohanga mō te pēhea o te pūnaha hauora e mahi ana (kāhore ana rānei) mā rātou.
Ko te pūrongo nei he hua o tētahi mahi ngātahi me tētahi tukanga whakawhanake i waenganui i te Komihana me Tākuta Corina Grey rātou ko Tākuta Api Talemaitoga ko Tākuta Debbie Ryan. Kei roto hoki ētahi whakaaro o te tokomaha, o ngā kaitātaki hauora Pasifika, rangatira o ngā hapori, ngā mātanga me ngā kaimahi hauora. Nā te Komihana tētahi rōpū tohutohu nō te iwi Pasifika i whakarite i te 27 o Haratua 2021 kia homai whakaaro mō ngā kitenga o Bula Sautu. Nā te rōpū nei i whakaputa ētahi tohutohu hei kōkiri tonu i ngā kitenga o te pūrongo.
Nā Bula Sautu i whakapuaki ētahi o ngā rerekētanga tino kino o te maimoa hauora e pānga atu ana ki ngā iwi Pasifika me te kore kōrerorero mō ēnei rerekētanga i roto i ngā waihanga hou o te pūnaha hauora. Ka kōrero hoki te pūrongo mō ngā kaiwhakarato, ngā hapori me ngā tāngata e urupare pai ana, e urupare tōtika ana nō roto i ngā herenga i utaina ai ki runga i a rātou. I tino kitea tēnei auahatanga i te wā o te KORONA-19.
E mea mai ana a Ahonuku Collin Tukuitonga o te Hauora Tūmatanui, Ahonuku Pasifika i te Whare Wānanga o Ākarana me tētahi mema poari o te Komihana, ko ngā iwi Pasifika e kī ana ko Aotearoa tō rātou kāinga kua aukatihia ngā motika ki te hauora me te oranga mō ngā tekau tau maha, ahakoa te tino kitea o ngā rerekētanga i ngā āhua hauora i tuhia ai.
‘Ko te tikanga me whakatere ngā iwi Pasifika i tētahi pūnaha hauora i kore ai e hoahoatia mā rātou. Me whakaora rātou i a rātou anō, i te mea e kore e taea e rātou te tahuri i ngā aukati ki te maimoa hauora. Ka whakaatu ēnei tūāhua i ngā tātai rītaha me te kaikiri i roto i te pūnaha hauora, pūnaha hauā o Aotearoa me te korenga o te kanorau i te ohu mahi hauora.
‘Kei te hiahiatia e mātou he pūnaha hauora e taea ai e ngā iwi Pasifika te tautohu me te hoahoa ngā otinga Pasifika. Me mahi niwha ngā kaitātaki me ngā kaiwhakatau i ō tātou wāhi whakangungu me ngā umanga hei tautoko, hei whakatipu i te ohu mahi Pasifika ki ngā taumata katoa o te pūnaha. E hiahiatia ana hoki kia tahuri i te kaikiri o tā tātou pūnaha; koia e kōkiri ana i ngā tukanga rerekē me ngā putanga o te maimoa hauora, ā, e pērātia ana nā te hanga o te pūnaha.’
E mea mai ana a Tākuta Corina Grey, Kaihautū o Pacific Health Data and Insights i te Poari Hauora ā-rohe o Ākarana, tētahi kaituhi o te pūrongo, nō roto i te rāngai hauora he maha ngā tino mahi ka taea e ngā ratonga me ngā tāngata, he maha i ngā rauemi tonu. Kua whakaaturia ēnei mahi i te pūrongo hei anga ki te whakapai ake i te hauora Pasifika.
‘Ko ēnei tino mahi ka aronui atu ki te raraunga; te tuku maimoa hauora katoa, maimoa whātahi hoki; kia pai ake te tiki ratonga hauora; te hono tika, te hono whai ngākau ki ngā hapori Pasifika; kia māmā kia mārama te kōrero; ā, kia tautoko hoki i te ohu mahi Pasifika,’ hei tāna.
‘Ko te kaha o ngā kaiwhakarato Pasifika i tino kitea i te wā o te urupare ki te KORONA-19. I mahi tahi ngā ratonga hauora Pasifika, ngā ratonga pāpori me ngā minita karakia, ngā kaitātaki hapori hei tere whakarite ratonga whakamātautau, whakarite tautoko mō te takitaki me te tuku kai me ngā ārai kanohi ki ngā hapori, te mahi tahi me ngā kaitātaki hapori ki te whakarato i ngā tauira maimoa katoa, maimoa whātahi.’
E mea mai ana a Tākuta Api Talemaitoga, he tākuta whānau, te tiamana o te Pacific General Practitioners’ Network me te kaituhi o te pūrongo, ko ngā kaupapa pēnei e whakaatu ana i te āhei kia panoni.
‘Heoi anō, e kore e tutuki te whakapai hauora Pasifika me te whakaiti rerekētanga hauora ki te kore he kaupapa tino panoni.
Ko tētahi rautaki e kīia nei “ko taua mahi anō” e kore rawa e panoni e hiahiatia ana.’
Auahatanga Pasifika
I raro nei ko ngā pitopito kōrero mō ngā huarahi auaha ka kitea i tēnei pūrongo.
Dr Maryann Heather – Tākuta, South Seas Healthcare, Otara, Auckland; pūkenga hauora Pasifika, School of Population Health, Whare Wānanga o Tamaki Makaurau
‘Mō ngā whakatō kano ārai mate mā ngā tamariki, me whakamihi au i ā mātou nēhi i te mea ko rātou e kaha nei te mahi kia whai ārai mate ngā tamariki. Nā rātou i whai. Ka waea atu, ka tukua he tangata kia haere. Nā te whanaungatanga tērā. Ka mōhio ō tātou mātou, tīpuna ki te hua o ngā kano āraihanga mate. Rite tonu ina pātai atu ki a rātou, ka mea atu mātou he aha e mātuatua ai, ā, ka tino whakarongo rātou.’
Sinia Saafi, kaimahi hauora hapori, Alliance Health Plus Primary Health Organisation
‘Ko te tino ki ahau ko te mahi mā ngā whare karakia. Me whai wā ngā kaimahi hauora ki te uru ki te hapori, ki reira mahi ai mai roto ki waho. Kei te kaikā ngā tāngata kia noho kanohi ki te kanohi, i te mea mā te hono ā-kanohi ka tū māia te kaimahi hauora.’
Dr Api Talemaitoga, Tākuta, Tiamana o te Pacific General Practitioners’ Network
‘I haere pai ake te mahi whakatō kano ārai mate mō te papillomavirus (HPV) i ngā iwi Pasifika i te wā i kaha mahi te Manatū Hauora me Te Hiringa Hauora kia tika ngā kōrero ahurea.
‘I whakawhanakehia he kaupapa whakamataara e hāngai ana ki ngā iwi Pasifika me ngā whakaahua o ngā whānau Pasifika. I huri te kōrero mai i te whakararata taiohi takitahi ki te whakamarumaru āmua me te hauora o ngā whānau Pasifika.
‘I tukua te kōrero ki te reo Hāmoa, reo Tonga me te reo Whiti. I whaihua te kōrero whakatō kano ārai mate i hāngai ki ngā whānau.’
Manogi Eiao, mātanga nēhi pre-dialysis, ratonga tākihi, Counties Manukau DHB
‘He raru nui tō te moni. Koia e pupuri whakamuri ana i te tangata – kāore i whai wāhi whakatā i te mahi, kāore rānei he utu ina māuiui rātou. Me haere ki te mahi kia riro i taua moni hei utu nama, hei whāngai i te whānau, ka mutu, ka “wareware” tō rātou hauora. Ka “wareware” ā rātou hui whakarite.
‘Ka tuwhera te whare mai i te 8.00 ki te 4.30, engari ina kite au kua raru tētahi whānau, ka haere atu ki te kāinga ā te 6.00pm.
‘Ka mahi tā mātou mātanga nēhi i ngā Rāhoroi. Ka kitea e ia ngā tāngata tokomaha i kore ai i taea te haramai i ngā rā o te wiki. Ko te tikanga ka mahi tahi me ā mātou tūroro ki tā rātou e taea ai.’
He tauira o ngā rerekētanga ki ngā iwi Pasifika
- Ka ora ngā iwi Pasifika e ono tau iti iho o ngā tāngata ehara i te Māori, ehara i te Pasifika.
- Iti iho i te haurua (47 ōrau) o wāhine Pasifika e hapū ana i rēhita ki tētahi kaimaimoa ōmahu (LMC) i 2018, whakataurite atu ana ki te 81 ōrau mō ngā whānau ehara i te Māori, ehara i te Pasifika.
- Nā whai anō he nui atu ngā pōauautanga ka wheakohia e ngā wāhine Pasifika i te wā hapūtanga, ā, nui atu hoki i te whakawhānau pēpi a muri hoki, kino iho ngā hua mō te māmā me te pēpi i tā ērā atu iwi.
- E 59 ōrau noa iho o ngā whānau Pasifika o ngā kōhungahunga i te tau tuatahi o te oranga i riro mai he āwhina a Tamariki Ora, whakataurite atu ana ki te 81 ōrau mō ngā whānau ehara i te Māori, ehara i te Pasifika.
- Nā whai anō ka nui atu te wheako a ngā tamariki Pasifika ki ngā āhua pēnei i te huangō, raru niho, mate taringa, mate kiri i ngā wheako a ngā tamariki o iwi kē. E 36 ōrau noa iho o ngā tamariki Pasifika rima tau ka wātea i te niho pirau whakataurite atu ana ki te 69 ōrau o ngā tamariki ehara i te Māori, ehara i te Pasifika.
- Karekau he raraunga ā-motu mō te hauora o ngā taiohi Pasifika engari e ai ki te kōrero kei te piki haere ngā tohu pōuri, ngā tohu whakamomori o ngā taiohi Pasifika, me te āhei kia riro maimoa hauora.
- Mō ētahi iwi Pasifika kei te pai haere pea ētahi o ngā mahi maimoa hauora, pērā i te wero ārai rewharewha, engari ka kaha pāngia ngā iwi Pasifika ki ngā mate roa tae atu ki te kauti, mate iaia-manawa, mate tākihi, mate pukupuku, me te huangō, ā, te mate huka hoki. Ko ērā ka pāngia ki te mate huka e toru ngā mate ka utaina ki a rātou:
- te pānga moata kia kino ake te mate
- tē pai o te whakahaere mate huka
- te tokomaha ake ka noho hōhipera i ērā atu iwi
- He tokoiti ngā iwi Pasifika ka kitea i te whānuitanga o te ohu mahi.