Pacific Peoples, Violence, and the Power and Control Wheel.

This qualitative project was the first to study values and practices about sexual assault among migrant communities from the Cook Islands, Fiji, Niue, Samoa, Tokelau, Tonga, and Tuvalu in New Zealand. It aimed to identify customs, beliefs, and practices among these ethnic groups that were protective and preventive factors against sexual violence. Researchers were ethnically matched with 78 participants from the seven ethnic communities, and conducted individual interviews and one female focus group using protocols that were culturally appropriate for each ethnic group. Interviews were thematically analyzed. The study identified the brother-sister covenant and the sanctity of women as strong protective and preventive factors against sexual violence, expressed differently in each culture. Most participants viewed sexual violence as involving their extended families, village, and church communities, rather than solely the individuals concerned. However, the communal values and practices of these seven Pacific cultures raise questions about the individualistic assumptions and the meaning of violence underlying the Power and Control Wheel and the Duluth Model of domestic violence. It also raises questions about how such an individualized model can help services effectively support women in these collective societies who are experiencing violence, and how it can contribute to Pacific community prevention of violence. This study is therefore relevant to countries with significant populations of Pacific peoples and other collective cultures.

Research fatigue among Tongans in Aotearoa: an exploratory study introducing the Fei'umu research method for empowering the researched.

INTRODUCTION: There has been a number of references in the literature to over-research and research fatigue, but rarely have the concepts been empirically investigated, and never for Pasifikans. There have been claims that researchers have built careers out of the 'natural experiment situations of the Pacific with minimal benefits to the researched, e.g. the Tongans. In response, an exploratory investigation into the New Zealand Tongan communities' understanding of and participation in, research, (HRC Seeding Grant No. 11/529), was conducted. METHOD: We consulted 2 different church meetings in Auckland (approximately 50 people in each group). We also engaged in talanoa/discussions of the issues with 5: church leaders from different denominations; Tongan researchers; business owners; and 5 community leaders from Auckland, Wellington, Hamilton and Christchurch, respectively. RESULTS: The study found, that the Tongan communities are subjected to a variety of research, information, and data gatherings, from a myriad of agencies. The respondents used a variety of mechanisms to avoid discomfort, get rid of researchers as expediently as possible, including; heliaki, white lies, sarcasm, or give expected answers, thus confirming research fatigue. The interviews and surveys employing the Tongan language and ethnic specific research approaches were preferred, especially for sensitive issues. The study suggests that ownership of the research process will improve the robustness of the data collection, and the community ownership of research outcomes. CONCLUSION: The presence of research fatigue will threaten robust data collection and ownership of research findings. This paper discussed research fatigue and its dangers, and suggest ways to address this problem, before researchers are driven further from the researched communities and the utility of research knowledge.

Cultural democracy: the way forward for primary care of hard to reach New Zealanders.

The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.

Circumcision of pacific boys: tradition at the cutting edge.

Circumcision of neonates and young boys, is a frequently performed elective surgical procedure, and is one of the oldest known surgical procedures. When properly performed circumcision prevents phimosis, paraphimosis, and balanoposthitis and has been shown to decrease the incidence of penile among men and cervical cancer among the women sexual partners of circumcised men. It may also result in a decreased incidence of urinary tract infection, sexually transmitted infections and HIV infection. Circumcision also has its own inherent risks. The risk are mainly associated with the procedure (pain, bleeding, inflammation) also included post operative infection, poor healing, excess foreskin removed leading to minor or major loss of sensation, accidental cutting of the glan penis, and cross infection if performed with un-sterile instruments especially during ritual circumcision. To make an informed choice, parents should be given accurate and unbiased information and be provided the opportunity to discuss this decision.

The First Tongan Health Professionals Conference: seeking cultural democracy for health.

The Tongan Nurses Association of New Zealand (TNA) organized the First Tongan health Professionals Conference as part of workforce Project funded by the Ministry of Health in supporting Pacific professional organizations. The conference theme was Cultural Democracy as an overarching philosophy for provision of ethnic specific health and social services in. New Zealand. The underlying motive for the conference was to place nurses in the context of health professionals and to promote the idea that Tongan nurses are needed and are willing to support all Tongan health workers. New Zealand. Dr Debbie Ryan, Chief Advisor Pacific Health to the New Zealand Minister of Health, opened the Conference. Several other Tongan health professionals expounded on the achievement of Tongan health workers in New Zealand and noted that these achievements were closely associated with their beliefs in "Tonganess" and the unique place all Pacificans have in New Zealand health. This conference generated much enthusiasm for Tongan ethnic specific health service provision, health work in general and nursing in particular. The fact that the nurses organized the First Tongan Health Professionals Conference was seen as a unique leadership initiative, emanating from the good will and trust usually expected of the Tongan nursing professionals at the health service level and in the community. There was desire to continue this type of ethic specific approach to enhance equity and decrease health disparities in New Zealand.

Commentary on diabetes and Tongans in Aoteroa.

Diabetes is a global challenge without universal personal solutions. A special diabetes clinic of the Tongan Health Society Incorporated, at Langimalie Health Centre, Onehunga, Auckland has about 1166 Tongans with diabetes in its register. This experience is very much the experience with Tongan diabetes patients and may be common to other Pacific ethnic groups. The characteristics of these diabetic patients can be explained through an understanding of the ethnic specific characteristics of Tongan populations. Among Tongans, illness and diseases are synonymous with symptoms. Non-communicable diseases have been labeled as the diseases of affluence in Pacific countries. Food is a high priority cultural commodity. Food consumption at personal level is determined and controlled at household level. Therefore patients with diabetes have little control over food preparations and meals. The study showed that the common sense association between food preference and food consumption was incorrect, mostly due to the inability to access the preferred food. The universal personal solution for diabetes is embedded in the ethnic specific fabric of populations. There should be more research by Tongans on Tongans so that ethnic specific nuances of language and behaviours of Tongan diabetes patients may be better understood and disentangled.

SIDS or Sitisi: plight and response of Pacificans in New Zealand (Aotearoa).

Sudden Infant Death Syndrome (SIDS) or Sitisi was considered a rare event among Pacificans worldwide. However, recent findings in New Zealand (Aotearoa) have shown that at least 33% of Pacific infant deaths in New Zealand since 1991 have been due to Sitisi, and the incidence of Sitisi among Pacificans has been on the increase since 1986. These findings have necessitated the development of a Pacific response, especially since a National SIDS Prevention Programme in Aotearoa, implemented in 1991, had led to decreasing rates amongst Pakeha (Europeans) only. This paper reports the Pacificans' experience with Sitisi and the response to the control of yet another epidemic amongst migrants. The response included research; community consultation; and training of Pacifically appropriate Community SIDS Educators. The importance and initiation of community-based strategies is central to the Pacificans' response to Sitisi and its determinants. The success of this approach provides a model for intervention and health promotion, at least, among Pacificans globally.