Improving Pacific Islanders health in NZ and the region

The University of Auckland has opened the first-of-its-kind research centre dedicated to Pasifika health, the Te Poutoko Ora a Kiwa (Centre for Pacific and Global Health).

Centre Co-Director, Dr Roannie Ng Shiu is a Samoan senior research fellow at the University of Auckland. She has 15 years’ experience in human geography, and Pacific health, education, and development. 

Ng Shiu says she’s very excited about the opening of Te Poutoko Ora a Kiwa, while honouring the hard work of Pacific pioneers that have gone before her.

“It’s about keeping their legacy going and we leave a legacy that our future generations can be proud of,” says Ng Shiu. “I see my role as providing strategic direction in terms of engagement with tertiary institutions and other scholars, both Pacific and indigenous scholars.”

Ng Shiu says that Te Poutoko Ora a Kiwa will take a transdisciplinary approach, looking at health in a holistic way. 

“It is also acknowledging that different people come with different skill sets,” she adds. “So it’s how do we bring those voices together to create solutions, be impactful and be innovative in order to improve the health and well-being of Pacific people not just in the region, but in Aotearoa.”

Sir Collin Fonotau Tukuitonga KNZM is a second Co-Director of the centre. The Niuean-born New Zealand doctor, public health academic, public policy expert and advocate for reducing health inequalities of Māori and Pasifika people, says the centre’s goals are two-fold.

 “One is to conduct relevant research on problems that affect Pacific people here in New Zealand but also in the islands. We have nominated four priority areas – climate change and health, chronic non-communicable diseases like diabetes and heart disease, outbreaks like COVID-19, and children and young people.

“The second part of the centre is to create an environment for young people who want a career in health research. We offer scholarships to provide support and offer training to young people. So it has a dual purpose if you like.”

Tukuitonga says climate work is already planned. “We have a project already funded by the Wellcome Trust from the UK studying the effects of heat on health and well-being, on sleep patterns and on a whole range of health measures. People in the islands are used to living in a really warm environment, however excessive heat can have a negative impact on health.”

Another project iis looking at mental health concerns in Polynesian countries.

“We just started in Samoa, and we are going to Tonga next. The idea is to find out what are the prevailing mental health concerns in the islands and the results of the study will be used to develop appropriate mental health responses in the countries,” Tukuitonga says.

In Samoa, just shy of 600 residents were interviewed about their mental health concerns, things like anxiety and depression. Tukuitonga expects the data analysis from that work to take several months.

Governance and support

The University of Auckland has invested NZ$1 million in the centre.

“We have received funding from the University of Auckland for five years but obviously that’s to just get us started and we are on our own after that. Like a lot of these things, we will have to find the money ourselves to continue the work,” Tukuitonga says.

The name Te Poutoko Ora a Kiwa was gifted to the centre’s founders by their colleagues from the Māori Education Faculty. Poutoko means leadership or to lead or a leader. Ora refers to health and well-being, and kiwa is the connection to the Pacific Ocean – Māori call it Te Moana nui a Kiwa

So Te Poutoko Ora a Kiwa means to lead in health and well-being in the Pacific. 

Having just opened, it only has a handful of employees right now, and a governing council chaired by Sir Ashley Bloomfield, who was until very recently, the New Zealand Director-General of health.

“We also have people from the islands, Lord Viliame Tangi from Tonga, for example. So it’s a combination of people from within NZ and from the Pacific region,” Tukuitonga says. 

Projects in Aotearoa 

“We have three studies, one completed and two underway on the impacts of COVID-19, how did COVID-19 impact the Pacific communities and their families,” says Tukuitonga. “One of the studies we have completed is looking at COVID-19 and contact tracing. We found that contact tracing in Pacific families was not as prompt as other New Zealand families.

“You will remember in August last year, an outbreak commenced in the Assemblies of God Church out in Mangere. We looked at the spread of that outbreak – who was affected, when and by who, and how quickly was contact tracing completed. So that’s the study that’s been completed and again the results are being sorted as we speak. 

“The findings from those studies will then be used to try to improve services,” says Tukuitonga. “For example, going back to the mental health studies in Samoa. Mental health services in the islands, by and large, are not well funded. So one of the things we hope to get from the studies to show the government and the minister of health for example, what type of mental health problems are common and more importantly, what they need to do to respond to those mental health concerns.”

Similarly, with the COVID-19 study in New Zealand, the analysis will consider what part of the pandemic response worked well, what concerned the families the most, how quickly did they get access to medical care, did they have concerns that were not addressed, how quickly were they able to secure additional social support such as food parcels and support for their families. The results will then be used to improve service delivery.  

Better data means a better response

“In New Zealand, health officials seem to think that all Pacific Islanders are the same,” says Tukuitonga. “They have very little understanding that even within the Fijian community, for example, there are indigenous Kaiviti, there’s Indo-Fijians and there’s Kailoma. So lumping all Pacific Islanders together doesn’t help us in designing a service response. The Samoans have particular needs, and you explain those in their own languages. You can’t design a service for a whole population if you don’t fully understand what their needs are.”

The centre will also partner with other organisations and experts, such as The Fred Hollows Foundation NZ to look at preventable blindness in the region.  The centre already has a memorandum with FNU (Fiji National University) to collaborate on research and is looking to similar arrangements with the Samoan National University and the University of the South Pacific.

“There’s lots of ideas and solutions everywhere and our centre is bringing ideas together and testing them in a robust way,” says Dr Roannie Ng Shiu. “We are also trying to develop the future leaders for Pacific health and Pacific research.

“It’s not just about bringing people here to New Zealand but getting our Pacific people who live in New Zealand back to the region and using their skills to help develop and support whatever else is required in the region. It’s about bringing the partnerships together and just seeing how together as a collective we can improve the health and well-being of our populations.”