Pacific Peoples Health Issue 1 - Summer 2013/14

A NEW HEALTH PUBLICATION FOR PACIFIC PEOPLE

ISSUE 1 SUMMER 2013 / 2014

www.pacificpeopleshealth.co.nz

Snapshot of Pacific Health p4

INSIDE

The Plight of Poverty on health SELIO SHEDS 60KG p20

STRENGTHENING PACIFIC FAMILIES ELDERLY HOMECARE SPECIAL p12

HEARTBROKEN ANNE FATIALOFA p6

SUGARY SWEET & DEADLY p18

MATTERS OF THE HEART p8 Pacific Peoples Health 1

Person-centredness is a way of life Spectrum Care supports people with disabilities to live great lives.

We do this by focusing on the people we support as individuals and adapting our practices to provide person-centred, Outcomesfocused lives of choice – lives like any other.

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early 20 per cent of our workforce identifies as being from the Pacific Islands, and a similar percentage of the people we support are of a Pacific Island heritage.

That makes us the largest intellectual disability support provider to New Zealand’s Pacific community, which we serve through the Spectrum Care Pacific Cultural Group.

Our Pacific Cultural Group’s philosophy is: “Focusing on the person and their families to create appropriate cultural linkages that allow the person’s needs to be addressed holistically”

The four key aims of the Cultural Group are: 1. To support Pacific Island people in a culturally appropriate manner 2. To increase our ability to develop culturally appropriate supports 3. To develop networks with external Pacific Island organisations, with whom we can form mutual support arrangements 4. To provide a social context for Pacific Island staff, people we support and their families Our services include 24-hour support for people living in residential homes throughout the Auckland and Waikato

Specialised Home Support, Behaviour Support and Aspirations services for people in the greater Auckland region.

regions, respite care for adults in the Waikato and Bay of Plenty, and respite care for children in Auckland.

We offer specialised Home Support, Behaviour Support and Aspirations services for people in the greater Auckland region, along with a School Holiday Programme of activities for children.

We’ve also recently launched a Choice in Community Living programme, supporting people with disabilities into their lives of choice in the community.

To find out more about Spectrum Care, visit www.spectrumcare.org.nz

CONTENTS

PACIFIC PEOPLES ISSUE 1 HEALTH

COVER: ERONI CLARKE AND HIS FAMILY - IMAGE © PATRICK FOSTER, OCEANIA MEDIA

WHAT’S INSIDE 02 04 06 08 10

22 18

Health matters A snapshot of Pacific health Anne Fatialofa’s heartbreak Tips for a healthy heart Healthier Pacific families in New Zealand 11 Eroni Clarke talks work and family (cover story) 12 Elderly homecare special

15 What motivates you with nurse

PUBLISHERS

DISTRIBUTION

Anne & Innes Logan Oceania Media Limited www.oceaniamedia.co.nz info@pacificpeopleshealth.co.nz www.pacificpeopleshealth.co.nz

Distributed by Oceania Media with an Auckland regional focus.

ABOUT PACIFIC PEOPLES HEALTH

• MOH Needs Assessment Centres

PACIFIC PEOPLES HEALTH is a free publication targeting Pacific people in New Zealand.

Educating and informing Pacific health service users, it is New Zealand’s only magazine style publication dedicated solely to Pacific peoples health.

• Community venues such as Citizens Advice Bureau and Libraries

PACIFIC PEOPLES HEALTH ONLINE Free download on the Web www.pacificpeopleshealth.co.nz www.SPASIFIKmag.com Facebook www.facebook.com/pacificpeopleshealth E-Newsletter Subscribe via website or email info@pacificpeopleshealth.co.nz

16 18 20 22 24

Maretta Hodgson The plight of child poverty Nicki Mackinnon dishes the truth on Fizzy Drinks Selio Solomon loses 60 kgs Sole Inspiration: Andrew FifitaLamb runs 160km Tui fights breast cancer

• Primary Health Care venues • Other medical venues such as diagnostic laboratories and dental surgeries

• Schools / selected education providers • Others upon request and subject to suitability and availability • PACIFIC PEOPLES HEALTH is also included as an addition to SPASIFIK magazine and included in its usual distribution by Gordon & Gotch, and to over 2,000 subscribers including schools, libraries and tertiary institutions Distribution Enquires email - anne@oceaniamedia.co.nz

IMPORTANT INFORMATION AND DISCLAIMER The information in this publication is intended to provide general information to the public and is not intended to address specific circumstances of any particular individual or entity. All reasonable measures have been taken to ensure the quality and accuracy of the information available in this publication.

12 www.pacificpeopleshealth.co.nz

The information in this publication should not be construed as legal or professional advice and readers should take specific advice from qualified professional people before undertaking any action following information received from this publication.

Pacific Peoples Health 1

Health Matters

Why Pacific Peoples Health?

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ur snapshot on the overall state of our health in a city that boasts to be the largest Polynesian city in the world (p4-5) explains why we’ve launched Pacific Peoples Health.

We launched SPASIFIK a decade ago.

During that time I’ve heard countless tales of the journeys and sacrifices our parents made (in my case my mother by boat in the early 1950s from Samoa) to set up a new life in the land of milk, marmite and manuka honey.

It’s all part of a global immigrant tale where people arrive in numbers into new world countries in a post colonial era such as us in Aotearoa, Australia, Canada and the United States. For many it’s a gradual but eventually successful process of assimilation. And while many Pacific people are part of that success, too many are struggling.

I’ve been advised by people I respect in the health profession to avoid the hard-nosed approach. Pacific people have been blamed and bashed around enough in mainstream circles.

I’ve known Eroni Clarke since he burst onto the rugby scene for Auckland and I was writing for our local Auckland community newspaper the Western Leader.

After a successful rugby career Eroni is working in the Pacific community as a Pacific Addiction Workforce Coordinator based at Le Va (p11) following his work providing clinical support.

“As a clinician you really do get to see the impact that alcohol abuse and mental health can cause,” he says.

“You see the hurt, the violence and the damage that it does to families.”

Those experiences have reinforced the importance that families have on individuals, and vice versa. It’s also made him appreciate his family role as husband to Siala (from Faleasiu in Samoa) and father to Shekynah, EJ, Caleb, Jirah and Zion.

“The work I’m involved with highlights the responsibilities I have as a father and a husband,” says Eroni.

“Life is hard and has its challenges along the way. The true way to show you care for your kids, whether they’re toddlers or teenagers, is not spelt L.O.V.E. “It’s spelt T.I.M.E.”

I agree with the strengths-based approach.

The time is right for Pacific Peoples Health.

It has been the cornerstone behind a decade of publishing SPASIFIK.

And there’s no better time to make a positive change than now.

It’s not about avoiding the hard issues altogether.

It’s about finding solutions and telling the personal success stories that inform and inspire. It’s why we asked ex-All Black Eroni Clarke and his family to be on the cover of our first issue of Pacific Peoples Health.

As the saying goes: ‘Yesterday is history, tomorrow’s a mystery, today is a gift.

That’s why they call it the present.’

Innes Logan

Framed: The Clarke family with Eroni, Siala and their children (L-R above) Zion, Shekynah, Caleb, EJ and Jirah (front) 2 Pacific Peoples Health

www.pacificpeopleshealth.co.nz

ENJOY POSITIVE lifestyle changes with PACIFIC HEARTBEAT

PACIFIC HEARTBEAT...

We are always here to support you by: • Offering Pacific heart health information and advice • Encouraging and supporting our Pacific families and communities to be smoke-free, eat healthy and be more active • Working to reduce high rates of heart disease in Pacific communities Contact Pacific Heartbeat: E: mafift@heartfoundation.org.nz P: (09) 571 9191 W: www.heartfoundation.org.nz

“My father passed away at the age of 57 from Ischaemic Heart Disease. I want our PI community to live longer…by being educated on how to change our eating habits, how to cook our meals in different ways AND still eat the foods we love... completing Pacific Heartbeat’s training programmes has equipped me with the knowledge and skills to pass onto my family, church families and community” - Losa

Losa Utalo (Left) and Siliva Fanolua (Right) Graduates of Pacific Heartbeat training

Health Snapshot

4 Pacific Peoples Health

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Pacific Peoples Health 5

Personal Story

Heartbroken

Anne Fatialofa holding photo of herself and late husband Peter Fatialofa

On November 6, 2013, the Pacific lost one of its true leaders when rugby legend Papaliitele Peter Fataliofa died from a heart attack in Samoa at age 54, becoming one of a growing number of Pacific male leaders who have died before their time. INNES LOGAN reports

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housands of Aucklanders provided a fitting farewell to Peter Fatialofa on a glorious sunny day at a packed Vodafone Events Centre in Manukau on 13th November 2013.

Three weeks later I drop by the Fatialofa home around the corner from the Events Centre. The sky is grey and it’s raining.

As President of the Papatoetoe Swimming Club Anne Fatialofa, Fats’ wife for more than 30 years, says she needs to help with the local Santa Parade scheduled that evening, despite the weather. Early the following morning she’s off to Samoa, as a whole nation wants to pay their respects to their hero.

“I’ve tried to keep strong, keep the business ticking along and maintain a normal routine,” she says.

“But in the last few days it’s really starting to sink in for me and the kids that Fats isn’t coming home … It’s hard.”

Peter Fatialofa died of a heart attack in Apia, Samoa. He had arrived for a morning radio interview. While friends chatted they left Fats in the car as he’d often be making phone calls or texting.

6 Pacific Peoples Health

By the time they realised he was taking too much time it was too late. Fats was gone and the desperate rush to hospital and the medical staff’s attempts to revive him were to no avail. Among the many tributes given to Fats were a number from former rugby teammates about a man who used to play hard, drink hard and party hard. String them all together, and it would be understandable if people thought it contributed to his early death.

Anne thinks otherwise.

“Yes, Fats liked a drink, but I honestly think he had too much on,” she says.

“He had his business in Samoa that he’d set up (Fats Tours). He was coaching the Manu Sina women’s rugby team and doing their fundraising. He was in talks about getting the Samoan Sports Association (which he was President of ) active again and he’d often ring us to see how the family and business were going.

“His mind was always ticking over with something. When he last returned from Samoa he didn’t drink. I couldn’t get over how much he slept. Fats wasn’t a big sleeper, but he obviously needed it.” www.pacificpeopleshealth.co.nz

From L-R: Courtney, Robert-Alan, Anne, Shelby & grandchild Pietersen Anne says Fats was well aware of the need to look after himself.

Pietersen His father Momoe, who brought the family over to New Zealand in the 1950s before returning to become a Minister in the Samoan Government, died in 1980 also aged in his mid-50s. Three of Fats’ brothers, Momoe, Filo and Mala died in similar fashion.

On returning home she received a text from him which read:

“Fats mentioned he was getting to the same age his Dad was when he died and he needed to watch himself … which he did when it came to drinking,” Anne recalls.

To your eyes

“One of my own nephews was eating too much and getting massive, so Fats was trying to encourage him to exercise and eat healthier. He changed a lot of his own habits to stay healthy, like having his dinner early at around 6 instead of eating late.”

“Fats didn’t like me smoking, but I felt the need to after he passed away. Strange thing was they went missing from the exact spot where I left them. I thought, ‘That’s Fats, still trying to hide my smokes.” z

I don’t know why I’m so shy To say goodbye In the days that followed, Anne wondered if that really was his last goodbye.

Anne Fatialofa is reluctant to draw too many lessons following the passing of her husband who she married in 1982. As she said at his funeral, the marriage may not have begun the way she wanted, with Fats spending his wedding night and the next day celebrating with his mates.

But the love and support she and her family have received meant she was married to someone who gave so much to so many and was loved and adored by his family.

“Fats mentioned he was getting to the same age his Dad was when he died and he needed to watch himself … which he did when it came to drinking ” “He spoilt the kids so much. They loved taking him to the airport or picking him up because he’d always shout them McDonald’s. If I said no, they’d go and ask him. He’d always give them what they wanted.

“Fats was away a lot, but it was always good when he was at home.

Just his presence gave you a feeling of security,” she says.

“If I had any advice, it would be not to take too much on. Work hard, but get some decent rest and make sure you get a check-up to know what condition your health is really in.”

Their last moments together were a couple of months earlier when she dropped him off at the airport as he headed for Samoa. www.pacificpeopleshealth.co.nz

Pacific Peoples Health 7

8 Pacific Peoples Health

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Pacific Peoples Health 9

Mental Health

The journey towards Pacific families flourishing in Aotearoa Dr MONIQUE FALEAFA, Chief Executive of Le Va, states a strengths-based approach embracing Pacific solutions and collective responsibility will lead to establishing and maintaining a greater positive state of mental health among families

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acific people will truly flourish in New Zealand if we look carefully to our culture, families and communities – and take collective responsibility.

Although Pacific people have had a presence in New Zealand for well over a century, most of our parents came in the 1960s and 70s with a vision of finding a good quality of life and flourishing in New Zealand - and for their children and generations to come to flourish well into the future.

Our parents had a shared vision of what flourishing looked like for themselves and their communities. Unfortunately, some might say that we may have had a “nek minute” moment - we now have huge inequality, inequity, intergenerational poverty and decades of disparity that prevents our communities from collectively flourishing.

The Le Va approach At Le Va we take a strengths-based approach to creating opportunities for families and communities to flourish through embracing Pacific solutions. We come with aspiration, courage and forwardthinking, much like our parents who came to the ‘land of plenty’.

This helps us to imagine what it would look like if Pacific populations flourished in Aotearoa. And if we do this, we may find that the solutions lie in our culture and in our own families and communities.

What we need to do We need to look at the reality of statistics, but we also need the hope and aspirations that uplift us and call us to action in a positive way.

For Pacific people to flourish in Aotearoa, we need to take collective responsibility for our most vulnerable and under-served populations, and the conditions which influence this.

10 Pacific Peoples Health

From a traditional indigenous Samoan perspective, a person may be seen as a relational being, a person does not exist as an individual, and there is no such thing as an independent person (Tamasese et al) - a person only exists in a collective context of genealogical lineage, family, village, nation, and the roles, responsibilities, identity and sense of belonging that comes with that.

So, just as a person’s identity exists only in relation to others, flourishing is largely determined by others.

“We need to take collective responsibility for our most vulnerable and under-served populations, and the conditions which influence this.”

From village to nation In New Zealand, we can transpose the village situation from a social justice perspective. For our most vulnerable to flourish we need our social, political and economic structures to support this. So, all people have access to equal rights and equal opportunities.

We all have collective responsibility by contributing to society through being employed, participating in education, tautua (service) and other forms of giving. And importantly, we have mutual responsibility for each other - we have compassion and care for one another and the environment, as individuals, but also from a corporate perspective.

This is not a benefit of social justice; it’s an obligation we abide by. This is a winwin situation for all of us because it’s a relationship of reciprocity where caring for others and nurturing and maintaining the relationships with people and things is fundamental to our own flourishing and happiness. We find fulfilment in this.

Towards an inter-generational vision Who was it that said “A vision without a plan is just a dream. A plan without a vision is drudgery. But a vision with a plan can change the world”?

Our parents had a vision and they had a plan. They came for a better life and for future generations to flourish – and what this looked like was being mentally, physically and spiritually healthy, having a good education that would open up opportunities, and being successful and financially stable.

If we treat relationships with people and the environment as sacred, look to our own cultures for solutions, take collective responsibility for our underprivileged, vulnerable and under-served populations, and draw from our past to achieve our future potential, all New Zealanders will benefit.

WHAT IS FLOURISHING? Flourishing is having meaning and a sense of purpose in life, positively engaging with people and our environment, and nurturing those relationships over time. The Mental Health Foundation of NZ defines flourishing as “a state where people experience positive emotions, positive psychological functioning and positive social functioning, most of the time.” This state is dependent on the inter-relationship with society and social determinants of wellbeing. It is more difficult for people to flourish and have positive mental health if they are subject to oppressive institutions, discrimination and societal inequalities.

www.leva.co.nz

www.pacificpeopleshealth.co.nz

From All Black to Advocator S

ince retiring from rugby in 2006 after a 15-year career playing for the All Blacks, Samoa Barbarians, Auckland and the Blues, Eroni Clarke exchanged the glamour of being a professional sportsman to building Pacific communities.

His work has included pastoral care and support services through the church, in promotions and careers for tertiary education, and personal development at all levels from students and athletes through to corporate groups and one on one training.

“The opportunities and life experiences I gained from rugby were priceless and I have adopted so much of them in my approach to life,” says Eroni, who is Samoan born (the villages of Saluafata and Vaiala), but also of Tongan heritage (Kolomotu’a in Nukualofa).

Eroni worked with Tupu Services as a regional clinician offering cultural support and practices to our Pacific clients in addictions and mental health. In 2013 he joined Le Va and Matua Raki, National Addiction Workforce Development Centre within Te Pou.

www.pacificpeopleshealth.co.nz

As Pacific Addictions Workforce coordinator Eroni is based at Le Va in Manukau on the implementation of the Pacific Workforce Strategy. He’s enjoying the challenge.

“The big shift is changing from being at the coalface of our communities to working at a strategic level. I’m part of a team that ensures there’s a Pacific voice within the addiction sector at a level where policies are made,” he says.

“At the end of the day it’s about advocating to create more opportunities for Pacific people to provide skilled, quality service and care for our people suffering from alcohol and other addictions.

There’s a lot of work to do, but I’m excited by it.

“I’m looking to expand on this role by using my networks and experience, guided by our teams at Le Va and Matua Raki.”

Eroni says his experiences in the sector have made him appreciate the sacrifices his own parents made to forge a new life in New Zealand. While many aspects of modern day life have changed, some of the principles in dealing with the inevitable challenges that arise haven’t.

“We still exist as part of a family and even though the definition of what a flourishing family looks like might differ from our parents’ views, there are commonalities,” he says.

“As a Pacific person that’s to have happiness, even though we know life can be tough, our children are provided for and our cultures and where we come from are at the forefront of our lives. z

Pacific Peoples Health 11

Elderly Care

Growing Concerns Elderly Pacific people have traditionally been cared for by family.

With the Pacific population living longer, the responsibility and demands on family are increasing. And many are not coping.

INNES LOGAN investigates as to when to ask for help

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s Chief Executive of Pacific Homecare, Hamish Crooks knows all too well the signs when an elder needs professional care.

“I’ve talked to quite a few of our people who struggle with the concept of seeking home help or putting their Mum or Dad into a home, but often it’s very clear that their parent needs more support,” he says.

“It’s not only the Mum or Dad who is suffering, but the kids as well.

They’re getting stressed and burnt out. In fact, we know of cases where the caregiver ends up dying first because of that.”

Hamish adds that as Pacific people live longer, like everyone else in New Zealand, there are increasing signs of dementia. It has become noticeable within their own client base.

“Generally, our people died a lot younger in previous generations, so we didn’t have the chance to get dementia.”

Traditional family structures have also evolved and there are economic factors that have a strong influence.

“Auckland is a big city, not a traditional island village structure where there’s family for support,” adds Hamish.

In April 2013 it was recognised at the NZHHA (New Zealand Home Health Association) Awards by winning the National Insite Service Innovation and Quality Award for improving the quality and/or effectiveness of service delivery, and the Workforce Initiative Award for improving service delivery through workforce training and development programmes.

In August it also won the Skills Highway Award at the Diversity NZ EEO (Equal Employment Opportunities) Awards for its workplace literacy training initiatives.

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horrific car crash in Samoa more than two decades ago almost claimed the life of Noa Noa (from Uafatu and Fagaloa). Initially he emerged unscathed and moved to New Zealand in the 1990s.

Noa Noa

After returning to New Zealand he was diagnosed with severe spinal damage. “The doctors told me that I had spinal injuries that went unnoticed after the crash,” says Noa. In 2004 he underwent spinal surgery, which was successful. Noa appreciates the support provided by Pacific Homecare Support Worker Uili Fanua.

“They come in every day of the week and help wherever it is needed. It has taken a lot of the pressure off my own family and I enjoy Uili’s company. We share a good laugh together.”

12 Pacific Peoples Health

Pacific Homecare, based predominantly in South Auckland but with an increasing client base across the city, has established itself as one of the leading providers of home care for the elderly and disabled.

Sefisi’s battle against blindness

Survivor’s story

Years later, however, his feet began to feel sore. He moved back to Samoa and was initially diagnosed with gout. Noa then experienced full paralysis of his body.

“Often our families are spread around the place. Both parents of young families are usually working so our elderly become isolated.

There are times when the grandparent minds the kids, but that can be both good and bad if the grandmother or grandfather finds it stressful.”

hen Tongan-born Sefisi Fisihoi’s eyesight worsened, a medical specialist presumed he suffered from diabetes. Laser surgery was based on that, only for Sefisi’s condition to deteriorate. He lodged a formal complaint to ACC and through Pacific Homecare he now receives homecare service seven days a week. Sefisi also had corrective surgery done and says his Sefisi Fisihoi overall condition has improved immensely.

“I really needed assistance,” says the 65-year-old.

“If you are half blind, a simple task like cutting your fingernails becomes very hard. It’s also hard to see if your house is clean or not. That’s why I appreciate the assistance I get from Pacific Homecare. My Support Workers help me with cooking and make sure that I eat healthy.”

Sefisi was a Pastor for the Wesleyan Christian Orthodox Church before his eyesight deteriorated. To read, he now needs magnifying devices provided by the Blind Foundation. That hasn’t lessened his determination to pursue his love of reading and writing.

www.pacificpeopleshealth.co.nz

Elderly Care

Taking care of Mama

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n 2013 Tagata Pasifika featured a documentary on Elderly Care which included Hamish’s mother Frances, known as Mama Crooks.

She’s a proud Cook Islander who lives in Tokoroa, where her family was raised. After her husband died in 2007, the family began to notice changes in their Mama’s behaviour.

Andrew took his mother to the Victoria Place Rest Home saying she needed to go for an x-ray. When she asked why there and not at the hospital, he told her the truth.

“That’s when all the swearing started,” he recalls.

“She was going to smash all the windows and doors to get out. She just wanted me to take her home. I was a wreck.”

Hamish’ brother Andrew recalls how she would go shopping, come home, then go out and buy the exact same items. Mama Crooks also started to get lost trying to find her way home.

Despite his emotions, he left her there and told the family. To help her mother settle in her new home Andrew intended to wait a month before visiting her. He returned only two days later.

Doctors informed the family that she needed fulltime care. Andrew went through the necessary assessment, gained legal backing and support from the local Alzheimer’s group.

“She looked at me and said, ‘It’s okay Andrew’,” he recalls.

Mama Crooks is settled. Andrew lives near the rest home and visits regularly. From three and a half hours drive away northwards, Hamish is content.

“For Mum it’s her new home. She’s like a queen there and she helps others. The people there are part of her community.”

But Hamish also knows there are still too many who struggle with the concept.

“As a Pacific organisation, we understand that you have to allow people to go through their own processes culturally, individually and as a family,” he says.

Mama Crooks with her son Andrew

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‘But that shouldn’t stop you from at least seeking help and advice to understand the realistic options that may be available. Don’t leave it until it’s too late. Your options become limited and you’re often left with regret.”

Pacific Peoples Health 13

Elderly Care Helena’s journey Among the many revealing client stories of Pacific Homecare is that of Niuean-born Helena Winch (from Tuapa and Tavahihi). The 80-year-old lived for many years in an abusive relationship with her former husband, who was an alcoholic, who physically abused her and killed their 14-year-old son. She is fiercely independent, but admits that after a major stomach operation she needed assistance.

That came by way of Pacific Homecare, which provides a Support Worker for her three days a week.

“Lama (her Support Worker) comes and brings me food and we usually share lunch together,” she says.

Helena appreciates Lama’s help with the washing while still allowing her to do things around the property such as sweeping.

“Lama is very good because she does my washing, hangs it up and takes it down. And sometimes when I run out of ribbon for my kahoa (necklace) she brings me the puzzle books that I love to do.”

Helena’s kahoa-making features in SPASIFIK on p32.

Helena Winch with Coordinator Amelia Joseph

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What Motivates

What motivates you?

Name: Maretta Hodgson Heritage: Samoan (Afega) Occupation: Registered Nurse at Waitakere

Hospital, Auckland, NZ

Age: 42 What did you do before nursing?

Prior to studying I sold real estate with my husband Karl, but I got to a point where I knew that if I didn’t do nursing I never would. I graduated in 2012 with a nursing degree from AUT and got a job at Waitakere Hospital on a general medical ward.

Why did you get into nursing?

I always wanted to do nursing before I had my children. I have four kids and my eldest is 22. For years I have been raising my family and I knew studying would come later. My Aunty and Nana on Mum’s side were nurses and on Dad’s side three aunties were too.

Nursing is definitely in the blood for me.

What’s it like at the hospital?

There is always a lot of support when we are having a bad day.

It is shared by the whole ward. I have always wanted to work at Waitakere Hospital, specifically because it is more of a community here.

What is the hardest thing you have to deal with on the job?

As a Registered Nurse time restraints and the high acuity required for some patients makes the job challenging and very very busy; I am on the move constantly throughout a shift. As a Pacific Island Nurse, not being able to speak Samoan is frustrating for me.

Having said that, I never have any issues building rapport with PI patients and their family and I have no trouble advocating for them despite the language barrier at times.

What motivates you and do you ever feel like you made the wrong decision?

On a recent trip to Samoa I visited the local hospital, and that really confirmed for me that my change in career was the right one. Going to the hospital in Samoa was such an eye opener for me. I think it is so important for more Maori and Pacific to get into nursing as numbers are lacking. My Maori and Pacific patients can point out that I’m a Samoan, and I can hold a basic conversation with Maori patients and some of my Samoan patients have even helped me learn the language by writing down words here and there. For me, I know this is where I am meant to be.

www.pacificpeopleshealth.co.nz

Pacific Peoples Health 15

Poverty Report

Plight of Poverty

More than half of all Pacific children in New Zealand are in families experiencing hardship*, with almost a third of those classified as living in poverty. The statistics featured in the first Child Poverty Monitor report released in December 2013 appear alarming. For Dr Teuila Percival, director of TAHA and Pacific Health Research at the University of Auckland and Consultant Paediatrician at Kidz First Children’s Hospital at Middlemore, the most alarming aspect is how the overall plight of Pacific children has worsened in the two decades she has worked in the field

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t’s a cold winter’s evening as Teuila Percival enters a small South Auckland home to meet a young couple cuddling their baby daughter. The baby has an incurable heart condition. The wind whips through and rattles the broken windows in the living room where the couple sleep in a bed with their baby. With at least 10 people regularly staying, there’s no place they can call their own.

Days later their beloved baby dies.

Such scenes are all too common for Teuila in a city dubbed the largest Polynesian city in the world. But their frequency doesn’t make such moments any less heartbreaking for her to bear.

“You get this vicious cycle of children who grow up in poverty and they never get out of it. I’ve seen it myself as they’ve become adults. They’re more likely to be sick more often, lack education and therefore earn very little,” she says.

“What’s alarming is that we’ve been saying these same things, like the need for better and affordable housing for a long time, but overall there has not been a lot of improvement.”

The Child Poverty Monitor is a joint project by the Children’s Commissioner, J R McKenzie Trust and Otago University’s NZ Child and Youth Epidemiology Service (NZCYES) which will continue to publish findings over the next five years.

It detailed four measures of child poverty: income poverty, material hardship, severe poverty and persistent poverty. Among the key findings in relation to Pacific were that 30% of Pacific children live in poor households while 51% of Pacific children experience material hardship compared to 39% of Maori, 15% European and 23% Other.

Teuila, who is of Samoan descent (Manu’a in American Samoa), is a strong advocate for the government providing greater support to narrow the inequalities, with a strong emphasis on children.

Dr Teuila Percival 16 Pacific Peoples Health

“What I find most disheartening is mainstream New Zealand blaming the parents on the children’s plight,” she says.

“What I mostly see are parents with very little money doing their best with what they have. If mainstream society washes their hands of the problem, the children will suffer and so then will society.”

As a single mother of three, Teuila knows single parents often bear the wrath of society. But what those struggling to survive need is genuine support.

“We hear about the importance of getting women back in the workforce. If that’s the case, why not make childcare free?” she asks.

“As it is, many mothers simply can’t afford it when you take into account the cost and the stress and amount of time it takes to arrange it week-in, week-out.”

Teuila’s service to the Pacific community was recognised in the 2010 Queen’s Birthday honours list, when she became a Companion of the Queen’s Service Order.

She says the key to finding solutions to the Pacific community involves looking at issues outside health, such as education, social development and employment. www.pacificpeopleshealth.co.nz

Poverty Report

“There have been initiatives that have worked extremely well in Pacific communities, such as the immunisation campaign against the meningococcal disease a few years ago and more recently the strong uptake immunising against pneumonia,” she says.

“And general attitudes towards domestic violence have improved in our community.”

That’s why the University of Auckland School of Population Health’s collaborative approach to research is so important.

“I fully support the key recommendation to have a focus and plan around children. With an ageing population it’s a huge issue, especially when there are less children and one in four of all New Zealand children are being left behind because of poverty,” she says.

“The first three years of a child’s life are so crucial to their development. If our children are healthy and getting the nutrition that’s vital to brain development, they can be productive members of society. When I look at the size, comparative wealth and resources of this nation to others, there’s no reason it can’t and shouldn’t be done here.”

Jacinta Fa’alili Fidow, manager of TAHA and a member of the Child Poverty Measures Committee, agrees.

“We as a society have the intelligence and the means of finding ways of investing in a sustainable solution to end child poverty and to improve the health of all our babies,” she says.

Jacinta Fa’alili Fidow

“We just need to express the will.”

* TAHA Well Pacific Mother and Infant Service is part of the University of Auckland’s Pacific Health Unit based in Tamaki, Auckland. It works collaboratively in the health sector on key areas of health and wellbeing for Pacific mothers and infants

An investment not a cost The findings of the Child Poverty Monitor report should be of serious concern to all New Zealanders, says Public Health Association (PHA) Chief Executive Warren Lindberg.

He says poor and unhealthy children lead to poor and unhealthy adults, who not only lead lives of hardship and deprivation, but who are also likely to be unable to provide for the next generation of children.

“We need to change the way we think about spending on the health and wellbeing of children and look at it not as a cost, but as an investment,” he says.

“Children growing up in poor households are more likely to become dependent on welfare, suffer family violence, do poorly at school and rely heavily on government-funded health care. www.pacificpeopleshealth.co.nz

New Zealand society as a whole must decide whether to invest in the health of its children or bear the increasing costs imposed on our health and welfare systems.

“We should also be concerned about the social inequities that result from child poverty in that Maori and Pasifika children fare much worse than their European counterparts.”

The report states 265,000, or a quarter of all New Zealand children aged 0-17 years live in poverty (i.e. a household with an income below 60 percent of the gross average). Three out of five children are living in persistent poverty, defined as more than seven years. * Material hardship is defined as families who experience four of more deprivation measures eg. living in houses that are damp, mouldy or in poor physical condition; that their children have to wear worn out shoes or clothing and the families are postponing doctors’ visits due to cost.

NEED TO KNOW • In 2013 Pacific people had the highest rates of unemployment for all ethnic groups at 15.7%, followed by Maori with 12.2%, Asian/Indian 6.7% and European 4.9%.

• Despite a general drop in unemployment overall, rates remain higher for Pacific and Maori, young people (15-19 years) and those without formal qualifications. Research suggests children in families where their parents are unemployed have higher rates of psychosomatic symptoms, chronic illnesses and low wellbeing.

• Hospital admissions for children increased rapidly from 2000 to 2003, then declined to 2007 before rising from 2008 • On a positive note, hospital admissions for injuries arising from assault, neglect or maltreatment were consistently higher for Pacific children but dropped markedly below both Maori and European in 2012 • The Child Poverty Monitor 2013 Technical Report can be accessed at www.childpoverty.co.nz or www.nzchildren.co.nz

CALLS TO ACTION Among the recommendations made following the release of the report include: • Extended paid parental leave • Free childcare for single parent families • An increase in the minimum wage and of benefits • Initiatives to build resilience within Pacific communities • A department ministry solely for children

www.taha.org.nz Pacific Peoples Health 17

Health Nutrition

The fizz on soft drinks

SPASIFIK columnist NICKI MACKINNON is passionate about a high standard of natural health care being accessible and available to everyone. She has a deep interest in traditional, indigenous medicine and naturopathic techniques, as well as evidence based natural medicine. She shares her increasing concern about the high consumption of soft drinks (sometimes called fizzy) by Pacific people

S

ione feels low. His body needs a boost.

He reaches into his pocket and finds a couple of dollars to buy a drink. He opens it and guzzles. He feels his energy return. Sione’s fix will last a couple of hours, enough to keep him alert for the rest of the morning. But then he’ll feel lower than before. He needs another.

The addict is 12 years old and his drug is soft drink. He and hundreds of thousands like him will attend classes supported by his school to warn about the dangers of drugs, tobacco and alcohol. But there’s danger in a product they can freely buy, often at their own school … fizzy drink.

Nicki MacKinnon says soft drinks contain an array of acids and additives, such as citric acid, phosphoric acid and caffeine, all synthetically produced. Sugar in these drinks is the most dangerous and addictive ingredient of them all.

“Research shows it’s sugar which increasingly causes people to become addicted, rather than caffeine,” she says.

“Sugar can become toxic for the body if we eat too much.”

Studies have shown how things like heart disease, obesity, stroke, dementia, and of course, diabetes, can stem from excessive sugar intake. It also causes gastrointestinal problems, where the body reacts to sugary drinks by producing too much stomach acid. This leads to gastric inflammation and possible erosion of the stomach lining. Soft drinks also act as a dehydrating diuretic, which inhibits proper digestive function.

“Pacific people are already over-represented in obesity, heart disease and diabetes figures,” she says.

“Sugary foods are leading to high levels of tooth decay among Pacific children.”

Nicki says the strong fizzy drink culture in Pacific communities needs to be broken.

But, she adds, sugar isn’t the only problem.

“Phosphoric acid added to give fizzy drinks a sharper flavour is a major issue,” she says. “When ingesting high levels of phosphoric acid through soft drinks, the body counteracts it by using up calcium in the body.”

The past 30 years has seen extensive research showing a link between soft

18 Pacific Peoples Health

drinks and the rise in osteoporosis and bone factures. Pacific people naturally have higher bone density than other ethnic groups, but future generations may not inherit the same strong bones.

Pacific parents need to be aware that high sugar levels are counter productive to learning. Sugar may affect children’s school performance by triggering obesity, depressive symptoms and replacing valuable nutrition needed for learning.

35% of primary school children have at least one soft drink per day compared with 50% of intermediate pupils and 60% of high school students.

After coming across far too many teenagers with high blood pressure in her clinic, Nicki spoke to a couple and got them to seek out family members and friends who would sponsor them if they stopped drinking fizzy drink. After just a couple of weeks their blood pressure was back to normal.

“As tempting as fizzy drinks may be, water is, and should be, the only option for hydration,” she says.

“Steer clear of them and you will notice massive improvements in you and your family’s general wellbeing.” * Nicki MacKinnon’s column on healthy smoothies appears in SPASIFIK p38 www.pacificpeopleshealth.co.nz

REASONS TO AVOID SOFT DRINKS

Tap into an easy, affordable way to good health - World class water In New Zealand the overall quality of our water that comes out of our taps is as good, if not better than anywhere else in the world. Drinking water from our taps is probably the easiest and most affordable way towards good health.

Here’s a number of other reasons why:

Balancing body fluids •

A single can of fizzy drink contains the equivalent of 10 teaspoons of sugar. This amount skyrockets the blood sugar levels in the body

The body is comprised of 60% water and drinking it pure helps digestion, absorption, circulation, creation of saliva, transportation of nutrients and maintenance of body temperature.

•

Fizzy drinks contain phosphoric acid, which interferes with the body’s ability to absorb calcium and can lead to osteoporosis, tooth cavities and bone softening. Phosphoric acid also interacts with stomach acid, slowing digestion and blocking nutrient absorption

Dieters drink lots of water to help lose weight. While water doesn’t have any magical effect, drinking it instead of higher calorie beverages will help.

•

In diet soft drinks, aspartame is used as a substitute for sugar, which can also be harmful if used excessively

•

Most soft drinks contain caffeine, another addictive substance which has been linked to certain cancers, breast lumps, irregular heart beat, high blood pressure, and other problems if consumed excessively

•

Studies have consistently shown daily and regular soft drink consumption increases the chances of obesity.

Consuming them with foods that have a high salt content such as potato chips spells double trouble as the consumer never feels full

•

Because of the high sugar, sodium and caffeine content in fizzy drinks, they actually dehydrate the body

•

Regular consumption of fizzy drinks causes plaque to build up on the teeth and can lead to cavities and gum disease

Helping lose weight

Energises muscles Cells that don’t maintain their balance of fluids and electrolytes shrivel, which can result in muscle fatigue. When muscle cells don’t have adequate fluids, they don’t work as well and performance can suffer.Drinking enough fluids is important when exercising.

Good looking skin Your skin contains plenty of water, and functions as a protective barrier to prevent excess fluid loss. Dehydration makes your skin look more dry and wrinkled, which can be improved with proper hydration.

Helping Your Kidneys Your kidneys have the job of cleansing and ridding your body of toxins as long as your intake of fluids is adequate.

Water is the most pure fluid of all.

Better than plastic If you’re heading out and want to buy a refreshing drink, it’s fine to buy bottled plastic water, as long as you consume it within the day. Have you tasted the water that’s been sitting in a plastic bottle in your car for a few days?

According to the US Natural Resources Defense Council, reusing plastic drink bottles increases the likelihood of impurities due to the introduction of bacteria and the potential leaching of plastic compounds into the water. Buy a proper drink bottle.

SUGARY DRINK FREE PACIFIC BY 2030?

On February 19-20 2014, the University of Auckland Medical School will host a two day symposium on sugar, sugar sweetened beverages (SSBs) and population health in the Pacific and New Zealand. It will cover the science on sugar, SSBs and poor health, and examine public health solutions.

VENUE:

University of Auckland Medical School, 85 Park Road, Grafton, Auckland

DATE: TO REGISTER:

Wednesday 19th February – Thursday 20th February, 2014. www.fizz.org.nz

www.pacificpeopleshealth.co.nz

Pacific Peoples Health 19

Personal Story

Selio’s weight to recovery is over At 147kg Pulotu Selio Solomon wanted to believe the common myth that Polynesians are ‘meant to be big’. Having lost 60kg he’s discovered a new lease of life and is determined to stay that way and shatter that myth forever. INNES LOGAN reports

S

elio Solomon felt shame as his 147kg frame hobbled on crutches along Dominion Road to Eden Park to watch his beloved Manu Samoa take on Fiji at the Rugby World Cup in September 2011.

When mates asked him what had happened, he replied that he badly sprained his ankle. The reality was far more embarrassing.

“I had gout,” says the 40-year-old. “But I didn’t want to admit it because I get gout from eating what I know I shouldn’t, not some accident.”

Selio also felt embarrassed at holding others up, so he insisted they walk at their own pace and he’d see them at the stadium.

It was a long and difficult walk.

“To see people of all ages walking past me was tough. It made me realise how much I’d taken walking freely for granted.”

The need to actually do something about it was cemented a few days later when, following tests, his doctor said he had a blood sugar level of 19, Selio asked what level was normal. The doctor’s reply was 4-6.

High blood sugar levels result in diabetes, which can then lead to other health conditions, including kidney failure, eye disease, foot ulceration and a higher risk of heart disease. She warned Selio that he needed to change his lifestyle or else he’d be lucky to reach 60.

His initial reaction was one of anger.

“I felt ‘Why me?’ I felt my body had betrayed me.”

He regularly went to the gym and exercised, even featuring in a fitness column in SPASIFIK in 2006 with columnist Jose Thomas, a friend of his. But then the truth hit him. He had betrayed his body.

Despite his regular exercising, he continued to eat unhealthy foods and consume fizzy drinks and alcohol far too much. Almost half of his 147kg frame consisted of body fat.

“I always enjoyed training, but what I learnt is that if I don’t address what I eat and drink, then I’m wasting my time,” he says.

He turned to champion bodybuilder Tony Ligaliga, 1999 Samoan Sports Awards Supreme Winner, who maintains his superb condition as he heads towards 50. Tony put Selio on a strict food and exercise regime, which included two regular power walks and jogs up One Tree Hill each week.

20 Pacific Peoples Health

Selio - 147kg

Selio - 87kg www.pacificpeopleshealth.co.nz

After overcoming the initial hunger and thirst pains, the weight was falling off. And when his weight fell, so he discovered, did his stress levels, despite his increased responsibilities as newly appointed Chief Executive of Martin Hautus.

“I guess the principles I’ve learned are that the discipline and sacrifices I’ve made to lose weight could be transferred to all parts of my life,” he says.

“I have more energy than I’ve ever had.”

Tony gave Selio the confidence to enter in a novice body building competition late in 2013. Selio admits he almost got stage fright and didn’t want to go on, thinking “the audience would still be looking at the overweight 147kg guy that I was.”

But Tony insisted he front up. Doing so and the reception he received gave him a moment to savour. So much so he’s doing it again.

I used to think that way, too,” says Selio, whose weight now sits in the mid to high 80kg range.

“But comparing the way I feel now and having got rid of diabetes and high blood sugar levels, I know it’s wrong. I’m loving it and so is my family.

“The only negative is that I’ve had to get rid of virtually all of my clothes and buy a whole new wardrobe. But at least I can go into stores like Barkers and not be restricted to the limited range in extra large sizes. It’s worth it.”

Selio’s 5 Daily Must-Dos •

Cardio at least 20 minutes a day

“It’s such a buzz. I don’t take supplements that a lot of guys do in body building. I regularly get a medical check-up to make sure I’m okay to do it because the diet before competition is so tough,” he says.

•

Personal Training sessions with Tony Ligaliga

•

No carbohydrates after 3pm

So, too, he admits, are initial whispers about how he achieved such a transformation.

•

5 serves of fruit and vegetables a day

“I heard whispers that I must have been on drugs. Mates have said that us Polynesian males are made to be at least 100kg …

•

Protein with every meal

www.pacificpeopleshealth.co.nz

Pacific Peoples Health 21

Personal Story

Sole inspiration Combining jandals with gumboots enabled New Zealand-born Tongan Andrew Fifita-Lamb to conquer the arduous 160km annual Steelformers Round the Mountain Relay around Mt Taranaki all by himself. KARL-JORDAN SAMUELA reports

O

f the hundreds of runners participating in the annual Steelformers Round the Mountain Relay, the vast majority share the challenge as members of a relay team.

Andrew Fifita-Lamb, a 48-year-old father of six from Manukau born in Ma’ufanga, Tonga, is one of a handful who took it on every step of the way.

What makes him stand out even more was the fact Andrew ran the entire race in homemade jandals made from gumboots and stockings.

crossed the Steelformers finish line. It took him a gruelling 31 hours and by that time the crowds had largely disappeared, but his family and friends were there to cheer him on, with his six children joining him on the last 5km leg of the race.

“It’s very hard to find the words for it. Even though I came in when everyone else had gone home, running into the finish line with my family was very emotional for me,” he reflects.

committing themselves to training and losing the weight, that inspired me to do something.”

Andrew has worked as a Needs Assessor and Service Coordinator for the Auckland District Health Board at Greenlane Hospital for almost a quarter of a century.

He has seen the health problems affecting Pacific Island people firsthand. His father became an amputee after suffering from diabetes for many years, his mother is diabetic also.

A keen runner, Andrew found traditional running shoes began to cause pain in his knees over long distances. He also wanted something less restrictive for his feet.

“Pacific people are prone to things like diabetes and high blood pressure, so it’s about being aware of these things and factoring them into the way we live.”

The solution was literally sitting at his door step, in the form of his jandals. So Andrew made some improvements to the traditional jandal design, including a special strap to prevent his feet from slipping.

Keeping active is essential. Since he started running, he’s noticed a boost in his metabolism that helps to maintain a healthy weight.

“Some people will hear my story and say that you need to be gifted or talented to run such long distances. It’s a matter of just being active,” he says.

“When I trialed the jandals I was running about 60-70 kilometres without any pain so I found that it worked for me,” he tells Pacific People’s Health.

“The gumboot material is light and it’s got a bit of a stretch on it, so it doesn’t restrict your feet. It’s also soft and durable and it folds with your feet when you run over rocks and tree roots. Plus, if your feet get wet they will dry quite easily, avoiding blisters.”

He eventually created three different pairs for the ultra-marathon, all with different functions like extra cushioning for rough terrain and more tread for slippery surfaces.

Andrew took up running early in 2012 after completing a 12 week health and fitness challenge with his Temple Ministry church group. Noticing dramatic improvements to his overall lifestyle he continued exercising through running, clocking more and more kilometres every week. On Saturday 9 November 2013, Andrew triumphantly 22 Pacific Peoples Health

“I wasn’t after a particular time. Finishing was my goal,” Before he started running, Andrew’s weight peaked at 111kg. Today he feels fitter than ever at a trim 78kg. But beyond losing the weight Andrew simply wanted to promote the benefits of a more active and healthy lifestyle.

“I wanted to inspire others because within the Temple Ministry programme we have a lot of different people – different sizes, different ages – and just watching some of these guys coming day-in and day-out,

“When I first started, it took me four stops to run the 900 metres to my son’s school.

Before I knew it I was running more kilometres than I ever thought I could. You have to keep pushing yourself knowing that keeping yourself active is good for your health.”

Andrew is taking on the 100km Vibram Tarawera Ultramarathon in March. The scenic course, which attracts athletes from all over the world, starts in Rotorua and ends in Kawerau in the Bay of Plenty.

He still has his sights set on improving his time at the next Steelformers Round the Mountain race as well, and 2014 will see a new and improved version of his trusty jandals.

You can learn more about Andrew at the Pacific People’s Health Facebook page. www.pacificpeopleshealth.co.nz

Media Kit

PASIFIKA INTEGRATED HEALTHCARE

Shore way to healthier communities Pasifika Integrated Healthcare CEO Dahlia Naepi wants North Shore’s Pacific community to be the healthiest in the country by 2015 “She became a prefect and after initially struggling did well academically. Her achievements have paved the way for a number to follow her path.”

Establishing her business in 2001 from her own garage, Dahlia was named Pacific Business Person of the Year in 2007.

After more than a decade following her humble beginnings the business has expanded from her Family Medical Centre based in Milford to providing Home Community Support and Primary Health Care Services.

Glenfield PIPC, winners of 5 of the 8 categories in the Aiga Challenge (see story p25)

T

he approximately 6,500 Pacific people living north of the Auckland Harbour Bridge make the shore the smallest of all the city’s main regions in terms of Pacific population size. It is also one of the more affluent regions.

But that doesn’t make it immune from the common health problems that affect Pacific communities elsewhere.

“We have pockets of meningitis and tuberculosis like elsewhere,” says Pasifika Integrated Healthcare CEO Dahlia Naepi.

Despite growing strains on her health budget, Dahlia will find innovative ways to continue programmes that have reduced funding which she knows work.

“We’re driving our healthy programmes towards our community creating ownership of them. We came from the islands where we worked hard in the plantations to eat and survive,” she says.

“We didn’t think of it as exercise, but we need to because it’s going to help us survive in our modern day environment.

Our people will embrace exercise with this programme far more, than if being told that they have to by some doctor.”

“And while we don’t have them in the same numbers, there are certain areas where it can spread through the community.”

Dahlia, who was born and raised in Avatele, Niue, is gathering a broad range of research information, including health, employment and education data. From her own family experience she has seen the benefits of how access to quality education can benefit the Pacific community.

“My daughter was one of the very few Pacific islanders to attend Westlake,” she says.

PIHC CEO Dahlia Naepi (left) with Lauitiiti Fesili, Emi Suaniu, Faimafili Tupu, Lita Foliaki & Tenga Schwalger-Teura

PASIFIKA INTEGRATED HEALTHCARE Pasifika Integrated Healthcare Ltd (PIHC) is a leading provider of home based support services across the Auckland region, with offices in Milford on the North Shore, Onehunga and Henderson. The medical centre’s mission is to provide quality, integrated, culturally appropriate and affordable family medical care for all family and individual health needs.

Pasifika Integrated Family Medical Centre

Pasifika Integrated Healthcare Home Community Support Services

1 Nile Road, Milford, North Shore Mon – Fri, 8.30am – 5pm, Open Sat from 8.30am – 1.00pm Ph 09 410 0275 Email: info@pifmc.co.nz

Head Office

Central/South Auckland

West Auckland

8.30am – 5.30pm 1 Nile Road, Milford, North Shore Ph 09 410 0251

8.30am – 5.30pm 17 Alfred St, Onehunga Ph 09 634 2194

8.30am – 5.30pm 295 Lincoln Road, Henderson Ph 09 839 7255

www.pacificpeopleshealth.co.nz www.pihc.co.nz

Pacific Peoples Health 23

Women’s Health

Tui’s tale a lesson for other women T

ui Allen had just turned 40 when her right breast started feeling sore. “Hot water made it itchy, and I scratched the hell out of it,” she says. “And if I knocked it, it’d be ‘Oh sh**, that really hurt!’”

Tui, who is half Maori, mentioned the pain to her GP and to her sister-in-law, a nurse, but they didn’t seem worried – neither of them thought pain could be a sign of breast cancer. Since Tui had other things to worry about, she was content to accept their opinion and ignore the problem. “My life was very busy, I was a rep on the road, I was busy with my kids – you don’t focus on yourself,” she says. “We women have a ‘she’ll be right’ attitude.”

Then she noticed a discharge from her nipples. At first, she thought it might be a lingering infection from her days working in the shearing sheds, where second cuts of wool would often get into her nipples. “I didn’t think of breast cancer at all,” she says.

But when her sister-in-law heard about the discharge, alarm bells rang. She told Tui to get a mammogram, fast. The mammogram revealed a small tumour, but when Tui went in for a mastectomy (surgery to remove her breast) the doctors found a huge 12cm tumour beneath the smaller one.

Tui Allen (centre) with her nieces

“I wouldn’t have waited so long to see the doctor if I’d known what my symptoms meant, we need to know all the signs of breast cancer – it’s not just a lump ” The big tumour was an advanced cancer that had spread beyond the breast. The doctors told Tui the bad news: secondary cancer cannot be cured, it can only be managed. She would have at most two years to live…unless she took a year-long course of a new drug called Herceptin, which might give her another 10 years.

The news was a terrible shock for Tui, whose sons were then aged 18, 16 and 14. Thankfully, her large whanau fundraised to pay for her Herceptin treatment (today, 12 months’ Herceptin is available free in the NZ public health system).

It was money well spent – seven years on, Tui is in good health, though she’s had two ribs removed to get rid of secondary tumours. “Sometimes I almost forget I’ve got cancer,” she says. “Until I go to grate the cheese, and my whole chest moves!”

She’s grateful that she has lived to see her grandchildren – three of her own, and three children of her beloved niece. She doesn’t know what the future holds, but she intends to keep enjoying her family.

Tui has some advice for other women: “I wouldn’t have waited so long to see the doctor if I’d known what my symptoms meant,” she said. “Women need to know all the signs of breast cancer – it’s not just a lump.”

24 Pacific Peoples Health

TAKE A LOOK AT YOUR BREASTS

IT MAY NOT ALWAYS BE A LUMP THAT INDICATES BREAST CANCER. CALL 0800BCNURSE

www.pacificpeopleshealth.co.nz

Media Kit

PASIFIKA INTEGRATED HEALTHCARE The 5 breast cancer signs you don’t know

Enua Ola up to the challenge

Most women know that a lump can mean breast cancer. The New Zealand Breast Cancer Foundation wants women to be aware of all the signs. In addition to a lump, the five lesser-known signs of breast cancer are:

S

ince 2009 the ENUA OLA programme has been helping the Pacific community in West Auckland and the North Shore to get healthy. It started as an initiative by providers such as Pasifika Integrated Healthcare with the Waitemata District Health Board.

With a focus on physical activity and nutrition, the ENUA OLA programme aims to improve health and wellbeing, while reducing the burden of diabetes, obesity and cardiovascular disease that many Pacific people face.

Lauitiiti Fesili is the ENUA OLA Programme Coordinator for the North Shore, looking after 11 Samoan, Tongan, Fijian and Niuean church groups that vary in denomination.

While most lumps and other symptoms turn out not to be breast cancer, the NZBCF urges women not to ignore these symptoms, even if you’re having regular mammograms.

“Around half of breast cancers are detected outside of mammogram screening,” says NZBCF chief executive Van Henderson. “Some are in women who are too young for screening, while others are interval cancers – tumours that develop between mammograms. That’s why it’s so important for all women to know all the symptoms and to report any changes to their doctor.”

Maori women have a higher rate of breast cancer than non-Maori, and both Maori and Pacific Island women are more likely to die of their breast cancer. The earlier breast cancer is found, the more treatable it is. All women over 20 should know the normal look and feel of their breasts so they can tell their doctor about any changes. From age 40, women should be getting regular mammograms.

For more information, visit www.anychanges.co.nz or for advice call the Breast Nurse at the New Zealand Breast Cancer Foundation: 0800BCNurse Order a free copy of the Breast Health DVD for Pacific Island communities: phone 0800BCNurse

www.pacificpeopleshealth.co.nz

After starting out as a Community Instructor she has seen the success in both the North Shore and Waitakere regions.

“Most church groups have really upped their game and have gone to a new level with their healthy living lifestyles,” she says.

“It has been a real joy to see. We have fun activities like Zumba, aerobics, Hot Hula, boxing and nutrition sessions that challenge our people to make those all-important lifestyle changes with diet and exercise.”

Sessions are scheduled throughout the week and are led by a trained team of Community Instructors that lead exercise and nutritional classes.

“The best way to approach our own people was to train our own people. Our instructors are involved in four weeks of training before they’re ready to get on the field.”

In 2013 instructors promoted the Aiga Challenge, which attracted more than 600 competitors, who took on eight weeks of healthy eating and exercise with a final weigh-in.

Glenfield PIPC (Pacific Island Presbyterian Church) won five of the eight prizes.

“Seeing families get stronger and healthier is a great success.

Many have also strengthened their family bonds through the programme.”

Lauitiiti attributes ENUA OLA’s success to the community instructors, families and church officials who have put in the hard work to become healthier.

“We’re now looking at other avenues to address Pasifika people who aren’t church-goers. We’ll continue to promote the programme to the community and it is important for them to know that classes are free. All Pacific people are welcome.” z Pacific Peoples Health 25

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