Transcript for:
Health and Well-Being in the Pacific

my name is dr debbie futapuati and i'm the campus director in the cook islands at usp here in beautiful rarotonga i'm going to chat with you today about health and well-being as part of your uu 114 course so today we're going to chat about pacific health and well-being and have a look at what some of the countries around the world consider being healthy and what well-being is and compare that to pacific understandings of health and well-being today this little conversation will explore the concept that health and well-being or healthy lifestyles are states that are greatly impacted by the environment that you're in the individuals and communities that you are part of your country's policies and the cultural economic environmental political and social environments that you live within we're going to be considering today the concepts of health and well-being discussing three pacific health and wellbeing frameworks and promoting some reflection around your personal health and wellbeing as a student at the university of the south pacific the first thing we're going to look at is a statement around health from the united nations the article 25 of the un declaration of human rights discuss health this definition talks about the fact that everybody has the right to a standard of living that is adequate for the health and well-being of themselves and their family see how language has changed over the years including food clothing housing and medical care necessary social services and the right to security in the event of being made unemployed sickness disability widow being widowed old age or a lack of livelihood and circumstances that'll be on their control and if you look at the date that the un adopted this uh declaration it was 1948 so it's been around for you know close to 100 years now i think one of the big questions that i would ask from the statement is what is the definition of adequate and i think what we can uh easily say from those of us who are living in the pacific is that many developing nations would still be struggling to be able to meet this uh article of the un declaration of human rights that a lot of these services are certainly not adequate in some of our countries and we have a lot of work to do let's think about uh well let's take a look now to see what the world health organization says when i ask the question of what is health of the world health organization they have a really clear definition they say that health is the state of complete physical mental and social uh well-being and not merely the absence of disease or infirmity so what we see here is the beginning of a broadening idea about health but it's not just about um you know eliminating disease from our bodies or the physical body in terms of illness it's also about your it's your physical wellness as part of it but also your mental and your social well-being the way that you can connect with the world and people around you when we consider these uh dominant sort of medical discourses around health that come from a predominantly western space they are quite different to the way that pacific peoples think about health when we look at the research across multiple pacific nations what we see is that there's a really uh there's connectedness with people there's traditional and or customary lands and the connection there knowing who you are in terms of your self-identity and your self-worth as a indigenous person and that those that knowledge of those indigenous knowledges actually support your health and well-being and that's the way pacifica people start to think about health that it's broader than just the body and mental and social there's usually a much more holistic view of the world and the way that we think about health so when we think about or look at pacifica health frameworks we see some common things we see connectedness between people and that can be both living people and people who are your ancestors and thinking about the connectedness of the people who are coming after you your descendants the importance of harmonious relationships not just with humans but also with the environment that you are living in your spiritual well-being so thinking about your uh values and your beliefs and how this connects to social justice and communal living and also seeing those connections between happiness and the connection to well-being so a much more broad concept of health and wellness in terms of pacifica understanding what we're going to do now is have a look at three pacifica models or concepts of sometimes called concepts sometimes called frameworks of health we're going to look at the fono fale model a pizza model and te feke and we'll see a bit more about that now so when we look at the funifali model this model was developed in the 1990s by groups of pacifica people living in new zealand so people from salmon cook islands tonga neway kokolo and fiji uh participated in a series of health workshops uh in in new zealand or alte aurora and what we can see here from this metaphor of a samoan and the way that it's representing the ideas that came from those workshops as it is a very strong foundation of family that underneath everybody's state of health is your connection to family and culture the two dominant features in this image are culture and family supported by the posts of your physical health your spiritual wellness your mental wellness and then there's some posts with other aspects of uh or dimensions of healthcare things like your sexuality your gender because women live longer than men those sorts of things your age and your socioeconomic status or how much money you earn or that your family earn and around the outside of that fale are the words context time and environment and so at any one time your health can fluctuate you know one day i get up and i feel full of life i'm full of vigor and i'm ready to go and do everything that i need to do other days i wake up and i'm feeling a bit more tired or fatigued or overloaded or i might be unwell with an illness or i might have too much stress on and so those impact on my health the context i find myself in if i'm sitting here in this beautiful classroom at usp it's a beautiful space and context for me to work whereas if i'm in a crowded noisy space that maybe it's not so good for my health and wellness and your environment also impacts on your health and well-being and you can see from this way that the circle goes surrounding the fonifale there then it's telling you that those things are constant and rotating around all the time impacting on you all the time your environment can be conducive to health you could be in a like i said a a classroom with aircon that's and helps me and supports my wellness but i could be perhaps living on an atoll with a cyclone warning coming in my environment will be very different it could also relate to being surrounded by people who support me to do the things that i need to do or people who detract from what i need to do that are negative call me stupid say oh who do you think you are going to university you're not clever enough uh those kinds of things or an abusive relationship that sort of thing definitely impact on your health and wellbeing but that's the ponefale model let's now have a look at the petunua model from the cook islands this this concept of health is uses the metaphor of avaka to represent something that allows us to visualize what this concept of health is about or petunia is about this will develop through two years worth of working with communities right across the cook islands so what we see here are five dimensions of health that cook islanders think are really important first of all the kopapa or the physical part of a house you can see there that it's the body of the vaca where people sit in that sailing vessel so the physical both the physical body its growth development the ability to move the ways of caring for it we know that if a bucket is full of borer it's not going to say what fail well equally if our body is sick it's not going to travel well for us or we're not going to last a long time the body in this baka is represented by the hull of the of the canoe and it's the main focus of the boat without the body there is nothing okay without the hull there is no bukka without the body there is no uh health and well-being let's look now at to mana core or the mental and emotional health that's represented by the key or the sale and the thinking there was about having well thought out thinking processes acknowledging and expressing thoughts and feelings being able to respond appropriately to the situations that you find yourself the fail represents the mental and emotional well-being as what wins go in your sale impact on the direction that your bucket goes and equally the thinking and the thoughts that you have impact on your actions let's think about um the vaidwa or the spiritual well-being that's represented here on with this metaphor by the ummah of the waka because the ummah balances the bucker out so our values and beliefs determine the way that people live the search for meaning and the purpose in your life your personal identity and your self-awareness for some individuals and communities uh spiritual health it relates to religion but for others it does not um [Music] just as our value so so we were thinking about the um uh we can be we can be knocked over by some of life's experiences and everybody experiences times that are tough and we have to use coping strategies and that's where our values and beliefs uh step in equally the armor balances the bucket and allows it to continue sailing and like our values and beliefs do for us that is uh recognized by the paddle in this or the oi and the corporate tangata is um the cook islands word for our connect our families our extended families so you can you need one more than one paddle and the paddles need to work in unison for this to be able to move forward if there's no wind so that represents our social well-being we have to be able to work in harmony with others have the communication skills and the strategies to be able to be out in the world and interact with others in a way that is beneficial for us but also beneficial for other people and finally we've got arorangi which is the dimension of the environment which we saw in the fornefali model as well it's not really recommend it's not really recognized in the who definition is that or the u.n definition but people in the pacific know that the environment definitely impacts on their well-being so the environment is about the sea that the tucker finds itself in how society influences you or how the sea influences this boat the way individuals are shaped by their environment for example the media the church you go to the village that you are part of your peers your school your surroundings your island your country um the interconnectedness that a person has with the land that they stand on and they know their land rights and they know the traditions that go with those whatever the environment that you are in we need to be equipped to uh with the skills to be able to manage them whether there's fine weather or rough weather and everybody has some tough times in their lives it's not all plain sailings so we need those skills so that gives you an idea of the way cook islanders think about health and well-being you may have a model of health that you know about from your own country and we'd love you to share those and and learn more about them the final concept that we are looking at today is from tavalu and this is from a very new phd that has just been completed and research and he has developed this concept called ola and using the metaphor of a octopus or feki to represent this concept of health so this uh image really shows us that the tavalo and view of health and well-being intertwines with social cultural economic and spiritual life with education uh connectedness to the land and the ocean so again we see the connections with the previous two slides and the previous two models where there's social environment environmental spiritual health intertwined with the way that we can be well or that enhance or protect us in our wellness or detract from our wellness and so the focus again is on the interconnectedness of all of these dimensions of health as they were in the previous models i really like fairfare here too which is around happiness and contentment and i think that happiness and contentment is very connected to gratitude and thinking about what we do have rather than what we don't have so let's think about all of this in relation to your own health as a usp student studying uu114 and the other courses that you're doing so i wanted you to do a little interactive activity here and you'll need to stop the lecture at some point so that you can do these activities now on a piece of paper i'd like you to draw the body of an outline like a gingerbread person so that there's enough space for you to put some words on in the middle of the person on their body of the person once you've got that body outline i want you to write all the words that you can think of that answer this question what makes us healthy so for example i might like to say if i was doing this activity that um connecting with my friends is really important it keeps me healthy because i can have a laugh with them a glass of wine with them maybe have dinner um walk along the beach or those kinds of things so connectedness to other people that i care for and love is important to my health as is the exercise of walking on the beach especially like the sand on my toes and feet and it's called grounding and needs lots of research to show that that's very good for us so those are two things that i might put on my gingerbread person body outline but you will have some other things so what i'd like you to do is pause the lecture get a piece of paper and write all the things that you think make you healthy on the inside of that body okay welcome back i hope that you could find uh at least half dozen ideas about what you might put on the inside of your body so what i've done here is given an example of of some things that someone might have written on the inside of their body i hope you like my gingerbread person um you will have maybe some similar things but maybe some different things and that's perfectly okay because what makes me healthy might not be the same as what makes you healthy but what we'll probably see is lots of commonalities between if we were doing this all in a room together so you can see this person uh has decided that having positive relationships and good friends by those social connections that we saw in the pacifica models of health are really important to them their self-worth is important liking who they are and knowing how to care for themselves and wanting to care for themselves is really important and that's our physical but it's also mental and emotional health managing their time well is important and reducing stress but so is that those physical aspects like exercise eating fruits and vegetables uh you know going for a walk and having a healthy body you can see here that having someone to talk to when they need someone to talk to is also important to them they recognize that that's important to keeping themselves well so there's lots of other things that could have been entered on in in this body outline and you'll probably have some very different things and that's okay so what i'm going to do is build on this now on the outside of the body outside of the gingerbread person again i want you to stop the lecture and to think about what makes it hard to be healthy where you live so when i did this activity with a bunch of young people in the cook islands they came up with lots of ideas about knowing what to do to be to be healthy but there were lots of barriers in the place and in the place that they lived that made it hard to be healthy so what i want you to do now is pause me and write down all the things that you can think of that make it hard to be healthy let's think about some examples before i turn to the next slide maybe not having enough money would be impacting on my health because i'd like to buy some healthy food but maybe it's too expensive uh maybe the fact that i have too much work on is causing me some stress and i'm not managing my time well i'm being distracted doing some other things and that might impact on my health as well maybe my time poor and i'm eating too many takeaways because it's easier okay time to pause me and write down all the things that you can think of on the outside of your body outline so here we have another example that's going to move me out of the way so you can see um so this person that we saw the flight over of all the things that make them happy it will make them healthy on the inside i saw having fun uh have written a whole number of things all sorts of things that impact on their ability to stay well all the time now these things might or might not be around all the time they might come and go so [Music] you can see that they're having trouble getting off social media so they're a bit too distracted there and maybe that gives them not enough time to do some of the other things that they have i think it's pretty common and one that people are spending a lot of time maybe doing um things on social media maybe other things that they should do not enough money too many things to do i'm juggling so many things and sometimes the pressure of that means we turn to something that's easy like makes watching social media they're having trouble getting some contraception and they don't want to have another child at the moment and so that is causing them stress and concern they're under some pressure from their family and and not being able to do all of the things that their family want them to do because they're busy with other things they've been fighting with their partner and that could be you know that will impact everything [Music] partying a bit too much with their new friends at university that wouldn't be anybody out there i'm sure um not enough time or money to cook the good food that they need to now that they're at uni and not working maybe maybe they're a person this person was somebody that came into uni after working or hasn't got enough hours at a new part-time job [Music] and they're also under pressure from their previous friends that they had before they came to university um who do who want them to continue to do the things that they used to do but they just don't have the time to do that anymore the last thing that they're worried about is they're a bit too scared to ask for help from their lecturer in their class because they think that they might think they're dumb and they've got a bit of that impostor syndrome about oh gosh maybe am i cut out for university but you know what everybody finds something difficult at uni and the bravest thing you can do the courageous thing you can do is ask for help because if you need help with doing something you can guarantee that there's other people that are struggling with the same thing so lots of things there right uh you will have different things and you might have some similar things i don't know um you might be living in a place where you can't get medical care or you might be having to look after somebody in your extended family all those sorts of things so juggling [Music] so what i want to do now is draw on those specific models of health that we looked at the fornofalia model the pituita model and the ola model [Music] and think about the fact that they had some dimensions of health that were very um similar across them the physical dimension mental and emotional social spiritual and environmental and what i've done here is a bit of a key but you could use a colored pen if you want to a different color pen for each dimension and i want you to look at the drawing that you've got in front of you and put a circle around each one that's related to physical put a different shape or key or a different colored paint around all the ones that are mental and emotional all the ones that are social and so on and what you will find is that some of them when you start to look at them perhaps are more than one dimension or they could even be all of the dimensions that you've got on your page just on one uh let's take a little think about about each one that you've got there on the outside of your body and on the inside of your body input me on pause and do that now so we have our person that we've been looking at and they have used the key before where a triangle is mental and emotional and oval is physical health a star is spiritual a square of environmental and the hexagon the social health and they've started to have a look at all of the aspects of health and well-being on their page and the things that make it hard to be healthy so let's have a look there we've got abuse okay and fighting with their parents friends or partner what we begin to see let's take better than as a as a as an example if we're fighting with someone that we love this impacts on our mental and emotional that we can see there it also impacts maybe on our physical because we will we might start to with the arguments that happen we might start to turn to food for comfort or alcohol for comfort or sleep some people when they're stressed with personal relationships might sleep too much or or not enough sleep can't sleep because they're worried about things so that starts to impact on your physical health and your social health is already impacted because you're arguing with somebody that you love and then it might also impact on your spiritual health and well-being because of getting you to challenge your values and beliefs about this person about yourself about the kind of relationship that you want to be in or don't want to be in and so you can see that fighting with someone you love whether it be your parents your friend or your partner impacts on multiple aspects of your health what i want you to do from looking at that is to see that many of these things are interconnected that when something is um great for your health it impacts not just on your physical but your social your mental and emotional your spiritual and your environmental health and equally on the outside of this body we see the same thing that when something is a barrier to your wellness or making it difficult for you to stay well multiple dimensions of your health and well-being are impacted so i want you to think about what activities what people and what habits help you to keep well those are called protective factors what is protecting you to keep you well and i also want you to think what activities or people or habits detract from your work wellness or from your well-being and from your health those are all words that we can interchange with each other and are in fact the barriers to keeping you well so by doing this activity you can start to really focus on doing the things that help you to say well and moving away from the things that are barriers to your health or at least recognizing the times when you are moving into that space where you are doing some of the things on the outside of your body outline that detract from your health more often than you should be yeah so what i wanted to do um finish this little mini lecture was to have a look at what the research shows in terms of you becoming a university student and how does that impact on going into that environment of doing tertiary education impact on your health let's have a look so how does becoming a university student impact on your health and well-being so you have decreased the chance of yourself being overweight because it's least common in those who have done post-secondary school um and schooling but you have increased the chance of risking your high alcohol use by approximately two percent because university students are quite renowned for having um uh parties and so think about that in terms of um how much you consume your alcohol you've reduced your risk of premature death by from 24 to 15 people who are educated live longer so that kind of looks at that life expectancy you'll live approximately four years longer than your non-university friends and that not only doing higher education or university qualifications leads to not only having higher income in the future for you in your family but also the increased likelihood that you will be happy and so those are pretty good uh odds i think in terms of the way that university can impact on your health and wellbeing so really only one decrease there and that's related to alcohol [Music] i'm just going to finish with the slides these are the references if you wanted to look at those models of health in any further way these are the references that you can find the um the concepts of of health that we've discussed today um go well think about what keeps you healthy be aware of what detracts from your health and study hard care manure you