Health professionals in Canterbury are rallying to change poor health outcomes for Pasifika people by creating a health care service that’s warmer, friendlier, costs less and meets the real needs of Pacific people.
That’s the idea behind the Etu Pasifika clinic which opened in Christchurch earlier this year.
In early June, Etu Pasifika, a Pasifika healthcare provider offering a wrap-around care model, moved into a new purpose-built building on Tuam St, with the goal of improving health outcomes for Pasifika people.
Pasifika people have significantly lower life expectancy, higher rates of chronic disease, and premature disability than the general population of New Zealand.
It’s a disparity Pasifika Medical Association Chair Dr Tearikivao ‘Kiki’ Maoate would like to see disappear. The Pasifika Medical Association is the parent body of Etu Pasifika.
“Our people put health at about a third or fourth tier level down,” Dr Kiki says. “When they need their health, they pick it off the wall and do something about it. But our people don’t prioritise health, because they can’t afford it. Availability, access, where do they go? Who’s going to listen to them?”
Etu Pasifika has shaped their approach around mitigating these barriers. Appointment costs are low and timing of payment negotiable, staff are predominantly Pasifika, people can book appointments or walk-in, and emergency care is available.
“In a mainstream model, you can be constrained by time or funding in terms of how we help people. But with this model, we are not restricted by funding or criteria,” says Etu Pasifika clinical director Dr Monica Nua-George.
The wrap-around service approach means that as well as providing medical care for physical ailments and injury, Etu Pasifika are also able to address the causes of stress and ill health.
“You come in for a medical illness on the day, but also needing some help with your housing, or your job,” Dr Monica says. “We try to help with that as well. So the doctors or the medical team deal with all the medical things, and we get our navigators to support people through their social needs. And then we have our mental health team.”
The Etu Pasifika service model is based on the ‘Nuku’ model, developed in Alaska in the 1990s, which garners community input into designing health services that meet their specific needs.
“We’ve done it this way because we know that our families have been struggling for decades around their wellbeing and around health. We know that our families’ needs have never been fully taken into consideration. It’s very transactional. Here’s your doctor, out,” says General Manager Amanaki Misa.
“For us, when our patients walk in, our philosophy is that they do not come to see a person; they come to receive a service and the service is made up of a team.”
The new building allows the Etu Pasifika team space to create a family-orientated environment, with play space for children, Aiga rooms, where family members can sit in on consultations, and a waiting room which is more like a living room, with couches, fruit, tea and coffee.
Little things can make a difference, says Dr Monica. “All the smiling that we see, we don’t normally see in a doctor’s practice. I think it helps to have a tea and coffee facility for people to go in and make themselves a hot drink while they wait. It’s feeling much more comfortable for our patients.”
“It has the Pacific feel right throughout,” says Amanaki, “through our art work so people can look and finally say, ‘Yeah, I see myself in this space.’”
Dr Kiki is buoyant about the future. “This building can go to five floors. So the next floor should be a community hall. Now, that’s one of my dreams.”
In the meantime, the Etu Pasifika team are feeling positive about the new premises, the wrap-around model and the difference they can make for Pasifika people.
“I think it’s the freedom to support our families” says Dr Monica, “to truly support our families.”
