Pacific Health reform is to be a collaboration that focuses on its people

Saturday, July 06, 2013

By Edwina Ricci (as published in the "Samoa Observer" 7/7/2013)

The 10th Pacific Health ministers meeting has concluded but the hard work now begins.  The Pacific Ministers of Health affirmed their support for the Healthy Islands Vision adopted in 1995 as the unifying statement for health development in the region.  Ministers supported the need to refocus the vision from a focus on healthy settings to actions  to enable healthy people. (Excerpt from the official communiqué from the 10th Pacific Health Ministers Conference)

There is no doubt that the last two years has seen many positive developments in the health sector, however, there was overwhelming evidence from all countries and NGOs that the issues facing the region are a job far too big for one sector.  Not only is the health sector not sufficiently resourced, it does not hold all the answers.  WHO, SPC and the member and invited nations were unanimously supportive of a multi-sectorial approach.  Jimmy Rogers, SPC director general, said in his opening address, “There can be no achievement of health outcomes without the participation of partners outside the health sector.” Whilst this sounds like an easy task, the lack of good working models suggests that it might be quite challenging, but if we are successful in the Pacific, we may well create the ground breaking model that could be used on a global level.

The Pacific Island Countries are not new to collaboration.  It is in our very nature and out of necessity due to our isolation that we look to find opportunities to work together to get maximum outcomes from minimal resource.  Although the evidence points to increasing incidence of NCDs and other rapidly emerging issues in the area of mental health, there is not likely to be additional funding.  In response the conference partners SPC and WHO encouraged each participating nation to consider a review of how their funding was allocated.  With the move to a more people-centred rather than settings approach, the resources will need to be thoughtfully allocated accordingly. Whilst currently this autonomy lies with a country, it may be important that a regional framework or strategy lead this process with a guiding principle of “doing more with less”.  Clever thinking to identify points of synergy between the sectors is critical to this outcome.

The sports sector via the Australian Sports Commission’s initiative “Healthy Islands through Sport Forum” may have begun this process.  They invited key sectors to a forum in Brisbane earlier in the year to discuss the issues and potential opportunities to work together moving forward.  The Australian government is investing heavily in “Sport for Development Programs” in the region, that have at their core, development outcomes through increased participation, as opposed to elite performance outcomes.  This change in focus has happened in response to the increased incidence of NCDs and the need to find better ways for inclusion of women and individuals with a disability.  Samoa is running some successful programs in communities and the very successful sport for development program through the FFA, Just Play. Another successful model is the Tongan netball program, awarded for its outcomes in using sport for development with its women via a multi-sector strategy.

NCDs were the clear winner in terms of emphasis for the week and under that umbrella Mental Health featured in a large number of discussions, not for work being completed in the area but for that lack of it.  Dr. Colin Tukuitonga, Director of Public Health, SPC, in his opening address stated the three major challenges facing mental health as, “myths associated with mental illness and treatment, a lack of a strong framework for the health sector to navigate itself by and the isolation of mental and physical health.” 

Does the solution to these challenges therefore lie within a strong collaboration between health, education, youth and sport?  Sport thinks it does and proposed in the final recommendation under the Mental Health resolutions that it takes up the charge to unite the issues facing physical and mental health with a goal of ‘individuals leading healthier and more fulfilling lives.’ 

Why does sport want to do this?  Whilst the incidence of mental health is across all age and socioeconomic sectors, sport has had a number of high profile suicides and public displays of poor behavior often associated with substance abuse.  Sport understands its responsibility in being role models for our young people.  It therefore needs to find a way to improve its image at the elite end and potentially find a solution that can be shared across all demographics. Samoa football has expressed an interest in being a pilot for the program as soon as is possible.

How does sport propose to do this? The answer lies in a proactive strategy.  It involves finding a preventative solution rather than one that deals with the symptoms.  American psychologist Martin Seligman is championing a new wave of psychology called Positive Psychology. He believes that psychology as a discipline has operated to fix the problems and has not focused enough on just helping normal individuals find ways to ‘lead happier and fulfilling lives’.  So therefore not waiting until there is a problem to fix, but providing education and strategies to change thinking and behavior for maximum impact.

The Organization of Sports Federations of Oceania (OSFO) in consultation with education and sports will deliver a program as a proactive strategy to build resilience and create more productive thinking, so that individuals are provided with the path to find their way to ‘healthier and more fulfilling lives’.  We hope this will drive increased participation and a more optimistic outlook on life in general.

As highlighted in the Observer on Friday, Samoa has a working model that has been part of the inspiration for the sports sector to champion the Positive Psychology response to the mental illness crisis. Samoan born NFL star Richard Brown and local businessman Greg Meredith have taken a charge of young men and women and given them not only a world class physical and skill building program, but one that comes with equal amounts of emotional and spiritual development.  Their 100% success rate in nurturing these young people to refocus their lives and to invest ‘what it takes’ to reach their potential in their academic and sporting abilities requires a closer look.

Melbourne-based The Reporters’ Academy, a not for profit youth media company, with the same youth development outcomes have taken up the responsibility to tell the story. Throughout the week they captured interviews and footage of the young Samoan men traveling abroad this weekend and the lives they are leaving.  This program was not conceived overnight.

In 2007 I had a chance meeting with Richard Brown when he volunteered as a driver at the South Pacific Games, and I was lucky enough that he was assigned to my family. Another testament to the quality of the person and the generous nature that underlies this sophisticated approach to ‘whole-person development’. We believe that it was God’s plan that created a fire and passion in both of us to take an independent road of a discovery over the last 6 years.  Here in Samoa after 6 years to attend the 10th Pacific Health Minister’s Meeting we met again to find that our respective journeys were aligned and so we joined forces.  In 2007 we discussed at length the issues facing young people in both Australia and Samoa and found a synergy; the lack of motivation and aspiration to achieve at their potential.   Being a teacher and mother of three daughters I knew the challenges of motivation and fulfillment that faced this new generation of teens. He spoke of the struggles of young Samoan teens and their lack of opportunity.   Richard spoke then of his desire to give back to a generation of young people because he had the means and felt it was his responsibility. Initially I had no idea that he was an ex NFL star, testament again to his humility then and now as he quietly works fulltime nurturing the development of these young people at his own cost. ‘I had no idea until I read it today in the paper,’ said Semi Epati, CEO of the Sports for Development programs in Samoa. He praised Richard’s work and said it was important that Samoa look to funding more of this work.

One of the most straight talking and inspiring presentations for the week was given by Her Excellency Honourable Tauveve O’Love Jacobsen, Niuean High Commission for New Zealand and former Minister of Health, Niue.  Her spiritual vision and challenge to the ministers was for them, ‘To serve, and not be served.  People build nations, nations build prosperity.  We forget who we serve. Could that be why the NCDs are a crisis?  We can’t build nations with sick people.  A healthy nation is a wealthy nation. Focus on the people being responsible for their own health.  As ‘coconuts’ it is our culture that shapes us….we behave as Pacific people – we meet, we greet, we eat.  Let’s research our region, our own data and create a bottom up approach so that we impact where the need is greatest, the lowest level.’  She again challenged the ministers, ‘use your heart and your imagination.  It’s all about relationships to help build one another up.  It is not serving yourself, it is serving those below you.  We’re (ministers) only as good as what we do by inspiring people in their everyday action to change their world.  We can’t live in a happier Pacific world until people can do for themselves.  We need to ‘START THINKING’. It is up to us to transfer the VISION.

To conclude each country gave their summing up of the three days of meetings, and gave unanimous praise for the outstanding leadership by Samoa’s own Health Minister the Honourable Tuitama Dr Leao Talalelei Tuitama.  Palau gave thanks for the ‘Fa Samoa spirit’ shown through leading the group in laughter and song.  Fiji presented Samoa with a canoe to symbolize the ‘taking away of our isolation’ and asked Samoa to hand it on to the next organizing committee as a sign of continuity. Japan showed its appreciation for the sympathy and solidarity shown to the victims of the Tsunami and asked for us to vote for them to host the 2020 Olympic Games. New Zealand was overwhelmed by the hospitality and thanked the Ministry of Health.  They offered this scripture as something for all of us to ponder – ‘To whom much is given, much is required…There is much we need to do!”  Australia extended their delegation’s appreciation for the hospitality and was grateful for the warm friendship. They endorsed again the outstanding leadership of the chairman and congratulated him for the important resolutions that he led the group to.

Finally the summing up and conclusions.  Fiji were unanimously chosen as the host of the 20th anniversary year for the meeting and seconded by Niue who have put their hand up for 2017.  SPC’s Director of Public Health Division thanked Samoa for their hospitality and reiterated the need for a collaborative approach.  He sought feedback for their work to ensure there was a greater level of accountability and transparency with chosen priorities. He affirmed his support of the Healthy Islands vision and focus from settings to people, and challenged the group to work towards a clarity in the regional and national frameworks.  SPC committed to supporting members to achieve their goals.  WHO’s Regional Director Dr Shin Young-soo supported the resolutions and encouraged each member to work together. The chairman thanked everyone for his or her participation and invited everyone to join him in the final celebration dinner at the Robert Louis Stevenson Museum.

Edwina Ricci – OSFO executive member and attendee at the 10th Pacific Health Minister's Meeting.