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Over the past few years, a fresh approach to grooming the next generation of Pacific health leaders has evolved. The result is a new leadership programme comprising three residential workshops. The participants were drawn from throughout the country and the sector to discuss what it means to be a Pacific leader in health. Voyages spoke to two people who have played a role in helping to shape and launch the programme – Fa’amatuainu Tino Pereira, the managing director of Niu Vision group, and Dr Karen Poutasi, the former Director-General of Health.

Fa'amatuainu Tino Pereira

“We are at the stage in this country where there are issues about Pacific people that have to be dealt with by Pacific people and health is one of them. We know we currently have the most significant ill-health in New Zealand society. So, while it is important for mainstream services to deliver, it is equally important for Pacific people to take some responsibility and ownership over this situation. This leadership programme is just one part of that big picture.”

Fa’amatuainu says all New Zealanders stand to benefit from improved Pacific health.

“Unless Pacific people can take control of these issues, they cannot contribute to wider New Zealand society. If Pacific people get their act together then New Zealand will benefit longer-term.”

He acknowledges that building a new generation of Pacific leaders is a challenge.

“There is a vacuum at the moment because there is not a long history in the Pacific health sector. You’ve got to realise that Pacific health service provision has only arisen over the last decade. In many respects we are just beginning and we have begun at a point in history where the challenge for Pacific people is great and the implications of what we are doing are very significant.”

If Pacific people bring things to the mix that are specifically Pacific and that help us to contribute to wider New Zealand society then I think the general New Zealand population would want that to happen.

Fa’amatuainu Tino Pereira

Dr Karen Poutasi

“The challenges for Pacific health leaders are balancing the needs and expectations of the Pacific community with the needs of management, bureaucracy and the public service. They have to have integrity, accountability and be true to both the Pacific community and to their role in health. This balancing act is an additional dimension to leadership that makes Pacific leaders very special.”

Community support and connection are a vital dimension, she notes.

“In health, you need genuine community engagement and support before you can get anywhere. Pacific leaders go about their business very aware of the community from where they come – the one that has nurtured and grown them, and to which they owe something – and they carry that awareness with them in their work. They have to deliver every day for their community. That’s what makes them unique, and so beautifully situated to get community engagement and deliver on a health programme. They have a marvellous opportunity to bring about the change that is needed in the Pacific health sector.”

She says while the skills of leadership can be taught, the role itself is an honour conferred by the community.

“A person is only genuinely a leader when others make them one. You don’t become a Pacific leader by telling everyone you are and saying, ‘follow me’. Leadership is accorded by other people saying, ‘you’re a great person; you’ve done a lot for your community; we trust you, so you can influence me’. You have that mana, that standing, status and trust of your community so you can bring about change. It’s a real two-way thing.”

Karen says there are as many styles of leadership as there are people and jobs, and that the programme has evolved to reflect that.

“When we were developing the leadership programme, we needed to make sure that we weren’t in any way imposing a certain style of leadership on the participants. We wanted to expose people to lots of different thinking on leadership and management, and so they could take the next step and say, ‘what is relevant for me as a Pacific leader?’”

Strengthening Pacific leadership is essential for reducing health inequalities, says Fa’amatuainu.

“Leadership means taking control and direction for service delivery, workforce development, research and policy development. It is going to be a combination of all those things that will ultimately deliver health gains for Pacific people and for New Zealand. That’s what this game is all about – reducing health inequalities. The benchmark for Pacific health needs to be between Pacific people and the healthiest New Zealanders. And the only way to reduce those inequalities is to ensure that Pacific health workers are as skilled and have the capacity, the experience and the knowledge to not only provide services but also strong leadership.”

The establishment of the leadership programme is timely as the current generation of Pacific leaders are getting older, notes Fa’amatuainu.

“Our generation of leaders has been leading the way, getting into mainstream services and processes of government to plant the seed for Pacific people. They have fought the fight. Now it’s time for the younger generation to stand up and continue that. This leadership programme provides an opportunity for people to be proactive about Pacific leadership.”

The programme itself is a unique combination of mainstream academic learning, Pacific cultural practices and traditions and personal perspectives. The emphasis is on self-discovery rather than simply lecturing people, says Fa’amatuainu. Participants are encouraged to share their own stories and experiences. Creating a Pacific learning environment has been crucial for programme’s success to date.

“Pedagogical research shows that if you bring Pacific people together they will engage more with the issues, contribute more and learn more,” says Fa’amatuainu.

“We wanted these workshops to provide the building blocks of a sustainable model of Pacific leadership. I think we’ve got it about right. People will be able to gain mainstream recognition and qualifications because the University of Canterbury is involved. But the course also gives them the chance to look at their culture and ask, ‘what parts of contemporary Pacific culture will work for me in what I’m trying to achieve? What’s the difference between a Pacific person leading the health sector and a non-Pacific person leading the health sector?’” he says.

Traditional models of Pacific leadership can provide a rich source of ideas.

“While it is hard to just transplant the Samoan or Tongan leadership model, there are elements that are very helpful. For example, the Samoan village matai system is very prescriptive and ordered. It won’t work to just bring it down here and say to New Zealand-born Samoans, this is how it’s done. We have to ask instead what is inherent in that system that can help? What can we learn from it and apply to our leadership structures? And the answer is, although we might do things differently, our traditional Pacific values will still be there. Values such as respect for others and leadership, service to the community, service as the pathway to leadership, collective responsibility. In an individualist age these are very important values to bring into a contemporary setting,” says Fa’amatuainu.

Pacific leaders bring an insight – which perhaps not all people have – into how to build systems for different cultures.

Dr Karen Poutasi

“I think there is no doubt that they will all go back to their workplaces better equipped. They’ll have a grasp of their culture and their context, and they’ll know what it means to lead. We have the whole range of people that interface with the health system represented on this programme – managers, clinicians, researchers, nurses.”

After the completion of the three workshops, an alumni programme will also be established to provide an ongoing support network.

“We intend to bring people together again to map out what other skills they may need in their work, for example, cross-cultural communication and negotiating skills,” says Fa’amatuainu.

“Any good development programme builds networks that people can rely on, use, build on and take somewhere. Networks are people you can trust, share experiences with, and with whom you can maintain an ongoing relationship. They can help you manage stress and develop as a leader. Pacific networks are very strong anyway, but having strong networks with people who are focused on leadership thinking, support structures and development is very important for Pacific leaders,” adds Karen Poutasi.

Fa’amatuainu points out that demographic changes on the horizon make leadership programmes such as this essential.

“Fifty years from now the demographics of this country will be very different. The ‘browning’ of New Zealand means one in three Aucklanders will soon be Pacific, Asian or Maori. We have to look ahead and think what Pacific leadership means in that context. It means Pacific people will need to be leaders in the finance sector, the telecommunications sector, the health sector. We are a multi-ethnic society yet many of our policy frameworks are still strongly monocultural. But the balance of power is going to shift significantly. New Zealand must prepare for that.”

He says New Zealanders should welcome the development of a Pacific leadership programme for Pacific people.

“At the end of the day it will help everyone. It is going to address an area of significant health need that will cost our society dearly if left unattended.

“If Pacific people bring things to the mix that are specifically Pacific and that help us to contribute to wider New Zealand society then I think the general New Zealand population would want that to happen.”

He says the new generation of Pacific health leaders have a pivotal role to play in ensuring the system as a whole better meets the needs of Pacific peoples.

“We need Pacific leaders who can interpret for the mainstream what it means to treat a Pacific patient. The health of Pacific people is a very holistic thing. If someone comes in with a broken leg, you are not just treating that. There will be other issues about how the health of that person impacts on their family, their church and their community because all those things are part of that person’s well-being.”

Karen Poutasi says having Pacific leaders who can help Pacific people engage with and make the health system work for them is a tremendous advantage.

“Pacific leaders bring an insight – which perhaps not all people have – into how to build systems for different cultures. People who come from different ethnic backgrounds can find it challenging to engage in a Western style of medical model. As the 21st century progresses, New Zealand is becoming more culturally diverse. We want everybody to be able to work to their potential, so we need multicultural leaders for our multicultural society, whose minds are broad, and who think laterally and not in silos, because they are used to thinking in different contexts. Pacific leaders will bring a real richness to the broader New Zealand society.”

She hopes the leadership programme will lead to Pacific CEOs, general managers and team leaders out there in the community, “delivering brilliant health programmes for Pacific people.

“We’ve got a lot of really good Pacific people who have stepped up into key leadership roles. Through the programme, they have more support in doing that. We want to see Pacific people lead and succeed in both the Pacific and mainstream health environments. It’s about being confident in a Pacific environment with all its demands, and confident in the broader New Zealand environment with all its demands. Watching the programme grow and develop has been absolutely tremendous for me.”

Both Karen Poutasi and Fa’amatuainu are full of praise for the new programme.

Fa’amatuainu echoes these sentiments. “This new programme has brought vision and a new intellectual rigour to the thinking around leadership development and what that means for Pacific people in the health sector.”

Fa’amatuainu says his role has been to provide “a dose of inspiration” to course participants.

“It’s like the old story, if you have no vision, the people perish. Working in Pacific health is more than just a job, you have to have a passion to serve the community. People need to be lifted out of the ordinary and be shown a vision. I always like the helicopter view of the world. The big picture.”

Leaning back in his chair he pauses for a moment and concludes, “I’m an optimist. I see great hope for our people. I think Pacific people have a great contribution to make to this country. We just need to make other parts of the community aware of what we can bring to the table. There are two sides to every coin. I prefer the side that faces the sun.”

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