Voyages Online

Olo Elise Puni, Trustee and Management Convenor of AuckPac, was a member of the Meningococcal National Advisory Group. Voyages asked Olo for his thoughts on the campaign and what made it such a success.

Olo Elise Puni

To use a metaphor, we were weaving a mat with different strands. Someone had to weave them together; I was one of that group.

Was this campaign unique or were there any precedents?
The Meningococcal B vaccine campaign was unique in many aspects but we did have a platform to work from. The earlier hepatitis campaign provided us with a framework to work with a model of collaboration. There were differences, though. The hepatitis campaign was regional, this was national. The hepatitis campaign was a collective one at hospital level, but this one was taking place in the DHB/PHO environment.

The mums and dads, the uncles and aunts, the grandparents and caregivers – they were all part of this campaign. And our churches and clubs and youth groups. In the end success depended on our community-ness.

Olo Elise Puni

What were the key challenges you faced?
Clearly one of the big challenges of this campaign was the issue of safety. Was this vaccine safe? You’re talking about people’s lives. At the outset there were unknowns which the scientists and the clinicians were working through – they provided us with the evidence and the robustness and the credibility which was so important. The vaccine had been used overseas but it was new to New Zealand.

So we had to address the unknowns and tackle the issues of efficacy and risk. If we didn’t manage and communicate that, then people wouldn’t participate in the programme and it would fail.

We had no illusion that this would be an easy campaign. There were risks but we couldn’t be paralysed by that. We made sure we understood the risks. We adopted all the top-down, bottom-up, diagonal-across systems and processes we needed. The top accepted advice from the bottom. The bottom took direction from the top. We listened to one another. We accepted the challenge of reaching across organisations and communities, and allocating resources according to diverse needs.

We knew we had to capture the hearts and minds of people. It couldn’t be just a campaign of the mind because people can have the knowledge but if they don’t have the emotion to be personally involved and committed, we wouldn’t achieve the campaign objectives set by the Ministry of Health. We had to win the trust and acceptance of people that this vaccine would be good and safe for people. You can have all the other aspects of the campaign in place, but without the trust of the people, it would fail.

To be successful in a campaign like this, you have to understand people. People have visions and aspirations and anxieties. You have to work through the systems and processes, and come out the other end, achieving what you want to achieve with the dignity of people enhanced.

What partnerships were critical to the success of the campaign?

Relationships are so important. We had to harness the strength of our Pacific providers. I acknowledge the achievements of the mainstream but I also acknowledge our Pacific providers – doctors, nurses, educators – everyone was part of it. It’s typical of Pacific people to work together but efforts are often fragmented. In this campaign however, we deliberately went out to say to people, “you are important to this campaign, come and help. We will call on you.”

With a Western lifestyle, you do your job and step out the door and it’s finished. Whereas for Pacific people, when you step out the door your community is waiting. They know where you are. They call you. It’s a 24-hour service. It’s relationships, it’s communication at church, on the sports field, in the marketplace, everywhere. This is the Pacific uniqueness. Inclusiveness.

In this campaign the whole was a lot more than the individual parts. It was a very collaborative approach. Clinicians had to play their part, we needed provider responsiveness, GPs – Pacific and non-Pacific – had to be flexible, we had to grab people when we could. But the mobilising of people to get them to the clinicians was also critical to the overall success of this campaign. And that wasn’t just about sending out communications, but it was about fronting up – fronting up in church and in the community in all the different cities where our people live.

What approaches were necessary to reach the various Pacific nations?
One thing you have to understand about Pacific is they are not one people. But often they plan as though they speak one language. The truth is they see the world differently. Yes, we have a common heritage, just like the Caucasians, but we have to address the uniqueness, respect the diversity.

In this campaign we took a multilingual approach to reach people and that had financial consequences, but it was the right thing to do. It was a very detailed, targeted approach. We had strategies for each Pacific nation, and ultimately a series of individual campaigns.

You might think this approach is too hard. People say it’s too hard, it costs too much. I say that’s false economy. It costs too much if you don’t achieve what you set out to achieve. It costs too much if your campaign is not effective, if it doesn’t reach people.

Like all campaigns, this campaign required us to understand with clarity the vision set by the Ministry of Health at the top. We had to get our heads around that and develop a strategic campaign. But we also had to understand the Maori and Pacific populations who were more seriously affected by this deadly disease. This is where the Ministry of Heath and the DHBs sought the assistance of people who understand the dynamics of Pacific people, understand what makes them tick, understand what is their structure and their landscape.

How were Pacific representatives involved in the campaign?
We were invited to participate in the leadership of the campaign and be involved at all levels. This was an opportunity for us. We had representatives at the National Advisory level, at PHO level, at the provider and clinician level, representatives in the Ministry of Heath and DHBs. We had people strategically placed at all levels.

Success required us to take ownership, to be involved in setting the direction, to help establish priorities. So we communicated and debated with the Ministry of Health and DHBs as leaders. We let our people know that we were having a say on these important matters.

The bottom line is that we were involved in decisions that affected our people. We participated. We had a say. We became part of the governance arrangements and we had a part to play in advising how this campaign was best rolled out.

I would like to acknowledge our Ministry of Health leaders and policy-makers. They took on board what we had to contribute. Let me say it was a campaign of equals, different functions, different contributions but equal. That’s the Pacific way.

So collaboration was a distinctive feature of this campaign?
Pacific providers constantly collaborate. They are good at this, good at helping each other out. If I can use a military metaphor, we fought alongside each other. If one went down, the whole would go down.

The Pacific way is to do with feelings, it’s not just a job. In this campaign there were strong feelings, positive emotions. We were connecting with what we were doing. This campaign was not just a job. It was intensive and we knew the risks were high if things didn’t go well.

We took ownership. We would be responsible. I was satisfied the vaccine was safe but if there were problems with the vaccine I would have to front up. I wasn’t going to hide behind anybody. I asked our clinicians the question, ‘are you going to jab your son or daughter?’ That was the last question I needed to ask them before I could go out and commit the community.

Our participation in the campaign had a number of effects upstream and downstream. It affected the way the Ministry of Health saw things and led to some positive changes. For example, some of the resources that were being pumped into the media campaign were redirected to make use of Pacific and Maori media and infrastructure. The fact was that the mainstream media was reaching 45 percent of our people and that wasn’t good enough. There were gaps. We needed to complement that media outreach with media that specifically reached the target groups. One size doesn’t fit all. People say it but often don’t practise it. In this campaign they did.

Were there any particular lessons learned?
This campaign provides a model for other campaigns. It wasn’t just a Pacific healthcare strategy but a national strategy with a Pacific strand within it. This project showed us how to enhance a national strategy. It was a similar issue for Maori and I acknowledge their contribution. Their fight made our fight easier, and our fight made theirs easier.

I think there’s a lesson in this campaign that experience counts. I’ve seen too many people in this sector coming, using it as a stepping stone and moving on. We’ve lost a lot of know-how because we haven’t done a very good job on passing on the knowledge to newcomers. It requires good succession planning.

We have to keep the intelligence, keep the experience. This article is one way of doing it. We have to help Pacific people find their voice, tell their own stories.

Do you have a final message you would like to share?

The mums and dads, the uncles and aunts, the grandparents and caregivers – they were all part of this campaign. And our churches and clubs and youth groups. In the end, success depended on our community-ness.

Community-ness is so important. Healthcare has become so technical, so professional, so demarcated, but we must rediscover the heritage of our public health system.

We must never forget the whole. There are many parts and the whole is more than the individual parts. It’s easy to become mechanistic and systems-focused, and these are good things but where is the soul and spirit alive in us all?

Thank you all for this campaign. People were busy and committed at all levels. Thank you all. They were busy covering every aspect – planning, finances, resources, communications, as well as providing the clinical services. It was all possible because people were linking, providing multi-perspectives, giving us the richness and an accurate position from which to navigate.

Key Milestones

Feedback on this story (0)