Voyages Online

LotuMoui, a church-based community development programme, is proving highly successful as an avenue for addressing the health problems of Pacific people in Counties Manukau.

“Our goal is to involve 80 local Pacific churches by 2010,” says Fepulea’i Margie Apa, the former general manager for Pacific Health, Counties Manukau District Health Board (CMDHB). CMDHB serves the largest Pacific population, approximately 90,000, in New Zealand.

“We believe there are around 120 churches in total with large Pacific congregations in Counties Manukau. In the first two years we enrolled 50 churches which far exceeded our expectations. We were overwhelmed by the number of applications we received which was fantastic.”

Churches are a logical and effective place to launch a health outreach to the Pacific community for two main reasons, says Fepulea’i.

“Pacific people are still strongly affiliated to their church and religious organisations. As the 2001 census showed, more than 80 percent of Pacific people registered an affiliation with a religious organisation.

Fepulea’i said the churches that enrolled in LotuMoui were very enthusiastic about the programme but, as expected, not all churches are at the same stage in terms of being able to implement health programmes. 

We were overwhelmed by the number of applications we received [from churches] which was fantastic. 

“Some churches need a lot of support and in particular need help in setting up the infrastructure to be able to run a programme; others have been able to take off with it immediately and exceed our expectations. A common requirement however is that all participating churches have a health committee that is committed and responsible for implementing the programmes, making the connections with providers and getting the messages through to their congregations.

“The other important requirement is people attending our meetings. The Ministers of participating churches meet once every six months and we bring together the health committees twice a year as well.”

There is diversity in the programmes being offered by churches but there are some common approaches. A large number of the LotuMoui churches are running exercise programmes for their own congregation. Some are running healthy nutrition and cooking classes themselves, while others have used the fund to bring in education providers to run classes. Some churches are running sessions on alcohol and other drugs and youth camps focused on health. The emphasis is on churches coming up with ideas themselves which they are enthusiastic about and keen to see work. It is hoped that by the end of next year all Pacific churches will be smokefree.

An evaluation of the programme is being carried out, involving both qualitative and quantitative measures, says Fepulea’i.

“Using national health surveys, we will be comparing people who are involved in LotuMoui, and their lifestyle factors, with those in the national population. And we’ll also be gathering the views from the Pacific community about how they feel LotuMoui is contributing to their own sense of wellbeing.”

Fepulea’i says that while the $200,000 fund for the next stage of LotuMoui is small compared with the money being invested directly in health services, it has the potential “to go a long way because it’s a catalyst for community action.”
Looking to the future, Fepulea’i says she envisages all participating churches will have a strong health focus so that their congregations have a real awareness about health issues and a good knowledge of the risk factors.

“Through LotuMoui we have taken some great early steps but it’s a long journey. It has taken two or three generations for the health inequalities between Pacific people and the general population to get to the stage they are at now. Pacific people were not in this position 20 years ago – they were fully participating in the labour market and earning good incomes. This initiative is about recovering that position and that will take time.

“LotuMoui has made a great start. Every time we set an expectation, we exceed it. First time around, we hoped for 30 applications and received more than 50. Every time we invite the community to a meeting, we are inundated with people. The enthusiastic response reflects the fact that Pacific people really take this seriously. They’re ready to engage and are looking for support, which LotuMoui can provide.”

Key components of LotuMoui

The four key components of LotuMoui are to:

• Grant funding for pre-approved lifestyle plans based in church settings to churches themselves;
• Provide access to workforce development initiatives as a way of building community knowledge of health issues (eg nutrition, smokefree);
• Build capacity in churches to focus on health (Church Minister forums, health committees);
• Evaluation programme to ensure qualitative and quantitative improvements in health.

Key outcome goals

• Increase nutrition practice
• Increase physical activity levels
• Promote healthy weight
• Reduce smoking prevalence
• Improve engagement with health systems
• Implement community education models

Body and Soul

Reverend Setaita Veikune

Pacific people see the church as their home, their extended family, their village, says Reverend Veikune.

“Back in the islands things centre around village life. Here in Auckland, churches become their villages and extended families. That’s where Pacific communities gather on a regular basis and that makes the church an ideal environment for addressing issues of health and wellbeing.

“Another important factor is the way Pacific people view Ministers. Ministers are trusted figures in the community and that makes churches very effective communications channels for messages about healthy living.”

Reverend Veikune, who is a member of the Ministers’ Steering Committee for LotuMoui, says the incorporation of messages about physical health and wellbeing are a welcome development in church life.

“Living life to the full is about physical as well as spiritual health – body, mind and spirit. We can’t just concentrate on the spirit when the spirit lives within a body. We must care for the whole person.

“So we, the churches, are very much behind the Counties Manukau District Health Board (CMDHB) in fostering the LotuMoui initiative. Through the LotuMoui, Pacific Church leaders and the CMDHB are speaking with a unified, determined voice.

“The programme began two years ago and at first it involved a small number of churches. Now there are nearly 50 and it is growing.”

Back in the islands things centre around village life. Here in Auckland, churches become their villages and extended families. 

Reverend Veikune says a range of health-promoting activities are offered by the churches – exercise and dieting programmes, healthy cooking classes, health check-ups.

“On some weekdays our church halls are packed with people exercising. Water, instead of fizzy drinks and juice, is available. We encourage people to avoid fatty foods and engage in regular exercise.

“We’re fortunate in being very close to Mangere mountain in my parish so our parishioners walk up the mountain together. It’s a fun activity and it’s healthy.”

Addressing health issues as a community is very much in keeping with Pacific culture and values, adds Reverend Veikune.

“People are more comfortable and motivated taking action together, rather than addressing it individually. We are also able to reach out to others who don’t belong to churches to come and join us. Recently, a lot of people have been coming along to our churches because they want to join in the exercise or the trips to the pool, or the volleyball in the courtyard. It’s been a good thing all round.”

Health, Healing and Wholeness

Reverend Dr Feleterika Nokise

This was the challenge issued by the Reverend Dr Feleterika Nokise in his keynote address at the LotuMoui Health Symposium, held in Manukau City. Reverend Nokise is principal of the Pacific Theological College in Suva.

Pacific Christianity has tended to be devotional and domesticated in style but the time has come for the Church to “reconfigure its theology on issues such as health, healing and wholeness”, says Reverend Nokise.

“The number one cause of health problems [for Pacific people] is poverty. And providing immunisations, medicines and even health education cannot significantly ameliorate health problems caused by poverty. The churches are called on to see this as a justice issue to be raised in the centres of power at local, regional and national levels. At the same time there is a call for a commitment to a more just distribution of available resources for health.”

Reverend Nokise said the churches have a vital role in promoting peace in society and respect for all created things, including ourselves.

“Churches are called by the Gospel to advocate and protect the integrity of creation, with concern both for the human body and for the critical conditions which are necessary to sustain life.

“In choosing life we choose health. Health is a dynamic state of wellbeing of the individual and society; of physical, mental, spiritual, economic, political, social wellbeing; of being in harmony with each other, with the material environment and with God.”

Reverend Nokise urged the churches to expand their thinking about the role they should have in promoting health at all levels.

“The churches have to take on an expanded understanding of issues such as health. They need to establish health programmes for members, not just offer Sunday worship services. They must look at the social dimension of their mission; get guidance on how to run health programmes for parishioners and for the community.”

Reverend Nokise said he was very encouraged by what LotuMoui has achieved so far and for that reason he had accepted the invitation to speak at the symposium.

“LotuMoui is instrumental in helping us revisit our theology and deepen our understanding of what it means to serve God and one another. For example, the churches have a lot of resources. These should not be used just to maintain structures or for doctrinal purposes but to help fulfill the social dimension of the churches’ mission.”

Reverend Nokise urged the churches to join with partners who are involved with healing, such as family, health professionals, traditional and alternative healers, other agencies and other faith groups.

The heart of the matter, said Reverend Nokise, is for churches and communities to be healing entities themselves, ready and willing to reach out to those in need.

“There are people within and outside their fellowship desperately longing for mutual caring and solidarity… the sick, lonely, disabled, oppressed, marginalised and those with social and pastoral problems… it is a ministry of healing that cannot be avoided.”

The churches need to be more than they have been in the past. I believe they have to take the lead, alongside the appropriate professional people. They must open their doors and initiate things. 

Reaching a New Generation

Ronji Tanielu

“I think LotuMoui is good because it takes a holistic view of health. To address the health needs of Pacific people you must acknowledge that there’s a spiritual side, a mental side and a physical side. Once you deal with the spiritual and mental I think the physical transformation begins to happen.

“I think church is a good place to talk about health issues for our people. We don’t have marae as Pacific people in New Zealand, our ‘homes’ are back in the islands. When you talk about critical mass and where you can best achieve that, the census figures show that church is where you’ll find most of our people. If you deal with the churches it echoes out into the rest of our community as well. I think LotuMoui is a great idea and a great model.

“I think information is the key to getting Pacific youth to lead a more physically healthy life. When I was young I didn’t know what nutritional eating was. I played sports but I didn’t know how to take care of myself. Once information is shared with young people then they can understand. People can see that if they want to be healthy, these are the steps to take. If things like LotuMoui were around when I was young, I’m sure I’d be 50kgs lighter!”

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