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Unlocking the Future

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The Pukapuka Community of New Zealand is a not-for-profit organisation representing people from the island of Pukapuka in the Cook Islands. Voyages spoke to its President and Chief Executive Nuku Rapana about its unique blend of educational, health and social services.

Nuku Rapana

What do you see as the biggest challenges facing you and your organisation in the area of Pacific health?
The biggest challenge for us in the health sector and other fields is to gain access and recognition. It’s also getting people to recognise that health is not just a physical thing, it’s also about the social and economic wellbeing of people. So when we are working in the area of economic development I see that as related to health. By improving our people’s economic wellbeing you are ensuring families are going to be able to look after themselves a lot better. They’ll be in a better position to make choices about health care.

What are your priorities at present?
Well, you can’t just deal with one problem. Pacific health is like a canoe having a whole lot of leaks. You can’t just fix one, you’ve got to be able to plug all the leaks at the same time. That’s what we mean by a holistic approach to health. That’s really what we’re doing. For example, it’s approaching health from the education sector to unlock the future for our people and giving them better career opportunities and pay, it’s forging links into business and business ownership. I see those things as critical for our future.

Pukapuka is involved in all these areas?
Yes, we have a number of different arms that look after social services, community wellbeing and education. We also have a business unit which generates revenue to keep the organisation going. It’s building capital and infrastructure for the organisation. That is one of the critical secrets for us to be able to move on as a Pacific organisation. It’s important that we own our own facilities and build our capital base.

When we look at middle class New Zealand, they’re well off now because of a lot of decisions their parents and grandparents made a long time ago. Now they are all in a better position economically and own their own homes, whereas a lot of our people have just recently migrated and are just starting this process. So boosting our economic position is crucial to the wellbeing of our people and their economic independence.

You’re running quite a unique organisation aren’t you?
We are. In addition to Pukapuka Social Services, we also run a training arm, the Pukapuka Training Academy which teaches literacy and IT programmes. We have a pre-school too. We have a housing arm that’s looking at developing home ownership options and we have a health arm that is promoting preventative health.

What motivated you to be involved in all this?
I came from the electronics industry. I was a sales engineer and then I established my own business. When I was elected by my people to be the leader back in 1995, I really had to make a choice. Do I let my people continue to struggle or do I make a difference and have an impact? Our organisation has been around since 1951 but when I joined its direction was unclear. We really needed to have a rethink. After all, we came to New Zealand to seek greener pastures and our people are only feeding on ‘dry grass’, they’re struggling. Struggling in health, struggling in education. This is a land of plenty, so why are we struggling?

So I took the bull by the horns and decided to do something about it and I left the world of electronics.

That must have been a leap of faith.
It was all about trusting in God. It got to the point one time where my house was almost taken away. We worked for a period of two years with no income coming into the family. We did that because I could see that my people were struggling and we needed to put something in place to help. Now we’re starting to get people through our training, we’re putting them into further education. So the results are coming through and the real results will be evident over the next five years.

What are your strategies in the area of health?
Our focus is really preventative. This is where we need to be pouring in the money in my view. We’ve got to stop people getting sick in the first place because once they get sick it’s too late and it’ll cost us a lot of money. But if we pour in enough resources at the front end, we can prevent that. I think the LotuMoui programme is a good example of a project that we’re involved in and encourage in our community.

So you’re working with churches to improve health in the community?
Yes, because the churches are where our people congregate. We relocated from a village setting where the meeting house in the middle of the village was the focal point. When we came to New Zealand, the church became that centre. It’s where families gather and connect so it’s a very good thing to use. I acknowledge the Counties Manukau DHB for having the courage to start LotuMoui.

What about non-church people or people who aren’t from the main denominations?
This is where organisations such as ours can really help. People of all denominations are part of the community we represent. It doesn’t matter which church they go to, they’re all part of our group.

Do you believe cultural connection has a big bearing on health outcomes?
Absolutely. It plays a huge role in helping us decide how to approach a health issue in our ethnic community. It’s also important to stress than when we talk about culture, there are new and emerging communities out there whose values we also have to take account of. Young people who are much more technologically advanced who may have different values.

Do you think that Pukapuka’s traditional values will endure?
They will endure because they are important, but the practices may change. But the values of love and respect are still there and they must not change.

When you talk about preventative health, at the end of the day it’s still an individual’s choice, isn’t it? Are you confident that a community-based approach will prove effective?
Absolutely. Our community likes to gather and connect with one another. We can take advantage of that by putting some scales there so people can weigh themselves or monitor their blood pressure. It’s about giving them the ability to monitor their health. We’ll continue to provide health information but the real key is to get them involved and doing it for themselves.

Are health messages about weight and nutrition being taken on board?
Yes, the signs are there but you know a lot of these problems did not start yesterday or in 2005 or 2004. They started way back in the 50s, 60s and 70s. So it’s going to take a while before we can be confident and say, ‘Hey, we’ve done it.’

That’s why a key aim for our organisation is ensuring long-term viability. We’ve got to build our capacity and focus on what will have the greatest impact.

At the end of the day, the problems live with us in our community. They don’t live down in Wellington. They’re with us here in Mangere. So we’ve got to come up with solutions that will work whether we get government funding or not. We’ve got to have an organisation that is capable of doing things for itself.

What’s your vision for Pacific health?
My vision is for my people to enjoy life to the full and live a full life. We came here to have a better life, not just Pacific Islanders but all New Zealanders. We don’t want to be a burden to the wider society. We want to be contributing. It’s in the interests of New Zealanders that we do because the statistics are showing that over the next 50 years the working population is going to be brown. So we better do something now or else you and I aren’t going to have our superannuation!

It’s not about race. It’s about all New Zealanders and the poor statistics in education and health that we must address. I see this as remedial action. We’ve been here a long time and how much money has been thrown at these problems up until now and hasn’t worked?

Albert Einstein once said that you can’t solve a problem using the same system that created it. You’ve got to come up with innovative thinking to address an issue. That’s why we’re developing this organisation. We’re taking a different approach. We’re not just grabbing money, we’re working with problems and setting up solutions.

At the end of the day, the problems live with us in our community. They don’t live down in Wellington. They’re with us here in Mangere. So we’ve got to come up with solutions that will work whether we get government funding or not. We’ve got to have an organisation that is capable of doing things for itself.

I’m passionate to the point where I live and breathe these developments. Helping our people to advance and move forward. It’s my life.

Cross-Sector Collaboration Crucial

The New Zealand Health Strategy seeks to address the social determinants of health and health inequalities through a cross-sectoral approach. This recognises that many of the largest risk factors for morbidity and mortality are influenced by factors beyond the control of the health system – affordable housing, education and safe and supportive communities. The Ministry is currently involved in intersectoral initiatives to reduce obesity, address alcohol consumption, prevent suicide and destigmatise mental illness. The aim is to influence behaviours and attitudes and change the wider environment through ongoing collaboration.

The Healthy Housing programme – a joint initiative between Housing NZ and DHBs in Counties Manukau, Auckland and Northland – is a good example of what’s possible. The pilot programme, which aims to reduce the risk of diseases associated with overcrowding, has achieved a 33 percent reduction in hospital admissions.

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