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The Otago Pacific People’s Health Trust is championing the health care needs of Dunedin’s 3,000-strong Pacific community through advocacy, research and a host of health promotion activities.

Wale Tobata

The Trust’s Manager Wale Tobata was the Solomon Islands’ first qualified pharmacist thanks to a scholarship he won as a top high school student. Wale could have trained as an accountant or a pilot, but chose pharmacy as the country had a pressing need in the area. He completed his degree at Otago between 1988 and 1992 and practised pharmacy back in the Solomons until the political situation made it too dangerous for him to remain.

He and his wife returned to Dunedin and Wale fully committed himself to the work of the Trust. The Trust evolved from work around sexual health programmes in the 90s and was launched in 2004 with two staff members. Wale says the early years were “a rough ride” with volunteers putting in long, unpaid hours. His challenge was to secure ongoing and sustainable funding from a variety of government agencies. Building professional governance systems and structures from scratch was a big challenge. Wale and his team worked hard to get to the position where the Trust is now flourishing with five staff and an array of health promotion activities underway.

Wale attributes much of the Trust’s success to its emphasis on research, evaluation and learning. The Trust has built strong links with both government and non-government agencies and has undertaken a number of joint research initiatives with the University of Otago’s medical, surgical and nutrition departments.

As Wale points out, it would be easy for the needs of a relatively small community to be overlooked. The Trust therefore works closely with the university to make sure its approaches for funding are based on solid evidence. A good example is a study looking at predisposing factors for diabetes among young Pacific people aged 15 to 18. Prior to the study it was estimated that perhaps 60 percent of Pacific youth might have predisposing factors. The results painted a much more disturbing picture – on the basis of the glucose, blood sugar and body mass index tests, it was found that 76 percent of local Pacific young people were at risk.

“A lot of academic research is purely academic. But our research establishes the need for action in an area for which we can provide a niche service,” says Wale.

Another research project looked at how Pacific people accessed local health services. The study revealed that Pacific people had a very poor knowledge of what services were available and how they could use them. In response to this, the Trust developed its own information packs.

“The information being provided was far too difficult for our people to comprehend. We’re working collaboratively with PHOs to address this. We’re also training people from a range of agencies on how to engage with Pacific communities and providing them with the tools and knowledge of protocol to do so,” he says.

Translating health research into action is a recurring theme in the work of the Otago Pacific People’s Health Trust.

The Trust’s Healthy Eating Healthy Action initiative is a great example. This entails weekly exercise programmes in church halls, aqua jogging programmes, summer walks, social netball events and sporting tournaments run in the school holidays that are attracting up to 600 participants (more than half of whom are Pacific).

“The tournaments always have a theme based around health promotion. This year’s theme is ‘It’s healthy to be active.’ Last year we encouraged people to drink water,” says Wale.

Every fortnight the Trust invites a speaker to talk to its local community highlighting a particular social or health issue. Wale has also taken to the airwaves to spread his message. His fortnightly community slot on Hills AM 1575 is dedicated to health promotion issues and simultaneously translated into Cook Islands Ma¯ori, Tongan and Samoan. The Trust is also running workshops on home ownership and a gardening competition with the city council to reinforce messages about good eating and good exercise.

A lot of academic research is purely academic. But our research establishes the need for action in an area for which we can provide a niche service.

Wale makes extensive use of Pacific traditions and history to further health goals.

“Nutrition is a huge issue but it’s all about having the right pretext for your health message. You can’t just tell people to limit their food. That’s too blunt. They won’t listen. But if you point out to people their true culture, people will come on board. For example, traditionally feasting was only seasonal and based around when fruit was ready for harvest. As time has gone on and people have become more affluent this has changed and people have been overdoing it. As Pacific communities we need to go back to our history and establish what is the norm and the tradition is not feasting all the time. So, a lot of Pacific people are in a state of confusion about what their authentic traditions actually are. We need to reach into the past to make gains in the future.”

Looking ahead, Wale says the Trust has the potential to become a leading community-based research group.

“We’ve got an opportunity to build an organisation that can really move things forward. Pacific values are enormously helpful here. Values such as reciprocity – whenever you give something to our people they want to give back. That’s why we had volunteers who worked for two years for no pay. These are the sorts of values we can harness. We can draw on the strengths of our people to deliver more for them.”

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