Module 1+2 Flashcards
What is critical for the pacific economy?
Natural Resources
What are the broad divisions of the Pacific?
Micronesia, Melanesia, polynesia
What are dependencies?
A territory that does not possess full political independence or sovereignty, yet remains politically outside the controlling states area
What is free association?
An international agreement establishing and governing the relationships of free association
What is independence?
Self governing, centralised system of governance
Tuamotu
Ancestors, descendants, seen and unseen, importance of relationship
Va
Relational space and recpricocity
Gerentocracy
Look after elders/most vulnerable
Mata ile mata
Eye to eye, sign of respect
Tulou
Excuse self if imposed on ones va
Aiga
Family
Nu’u
Village
Fa’a matai
Traditional governance/organisational system
Matai
Chief system
Alli
High chief
Tulafale
Talking chief
Tulafale Alli
hybrid (high chief who can’t speak)
Taulasea
Traditional healers
‘Ala Mou’ai
pathways to the essence of life force (comes from a combination of pacific languages). Represents the holistic view of health and wellbeing, encompassing the physical, mental, cultural and spiritual dimensions
Influenza (1918 Pasifika)
19-22% of pasifika people died due to influenza, SS Talune (Ship of death which killed 9000 on pacific islands, 45% of matai)
Samoa Measles Outbreak (2019)
low vaccination rates because of past experiences, cultural norms, family structure, language barriers, low health literacy, no reminder system, not have available vaccine and poorly communicated incentive programmes
COVID 19 samoa
Restricted travel very early because of the impact other outbreaks have had and want to be prevented, gerontocracy was important
Ta vaka atafaga model
Tokelau, represented by a canoe, incorporates mind, family, spirituality/belief systems, mind, social and physical body
Tivaevae model
Cook Islands, represented by fabric, incorporates collaboration, respect, reciprocity, relationships and shared vision
Kakala model
Tongan, represented by a wreath, incorporates establishing relationships, collect, search, selection, weave, present/gifting, monitoring, continuity
Fa’afaletui Model
Samoan, fall means house and tuition means to weave
Ta and va model
tongan, time (future and past) and space (physical, intellectual, social, symbolic)
Fonua Model
Tongan, represented by overlapping circles, incorporates mental wellbeing, physical wellbeing, spiritual wellbeing community and environment in four phases: exploratory, formative, maintenance and reformation
Key characteristics of pacific health models
holistic and communal focused, importance of family, respect, relational space, spirituality and reciprocity
Fonafale Model
Pan-pacific, represented by a hut, foundation is family with four pillars (physical, mental, spiritual, other) and culture as the roof. Context, time and environment surrounding
Hauora
Health
Wairuatanga
Spirituality
Hinengaro
Mind
Whenua
Land placenta
Whanaugnatanga
Family connection, kinship
Manaakitanga
Hospitality, kindness, generosity
Aroha
Love, emphasise, compassion
Mauri
Life force
Wairua
Immortal spirit/soul
Utu
Recipricocity
Mana
Prestige/authority
Tapu
Restricted/sacred
Noa
Free from tapu (balance)
Whakapapa
Lineage/ancestory
Tangihanga
Similar to funeral, usually on marae over 3-5 days
Atua
A god or gods
Ranginui
Rangi
Papatuanuku
Papa
Waka
Canoe
Iwi
Tribes
Hierarchy of collective
Waka > Iwi > Hapu > Whanau
Tikanga
Right way of doing things according to values (adapting)
What is involved in Maori health?
Communally orientated, highly spiritual, active people, infectious diseases were unknown, believed disobeying tapu was how people got sick
Awa
River
Maunga
Mountain
Kai moana
Seafood
Karakia
Recite ritual chants
Tohunga
Have healing powers - responsible for the health and wellbeing of the community
What is illness from the Maori perspective?
Being punished by atua for violating tapu
Makutu
Curse
What is divine origin illness?
Karakia, medicinal plants, wairua, massage
What is human origin illness?
Muka, splints
What happened to the Maori in influenza (1918)?
Disproportionally affected, mass graves = no tangihanga, Maori and wairua impacted, Hongi discouraged = whanaungatanga and aroha impacted
What happened with maori in covid 19?
disproportionate health disparities, rural living have low internet access so cut off from GP access, resource strain, whanau extended bubbles targeted by covid regulations, tikanga affected because of no tangihanga and hongi
Te where tapa model
Four taha (physical, spiritual, whanau, mental)
Te wheke model
Octopus with head = whanau, eyes = waiora
Restitution stories
- Associated with the recently ill and compelling because they are often true
- Plot line (“yesterday I was healthy but today I am sick but tomorrow I will be well again”)
- Only relates to physical changes in the individual
- Biomedicine emerges as heroic or triumphant
Chaos Stories
- They are not admired
- People are consumed by their illness
- Storyline of ‘and then… and then… and then…’
- Moral duty to honor these stories by listening
- All treatments are seen as pointless so is difficult for health care workers
- Belong to the sufferer and no one else
Quest Stories
- Departure date, initiation period and then a return (like the stages of a journey)
- The key characteristic of the story is endurance and forbearance by the teller
- People are suffering and learning the integrity of suffering is the reason for the quest
Testimonial Stories
- They are ‘testimonial stories’ - pressing you to witness and to believe and excluding information information that contradicts their key storyline
- All stories are testimonials
Disease
- Disease is what we have when we leave the doctors office (Cassell 1976)
- Disease is a departure from the norm established by a biomedical authority and to which the practise of medicine seeks to return the clients (Canguilhem)
- Objective set of biomedical facts in which the body is not functioning as is usually would
Health
Universally seen as a good state to be in
- The ability to continue living your life in a wide array of future circumstances (ups and downs) canguilhem
- A stats of complete physical mental and social well being and not merely the absence of disease and infirmity - WHO
- A set of common sense disease which we have all been learning since childhood about our bodily processes, the way in which we monitor them, and the standard rhetorical devices we which we use to describe them - Kleinman
Contested Diagnosis
- Can work in two directions
- You consider yourself ill but few agree you have disease
- Others think you have disease but you consider you are just one more variation of how to be normal
Illness
- Illness is what we feel when we go to visit a doctor (Cassell 1976)
- Illness can be thought of as a type of misfortune which brings on a subjective experience of physical and emotional changes which are generally conformed by other people (Helman 2007)
- To become demoralized with one’s world (Kleinman 1989)
Hierarchies of Resort
- Hierarchy of resort links the severity and annoyance of the illness to the type of care seeked
- At the bottom of the hierarchy are folk and lay which is where most of the time is spent
- Professional is at the top of the hierarchy
- People don’t normally go straight to the professional
Language of Distress
- The stories others tell to communicate their experience of illness (bridge between subjective experience and social acknowledgement)
- They can be acknowledged (validated) or not acknowledged by others, with severe consequences for the person who is ill
- Heavily influenced by culture and what is culturally acceptable
Health Care Pluralism
- There are multiple sources of expertise/knowledge of health (Lay, folk, professional)
- Professional = they have learned and become qualified
- Folk = People in alternative medicine with no qualifications
- Lay = People who help you and understand your normal state of health such as friends, family and hair dressers
Healing
- Healing is finding meaning by rewriting your own story to fit the new circumstances
- Healing is regaining your voice in 3 phases: mute suffering, expressive suffering (narrative), finding authentic voice (Younger)
Suffering
- Is a state of distress brought about by an actual or perceived threat to integrity (Cassell 2004)
- Suffering occurs through alienation in 3 phases: from yourself, from others and by making strangers out of those you know well (Younger 1995)
Intersectionality
How social and political identities can influence how people are treated (positive or negative) and how they overlap cancel and reinforce each other
Structural Suffering
- Systematic,widespread, predictable inequality of access to those processes that enhance and sustain well being
- Occurs everywhere and seemingly caused by no one and everyone simultaneously.
Social Model of Disability
- Society as disabling
- Circulating norms about what is appropriate, restricts the life chance of people who demonstrate perfectly ordinary forms of difference.
Predicament Model of Disability
- Views disability as a ‘predicament” that we must resolve ourselves as best as we can
- Noting that disability has medical and material components
Biopower
- It is the ways that ideas about how people should see themselves trickle down from those in power to influence everyone’s way of self regulating
- It operates persuasively and almost unnoticed
- It operates continuously along two major axis, at the level of large populations of people and also at the level of the individual
Technologies of the self
Many ways we monitor and change our behaviour to meet society’s idea of a good life
Mind body dualism
- Mind body dualism with a reductive view of the body
- Prioritises numerically expressed data
- Dysfunction and structural deviance to explain disease
- Based on scientific research
- Use mind and body as separate entities. Treats the body as a malfunctioning system and leaves the mind to other disciplines. Ignore spirituality and meaning.
