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Raising Health Awareness in the Pacific Islander Community

Community members stop by the Lucile Packard Children’s Hospital mobile van for health screenings. Photo by Janet Ng.

By Neela Banerjee/Janet Ng

Tonga’s King Taufa’ahau Tupou IV is a leading health advocate who practices what he preaches. A few years ago, the 83-year-old made international news — after losing 150 pounds.

Along with the kings of Samoa and American Samoa, who are also over 80, Tupou and his medical team launched the Healthy Lifestyle program calling for increased physical activity, healthier eating habits, and the elimination of smoking and drinking.

On July 12, the three kings kicked off a ground-breaking medical conference focusing on Pacific Islander health issues, held at Stanford University. It was Tupou’s second visit to the Bay Area to promote his health initiative.

Pacific Islander Outreach Executive Director Dee Uhila. Photo by Neela Baner

“We spent at least three years working around the Healthy Lifestyle program and trying to educate people around it in this community,” said Dee Uhila, executive director of East Palo Alto-based nonprofit Pacific Islander Outreach (PIO). “So, it was really important to bring [King Tupou] out because he is a major role model.”

Uhila has been working on organizing this conference over the past three years, saying that health issues have become one of the biggest concerns in the Pacific Islander community. A kick-off celebration with King Tupou, the day-long conference, and a cultural community festival on Saturday made it an important weekend for the Pacific Islander community.

“The main function of this conference is to bring care providers, Pacific Islander and non-Pacific Islanders alike, to collectively look at how we can work together to attack these health problems that are really affecting our community,” Uhila said.

Both here and in the Pacific Islands, increasing Westernization and lifestyle changes have resulted in a rapid rise in the consumption of fat and a decrease in physical activity, according to Tongan physician Taniela Palu. Because of this, Pacific Islanders have high rates of diabetes and cardiovascular disease.

Made up of peoples from the island nations of Samoa, the Cook Islands, the Marshall Islands, Micronesia, the Solomon Islands, Kiribati, Tahiti, Niue, Tuvalu, Vanuatu, New Caledonia and Tonga — Pacific Islanders are marginalized communities in Australia, New Zealand and the United States.

There are more than 67,000 Pacific Islanders in the Bay Area alone, but little research has been done concerning this population in the United States. Census figures show that nearly 20 percent of all Pacific Islanders live under the poverty line. Uhila and other community organizers say that the same issues face their community as any other struggling group – poverty, limited access to services and youth troubles.

DOCTOR’S ORDERS

Pacific Islander physicians and care providers from Tonga, New Zealand and the United States spoke at the daylong conference on Friday. The conference sought to increase cultural competency, explain the medical beliefs of traditional medical care, and inform about diseases common in this community.

A number of Royal Physicians from Tonga gave overviews of health issues in their countries and the creation and practice of the healthy lifestyle program. Topics ranged from HIV/AIDS in the Pacific Islander community to aspects of traditional Pacific Islander healthcare.

Dr. Corolinda Helu, the chief pediatric surgical resident at New York Community Hospital in Brooklyn, gave a detailed presentation about complications from diabetes.

Research done in the early 1990s showed that Tongans had considerably worse diabetes control when compared to Australians — resulting in at least twice the rate of blindness and six times the rate of amputation. Helu noted that diabetes control for Pacific Islanders in the United States was also poor.

Helu spoke about important safety factors that care providers must emphasize to Pacific Islanders more than other patients, such as securing proper footwear, since traditionally, many wear sandals which offer no support or protection.

Oftentimes, Pacific Islanders will not seek Western health care because of lack of insurance and cultural barriers, Helu said.

“I had patients that I literally had to hold by the hand and explain everything to,” Helu said. “And because they would not seek out proper care, their condition worsened.”

Dr. Sitaleki Finau, a senior lecturer in Pacific Health at the University of Auckland Medical School in New Zealand, suggested ways to deal with medical non-compliance among Pacific Islander populations.

He pointed out that for those who are low income, health care is not a priority.

“They can’t really think of exercising to make sure they are healthy 20 years from now,” Finau explained. “Instead of telling them they need to change or they are going to die, talk to them about how lost their children will be when they die, how someone will pinch their wife.”

Doctors must be culturally competent, Finau said, and they need to be more positive when treating patients.

“Instead of talking about obesity and telling people that they are fat, tell them that they are beautiful. Talk about shape instead of size. For many traditional people, death is not the end, it is just the next phase of life — we have to be aware of these things.”

Filieta Ofa, a registered nurse from Dallas, Texas, works with a Pacific Islander outreach group that produces a television show on local cable access called The Voice of Tonga. Because of the positive response, The Voice of Tonga started a Web site, publishes a newsletter and holds classes to educate around health issues. In six weeks, 95 percent of the class attendees showed improved blood sugar and blood pressure levels.

Ofa, who spoke about her work at the conference, said some 3,000 Pacific Islanders reside in the Dallas-Ft. Worth area, many of whom are employed by the airport.

“We grew up with a certain lifestyle and its so hard to change,” Ofa said. “We really need the education, and from our class we saw that it can really make a difference.”

A TIME TO CELEBRATE

Uhila said it was important to have the conference at Stanford University because of the large Pacific Islander population in East Palo Alto.

“We are right here, just on the other side of the freeway, as a matter of fact,” Uhila said. “Here at the university hospitals, there are a lot of Pacific Islanders who come through, and we need those providers to be educated on these issues.”

The cultural festival held on Saturday was a way to celebrate the Pacific Islander culture and a time for the care providers to come out and share their information. The day began with a parade and featured traditional dances throughout. Health screening and informational booths, such as the Stanford Liver Center and Startup, a non-profit that teaches entreprenurial skills, lined Caesar Chavez park in East Palo Alto.

Senter Uhilamolang, Uhila’s husband and PIO Board member, estimated there were over 300 people who attended.

“This is the culmination of our efforts,” Uhilamolang said. “This way we are bringing together the community and the providers. And we are also celebrating everything we have achieved so far. I hope this will make people realize how important their health is, and then our community can grow.”