European Society for Oceanists 2015 Conference

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Session Detail (parallel)

A healthy relationship?: European and Pacific encounters in relation to health transitions and lifestyle-related non-communicable diseases

Coordinator(s)

Roy Smith, Amy K. McLennan

Session presentation

At the Third International Conference on Small Island Developing States, held in Apia, Samoa, 1–4 September 2014, Pacific Island leaders launched the Pacific Non-Communicable Diseases (NCDs) Partnership. This initiative is a response to the recognition that Pacific islands have some of the highest incidences per capita of NCDs in the world, and that these NCDs have significant social, economic and health-related impacts. One of the consequences of the NCDs Partnership is that the majority of island states’ health budgets are to be directed towards treating these diseases.

For this panel it is envisaged that 4-6 papers will be presented covering: the growth of NCDs in the region; the dimensions of how and why this growth has occurred over time; and innovative initiatives that are in place or which may be needed to combat NCDs in the region. An emphasis will be placed on the Pacific region’s changing relations over time (from community-level interactions to international trade) and how these interconnections may have contributed to the NCD burden, as well as present opportunities for intervention.

Following the PACE-NET+ Think Tanks in Bremen (September 2014), the overarching theme of the panel will be partnership – in terms of relations between both Pacific and European government agencies and also civil society stakeholders – in addressing NCDs. The role of European partners in the past, present and future of NCDs in the Pacific will be considered, as will the possibilities presented by Pacific island experiences for understanding and addressing the rising burden of NCDs in Europe.

Paper submissions are closed

Accepted papers

Diverse experiences of NCDs in the central Pacific – Rongelap, Marshalls, compared to Wallis Island

Nancy Pollock (Victoria University of Wellington)

The diabetes 'epidemic' as Zimmet (1979) labelled it has been followed up over the intervening 30 years for various Pacific islands populations, drawing on both epidemiological and social data. In this paper we contrast the experiences of diabetes in two central Pacific communities from the perspective of diets and health policies.
The people of Rongelap have experienced diabetes, and other ncds, as a result of having to move away from their home atoll where heavily contaminated food sources resulting from radioactive fallout from US atomic testing have necessitated living mainly on US foods (Pollock 2012). The people of Wallis, in contrast, have been cited by epidemiologists as having low incidence of ncds until recently owing to their heavy reliance on local foods, particularly taro and yams.
When we contrast the health experiences of these two populations, we find that diverse colonization processes have affected their food access. Rongelap people moved to Mejatto, Kwajalein atoll, where they have lived for the last 30 years, purchasing most of their food from the US military base 6 hours away by boat. Wallis people have remained dependent on home grown taro, yams, from their gardens, plus fish due to France's failure to develop their economy beyond subsistence. Divergent colonial policies are thus reflected in the development of diabetes and other health concerns now experienced by these two populations. They illustrate the diverse histories of diabetes across the Pacific.

Health and Transnationalism in the Pacific

Evelyn Marsters (University of Auckland)

How are the health needs of highly mobile transnational citizens conceptualised and responded to by families and national health services?

This paper explores health and transnationalism in the Pacific through the lens of Cook Islanders living with the double burden of TB and diabetes mellitus (diabetes). Cook Islanders weave in and out of different health promoting or demoting environments and come into contact with and creatively use disparate health services across multiple countries, and responsibility for public health is spread across two nations. By drawing connections between diseases and across political boundaries, I argue that a syndemic approach to TB and diabetes provides a way to explore the range of harmful social and biological forces acting upon the Cook Islands population in both the Cook Islands and New Zealand.

The research for this paper arises from my recently completed PhD study which conducted multi-sited ethnographic research over the course of two years to gain an understanding of the range of health threats, and health service access behaviours of Cook Islanders around the Cook Islands, and New Zealand. By paying close attention to the interaction of harmful physiological and social conditions, this research highlights some of the obstacles to delivering health services for both non-communicable diseases (NCDs) and infectious diseases amongst transnational populations. I argue, that in order to respond to the diverse needs of highly mobile people in the Pacific, health policies and health research must focus on the emerging threat of disease interactions and extend beyond the nation state.

The Under-addressed Influence of Cultural Institutions and Foreign Agency in NCD Research: The Case of the Samoans

John Patu (University of Hawai'i-Manoa)

Implementation of health initiatives aimed at curbing the increasing rates of NCDs in the Pacific are largely deficient with one respect: the lack of adequately addressing the inclusion of cultural factors and perceptions that largely determine social behaviors that influence overall health habits. This paper looks specifically at the Samoan case with regard to the underrepresentation of data on the influence of cultural institutions and socioeconomic motivations on the increased rates of obesity and its related diseases. I look specifically how, under the indigenous socioeconomic institution and practice of fa'alavelave, systems of food exchange are neglected in the ritual and ceremonial exchanges of foodstuffs and the overall research. European and American agency in contributing to this exchange system and the overall economic developments cannot be overlooked.

Certain regulatory actions taken by the state, for example, the ban of turkey tail sales in Samoa, were overall unsuccessful as preemptive measure due to technicalities at the larger levels (e.g., violations of World Trade Organization rules on singling out specific products) as well as social factors regarding the practice of food exchange.

Successful interventions need to tackle partnerships between the private, government, and NGO sectors that influence the influx of products that contribute to overall NCD rates as well as health campaigns comparable to the early public health nursing initiatives that worked together with traditional authorities. Researchers can draw from anecdotal evidence to translate into effective considerations of both qualitative and quantitative measurements of customary socioeconomic institutions on health choices that affect NCD rates. State health policies and initiatives must take into consideration this data and implement relevant strategies to better effect the mediation and reduction of overall NCD rates in the Pacific.

Push and pull factors in relation to NCDs and migration from the outer islands of Tuvalu

Roy Smith (Nottingham Trent University)

In March 2015 Cyclone Pam caused widespread damage across Tuvalu with the central islands of Nui, Nukufetau and Vaitupu experiencing particularly severe disruption. The United Nations’ Office for the Coordination of Humanitarian Affairs (OCHA) reported that in Nui and Nukufetau approximately 90% of crops had been damaged and that many parts of these atolls had been completely inundated by storm surges, with adverse impacts on fresh water supplies. While rebuilding of houses, reconnection of electricity supplies and repairs to seawall defences are underway this experience underlines the ongoing vulnerability of these communities and brings into question their longer-term resilience to further climatic impacts.
Although the above event may be seen as an aberration to the normality of life in Tuvalu it does highlight broader, ongoing concerns in relation to food security among these outer island communities. With an ever-increasing reliance on imported foodstuffs there has been a noticeable increase in diet-related NCDs. This paper considers the various factors that bind the residents of these atolls to their homes in relation to the processes and events that also bring into question the longer-term viability of these communities resisting migration to the main island of Funafuti and, possibly, further overseas.