Ola Lei: Developing Healthy Communities in Tuvalu

Abstract

My research examines the relationships between the formal health and education sectors, schools, external donors, non-government organisations (NGOs) and communities with regard to health in Tuvalu. A significant contribution of my research is the development of a Tuvaluan conceptual framework for health and wellbeing, which I have called the Ola Lei Conceptual Framework. My thesis takes seriously the embeddedness of culture in health (Dixon, Banwell & Ulijaszek, 2013). Throughout my thesis I raise the issue of the autonomy of Tuvalu as a recipient of aid, and the necessity of developing cooperative partnerships between donor and recipient through which can be forged mutually agreed goals and practices. Indeed the concept of caring for relationships or partnerships (tausi te vasia) pervades the thesis, because relationships at all levels are central to all aspects of health. But even when there is equality in specific partnerships, Tuvalu is faced with a major challenge to its society and culture, which was introduced with colonialism and continued through the postcolonial period: that of a sharing-based economy which used mainly local products now being progressively integrated into a market-driven globalised economy with very different values and practices. My research was based on a series of three fieldwork periods between 2010 and 2014 in Tuvalu on the contrasting islands of Funafuti and Vaitupu. Funafuti is urbanised, while Vaitupu is rural and the site of the national state secondary school. I employed qualitative methodologies including document analysis, interviews, participant observation, and focus groups, and I supplemented this material with available health and population statistics. My particular focus is to examine the ‘gaps between’ (vasia) health policies, what people say and do about health, what happens in everyday life, and the needs and desires of communities and schools in relation to health. As a result, I argue that an approach to health and wellbeing development, which is built on frameworks drawn from contemporary health promotion and ola lei, can assist the health and education sector to work together with NGOs, communities, and external agencies to promote health and wellbeing in Tuvalu. Keywords: Pacific, Tuvalu, development, health, education, ethnography, indigenous