PMA CONFERENCE – TONGA 23 – 27 September 2013.

1. NetiTamarua HermanPhD Candidate Dept. of Social & Community Health Faculty of Medical & Health Science University of Auckland. PMA CONFERENCE – TONGA 23 – 27 September 2013.

2. Title: “Investing in our Youth: Aka’upokotua’nga i ta tatou au mapu note au tuatau ki mua.”

3. AIM: To develop a “Health Promotion Model” within a Cook Islands Maori context, to promote the health and wellbeing of young people in Vaka Takitumu, and the Cook Islands.

4. Map of Rarotonga: Vaka Takitumu

5. Research Objectives: 1. To review the literature on the health of young people, health promotion, and positive youth development. 2. To define Health from a Cook Islands perspective 3. To identify the positive contributions by young people to themselves, their families, communities and the country as a whole 4. To examine the health issues and concerns among young people in Vaka Takitumu. 5. To explore strategies to eliminate or minimise the impact of the issues and concerns identified by the participants..

6. Definition of Youth WHO definition - Adolescence 10 to 19yrs Youth - 15 to 24 yrs UN and SPC: 12 -24 yrs for policy reasons, but respect other countries definitionseg., • New Zealand - 12 -24 yrs (NZ Youth Strategy, 2002 • Samoa - 15 to 29yrs (TALAVOU, 2006 ) • Cook Islands - 15 to 34 yrs (CINYP, 2007) - 37% of Cook Is. Pop. (2006 Census).

7. Why Young People? * Concern about the negative reporting by local and international media about the issues and concerns relating to young people, such as Substance abuse, Unplanned pregnancy, Crimes, Suicide, Drink driving, MVC, Premature deaths. * Concern about the increase morbidity and mortality amongst young people in the Cook Islands. * As a mother, I was concern about the health & wellbeing of my 6 children (16- 26) * Provide evidence based information for policy and program development, as well as for academic/scholarship public health literature. * They are our future parents, leaders, most productive age group. They should be good healthy role model for future generations.

8. Methodology: • Qualitative Research • Community Based Participatory Research (CBPR) • Needs and Strengths Assessment – Interviews • Prioritise issues, concerns & need • Plan & Develop Model

9. Needs & Strength Assessment: Interviews • 12 Focus Groups (young people)interview :– - school council, churches, sports, Peer educators, NGO Groups, cultural, prison inmates, probationers, CISA by (Kevin Iro) • 20 Key Stakeholders: – Traditional leaders; church, youth, sports, cultural group leaders, MP, Mayor, College Principal, PTA Chair, Business, Parents, Community Police. • 20 Key Informants: - Dir. Of Youth & Sports, Gender Division, MOH, MOE, MOJ, CINYC, CI Red Cross, CIANGO, CISOA, PunangaTauturu, NHRC, Prison Superintendant ; Probation Officer; Media, Police; House of Ariki; Te Koutu Nui, Opposition, RAC.

10. Developing Foundation of Model • Community Based Participatory Research(CBPR) is where researcher and participants work in partnership/ collaboratively (Minkler & Wallerstein, 2003) • Multi-systemic ecological Environment(Bronfenbrenner,1979 • Social Determinants of Health (Wilkinson & Marmot, 2003) • Takes a holistic approach to health, sensitive to physical, mental, social, cultural, economic, spiritual, and political needs of young people • Positive Youth Development (PYD) focus on strengths of all Y/P, that defines positive outcomes(Pittman, 1997) • Health promotion – process of enabling young people to increase or have control over and improve their health and wellbeing (Ottawa Charter, 1986)

11. “Pu Ara” – Pandanus TectoriusTree

12. “The Pu Ara O Takitumu” • The “PuAra”metaphorically represents the “PuAra o Takitumu,” the Traditional Leadership body- Ariki (Paramount Chiefs) & Mataiapo (historical, cultural & spiritual aspects) • Special “ identity, meaning, tapu, mana, and value” of the PuAra o Takitumu and their people. • The primefunctionof the PuAra o Takitumuis to provides protection - shelter and safety for their people/tribes in VakaTakitumu. • The PuAra o Takitumu is respectedby people in other Vaka, outer islands, Govt., NGOs.

13. “Te Pu Ara Model” • The PuAra like a young person is a living entity. It is alive and has multi purpose use, which symbolises a lot of factors relating to “positive development ”of young people. • PuAra is part of big picture of Natures vegetation – young people is part of the biggerpicture of our population. • The tree has 600 different varietieswhich represents the “diversity”of young people- (no two young persons are the same) • It was built on the foundation of MSEE, SDH, Holistic aspects of health, PYD and Ottawa Charter.

14. The mature trunk of Pandanus tree - strength in youth • PuAratreesvary in size from small shrubs less than one meter tall to large trees of 20 meters tall. • As the trees grow and mature, their trunks become ringed with leaf scars from dead leaves when they fall off (in Lt Picture). • The mature tree (on the right) is fairly straight and strong, and traditionally used as posts for traditional homes, thus represents “strength”in young people.

15. The base of the tree and its many thick roots (exposed and ingrown) anchors and stabilise the tree, represents strong foundation family unit (nuclear & extended) for young people. • * The roots provide nutrients from soil/ground to sustain growth of the tree, represent “connectedness or bonding with the mother earth/land” • * The roots has medicinal use, and represents physical, cultural, spiritual and healingperspectives.

16. The many branches which connect the stems to the trunk, represents the connectedness or relationships between the young people and their “multisocio ecological environment (MSEE) • MSEEeg. - peers, neighbours, communities, schools, churches, culture, sports, Govt, NGOs etc.

17. The leavesexposed to sun and rain, allows photosynthesis to take place so the tree can continue to grow to maturity. The dry leaves are used for thatch roof and walls to provide shelter for homes, and this represents provision of “shelter and safety” for young people as they grow and mature. The leaves of the young plants are dried and use used to make craftwork – mats, baskets, hats hats, fans useful for domestic & economic economic purposes. .

18. The different varieties offruitwhen ripe has beautifulcolours and fragrance which resembles the youngnessand beauty (external and internal)of young people. • Colourful fruit made into ei or lei - represents the physical, mental and emotional aspects of health

19. Picture of Garlands or “Ei Ara” • Also mixed with other flowers to make garlands or eis or leis) and sold for NZ$10- $15 for economic reasons.

20. Edible variety of Pandanus Fruit “Ara” • A special variety of the Pandanus fruit is edible, and it is domestically grown as a staple fruit. • The flesh of the fruit can be eaten raw or preserved as a pulp, which is similar in taste to dates, and flour in texture. • The flesh can also be scraped off and mixed with flour and baked in the traditional oven,umu, as a form of bread, represent nutritional needs of Y/P. • Good source of vitamin A, vitamin C, calcium, iron, and beta-carotene, represents physical health

21. The White Flower or hinano, (female on left and male on right) has a beautiful perfume, and is used together with the colourful fruit and other different flowers and leaves to make garlands or “ei.” • The hinano is threaded into thin strips and mixed with fermented grated coconut to produce coconut oil for sale , used for massaging, or as a skin lotion on young people’s skin giving it the beautiful brown olive skin colour. • Represents physical, cultural, emotional, economics aspects of health.

22. The garlands or “eis ” made of ara and other flowers and leaves are worn by young people and adults during special “social and cultural” ceremonies and celebrations. • This signifies emotional feeling, high self esteem, self worth, and happiness. • Alsoused for welcoming tourist and marketing tourism promotion.

23. . • Partnership betweenTraditionalleaders and Min. of Environmental Services, has a Conservation policy in protecting coastal areas from Climate changes and erosion - Represents physical, economic and political aspects. • A voluntary group of young people periodically cleans the white sand beaches as the prestine clear blue lagoon with its white sandy beaches are popular tourist attraction in the country. Represents economic aspects as tourism is our main revenue)

24. Pu Ara Tree Model

25. The Puara Model: • The model is “not a one size fits all” approach • It is an inclusive family and community based participatory model of service integration using Cook Islands cultural and spiritual values. • It enhances the Ottawa Charter for H/P foregrounding a “Holistic Approach to Health” • Its successful implementation need a multisectoraland collaborative efforts by government and civil society. • If successful, model can be transferable to other Vaka, Islands in CIs, CIs communities in NZ, and maybe other Pacific Islands.

26. Competencies for Young People in PYD Competencies/ExamplesPhysical - Attitudes, behaviours, and knowledge that will assure future health and wellbeing. Social - Responsiveness, flexibility, empathy and caring, communication skills a sense of humour, self discipline, assertiveness, ability to as for help. Cognitive - Good reasoning, problem solving, planning skills, the ability to think abstractly, reflectively and flexibly. Vocational - A sense of purpose and belief in the future, educational aspirations and preparations for work and family life. Moral - The development of character, spiritual values, personal responsibility, and be involved in efforts that contribute to the common good.

27. Howcan we promote PYD? • Surround young people with positive influences • Acknowledge Y/Ps contributions and build consistent strengths into their lives (increase self esteem & efficacy) • Provide support, optimum nurturing, warm loving parenting, relationships and connectedness. • Recognise Y/P’s rights, strengths, good values, beliefs, honesty, integrity, respect and compassion • Provide services oriented to youth needs – RH, rewarding employment • Engage Y/P in decision making relating to policy and program development on matters concerning them.

28. Conclusion: Quote from a Young female delegate at the World Youth Forum 2010. Her speech was a plea to the adult population of the world. We the youth call upon the adults to join us in making this world truly fit for children and young people working inter-generationally. Allow us to make this world truly our own filled with love, where each child is eveyone’s child, where parents and their children can be friends, where men and women are treated as equals, where no one is judged by for being who they are by society. Assist us in building a world where our rights are truly entitlements and not privileges. From an Adult perspective: “Young people have much better chances of success in many areas of their lives when the world they live in is full of strengths and positivity.” Kaye McLaren (2002).

29. Malo Au PitoMeitaki Maata E Kia Manuia.