December 2003
Occasional Paper – No. 4
Family – A Samoan Perspective
Keynote presentation to the SF National Conference,
Christchurch Convention Centre 13-14th September 2003
By David Lui, Mental Health Practitioner
By Jan Dowland
Chair Commissioner
The Mental Health Commission is pleased to distribute this speech by David Lui, a Samoan
mental heath worker. It is about the importance of cultural and family values to Samoan
people, and their impact on mental health. There are many, many factors which impact on
our physical and mental health. Our culture and how we view it is just one of them. In this
speech David Lui presents his perspective of the Samoan view of family and mental health.
He acknowledges that others may have a different view.
The Commission is aware that Pacific peoples are diverse, and we are planning further
occasional papers prepared by Pacific people from their own unique perspectives.
Recognising and celebrating diversity is vital to everyone’s mental health. We look forward
to fostering this over the coming months.
Introduction
From the Islands of the Pacific I greet you.
From the Kingdom of Tonga: Malo e Lelei.
From the beautiful Cook Islands: Kiorana koutou katoatoa.
From the Rock of Polynesia, Niue: Fakalofa Lahi Atu.
From Tuvalu and the Atolls of the Tokelau: Taloha Ni.
From The Republic of Fiji: Bula Vinaka.
And from my own lush green volcanic islands; The Pearl of the Pacific; Samoa:
Talofa Lava.
Oute muamua ona 'ou faatulou atu i ta'ita'i ma le 'au mautofi, auauna a le Atua ile
susu i ao faalupega, tupu ma e'e, faleupolu o tofiga, tamaita'i ma ali'i faigaluega mai
matagaluega 'ese'ese, ae maise le mamalu ole aofia i lenei taeao. 'O o outou paia
ole fa'anuunuu atu faatini o tausala, ae ole a fana sa'o le malama ma vili le ifi a
maina e tusa ma lenei faamoemoe, male vala'aulia atu i lo'u nei tagata. Malo le
Soifua maua.
It’s my privilege and I'm very grateful for the invitation and the opportunity given to
speak at this conference, particularly on a topic that is very dear to my heart. A
Pacific person is a term commonly used in New Zealand to describe those of us from
the islands of the South Pacific. That is problematic for us at times because it has
implications that we are a homogeneous group of people. The fact is while there are
some similarities between our various nations; we all have different languages,
cultures and values.This morning my comments will be based on my opinions,
knowledge, understanding and perspective as a Samoan. I don't purport to speak on
behalf of all Samoans. In fact there may well be other Samoans who may hold a
different opinion from my own.
Samoan perspective of health
Pacific people have a holistic view of health where a person is in tune with his/her
environment and community. Health is achieved when there are positive and
balanced relationships between these three elements: Atua (God), Tagata (people)
and Laufanua (land/environment). Health is the state in which a person’s physical,
mental and spiritual needs are in balance and the person is able to meet their
obligations to themselves, their family, village and community. The relationships
between these three elements are defined and guarded by tapu. There are also
relationships between people. In Samoa every relationship is sacred (tapu), and
every relationship has boundaries. These are also defined and guarded by tapu.
Infringing of the tapu means a person enters an area of risk. It may result in the
person being punished by the guardians of the tapu thus finding his or herself outside
of the correct relational arrangement resulting in an unbalanced relationship leading
to and illness (faatafa gasegase) or at worse the breach if serious can bring upon a
curse.
Basic values of Faasamoa
The three basic Values of Samoan Culture are: alofa, faaaloalo and faamagalo.
Alofa (love) is the concept of giving, receiving and sharing of gifts and qualifies most
Samoan ideals. In health, the traditional healers (Taulasea) provide their service out
of their love for people and their desire to help them. For this reason, the skill or
mana of healing that they possess is a gift that has been handed to them from one
possessing this gift. This process involves the washing (fafano) of hands. The
person who has the gift of healing washes their hands in a bowl of water together
with the recipient. Thus, the gift is handed over. The recipient is then able to
perform the treatments (Fofo) that the previous healer performed for those seeking
wellness, knowing that alofa (love) underpins the receiving and giving of the healing
process. In return the sick person (Ma’i) seeking remedies from the Taulasea will
show their alofa through the genuine offering of gifts (food, fine mats, money) to the
Taulasea for their service. Love and care is usually transferred to the person who is
unwell through the touch of massage and gentle rhetoric.
Fa’aaloalo. (respect) is the foundation of good relationships. Relationships bind
everything together. The protocols and etiquettes that define the respectful behaviour
(tu ma aga) are known by samoans as va fealoaloai or ava fatafata. These
protocols and etiquettes are needed to maintain good relationships (relational
arrangement).
Fa'amagalo. If a person breaches a tapu, it finds him/herself outside of the correct
relational arrangement. The protocols and etiquettes allow the person to return to the
correct relational arrangement. The individual can seek forgiveness (fa’amagaloga)
by undergoing the process of fa’atoesega (formal apology) in order to rebuild
relational bonds. The process of fa’atoesega is an appeal to a person's sense of
forgiveness (fa’amagalo).
Consider an extreme case where a person is killed in an altercation with a person
from another family in another village. Members of the accused's family and/or
village will undergo a ifoga which is a process where chiefs, elders, parents of the
2
accused, covered with fine mats, will kneel outside the victims fale (house) basically
leaving themselves at the mercy of the victims family and village. They can spend
any amount of time in the hot sun while the victim’s family contemplates their
position. The decision to forgive is almost inevitable. In which case they will bring the
family/group inside the fale and begin a process of reconciliation and forgiveness
(fa’amagaloga). This process is very important not only for the accused and their
family but also for the victim’s family as well. Hate destroys the soul. The process of
fa'amagaloga instigates the healing of the soul and allows both victim and accused
and their families to deal with the past and move on. Fa'amagaloga and fa'ato'esega
is not about justice, it is about rebuilding relationships. Even if a person is deemed
justified in carrying out an action, he/she must apologize to the victim so that both
can deal with the past and move forward to the future.
Important concepts of Faasamoa
Important concepts of Samoan culture are kinship and family. Samoans have a very
strong sense of identity and belonging. Samoans have a strong link and attachment
to each other but also to God, our spiritual side, to our ancestors, our land and
homeland. Even those born overseas still feel that sense of belonging. An example
is my earlier work in the marketing field for the Samoan Government, after I
graduated from Varsity here in the Garden City, in the early eighties. My job took me
to some exotic places around the world, to cities and places much bigger and
modern than Samoa, yet I my greatest feeling is on my return. When the pilot
announces that we are about to land at Faleolo Airport, a warm feeling from inside
you, and the feeling of returning home. My sense is most people get that feeling
when they return home.
Family
In Samoa the unit of society is the family not the individual. In Samoa everyone
belongs to a family. Your family is your refuge. Families make up the wider
community. Communities make up the society we live in. When a person says he/she
does not have family, the message that conveys to me is there may have been a
falling out or there are relational issues that need resolving to bring the family back
together again.
Family is made up of individuals. These individuals are held together by relationships
(va). Every relationship is sacred (tapu or sa) and is sealed by feagaiga (covenant).
Every relationship has boundaries, which are defined by tapu and sa. Breaching the
tapu can result in a curse being brought upon a person. On the other hand,
maintaining good relations (teu teu le va) can bring blessings (faamanuiaga). An
example is given by Tamasese, K & Laban, LW (1993) in their paper titled Gender –
The impact of Western Definitions. It refers to the relationship between brother and
sister. “The sister, when born, is known as Tama Sa or sacred child, the brother,
Tama Tane or male child. … The covenant relationship ensures the sister’s powers
of blessing and cursing…the brothers were required to seek their sister’s agreement
for any decisions relating to lands and title. Without that agreement he risked a
curse.”
Factors Affecting Relationships
1. The way to maintain relationships is called ‘va fealoaloa’i or ava fatafata
(referred to earlier). Va and ava refers to the gap or relationship, fealoaloa’i and
fatafata refers to face to face. Hence the importance that Samoans have on
verbal and personal contacts and meetings. This concept sometimes conflicts
3
with clinical practice that workers should not form personal relationships with
clients. Writing letters, emails and phone conversations are not the preferred
means of communication for Samoans. It must be accompanied with face-toface visits so that good relations are maintained. For Samoan and Pacific
workers it creates a dilemma.
2.
The New Zealand environment puts emphasis on the individual and being
independent. Samoan culture puts emphasis on family and interdependence
between individuals. The conflict and pressure on Samoan worker, to adopt the
palagi way contrary to their culture and upbringing, results in dilemma for the
worker. If the worker follows the palagi way the outcome may not be as good; if
you follow the Samoan way you get in trouble with your employer.
3.
Another factor that impinge on family and relationships is the financial
pressures. In some families both parents work. In some cases they work two
jobs and surviving on only a few hours sleep in order to make ends meet. The
effect is two fold. Firstly there is no time to maintain relationships with children
and extended family. Secondly, the children are now being taught by the TV and
teachers at school about contemporary values, but not having the opportunity to
learn about their Samoan culture and values.
4.
Another important issue is the emphasis here on individual privacy and
confidentiality. Samoan families were in some cases denied visitation rights and
not given information about family members, thereby denying the family the
opportunity to participate in the planning, treatment and care of their loved one.
In Samoa confidentiality rests inside the realms of the family, not the individual.
Moe importantly the solution, treatment or healing must also be done in the
same family environment (fofo ele alamea le alamea). When families are denied
that right, then the healing process is adversely affected.
Decision-making
The process for reaching decisions is called soalaupule or sometimes referred to as
faafaletui. The matais or chiefs and elders take the lead but everyone’s opinion is
valued. This process can take hours, days even weeks depending on the issue. The
participants will continue dialogue and discussion until they come to a decision
(consensus). Soalaupule is not so much about reaching a consensus of opinion as it
is about process for agreeing on a way forward. At the conclusion of the process
participants do not necessarily agree to have the same viewpoint/opinion but there is
agreement on how to proceed. These processes allow families and individuals to
resolve issues and maintain good relations. The adoption of western justice systems
now means many of our conflicts are resolved in court rather than through the
process of soalaupule and dialogue with different outcomes. A simple analogy is
justice systems results in winners and losers. The cultural process results in win/win
situations and all parties can move forward with no hard feelings.
Ability to cope
One’s ability to cope determines their state of wellness/health. Worry, stress, despair,
mental instability originates from our not being in control of things and from the failure
to cope. Ones knowledge of their culture and heritage is an important element in
developing the ability to cope. The idea of returning to one’s culture and roots to find
peace and acceptance is one way of coping when faced with uncertainty, adverse
situations, illness and even death. This knowledge allows a person to understand
4
their place in the bigger scheme of things. So you don’t fear, get confused or despair
but celebrate living and life. Even in death, the knowledge of the after life and heaven
as an extension of being or family is a soothing thought and helps us to cope. The
family provides the individual with the atmosphere and the environment to heal (the
idea of refuge mentioned previously).
Traditionally in Samoa, family members and extended families look after [mental
health] consumers. Sometimes even the whole village plays a part. Consumers
participate in normal everyday activities of life, – preparation of food, cleaning,
looking after children etc. They attend evening prayers, church, family and village
meetings or fonos like everyone else i.e. the same expectations are put on them as
everyone else with perhaps an adjustment for their disability.
In New Zealand families still try to cope with looking after family members with
mental health issues. But the usual structures and relationships that exist in their
homeland are not in place here in the New Zealand environment, so they struggle.
The result is many of our Samoan and pacific consumers present to the mental
health services in a very severe state, usually under the Mental Health Act, because
families have tried to look after them at home. (Case Mix Study, HRC, results
released recently clearly showed this).
Cultural Knowledge and Identity
The learning process starts from home – family. It is the arena where we learn about
health, decision-making, culture, social issues, health, conflict resolution and life
itself. Some Samoan families don’t have the knowledge of their culture to pass onto
their children as they have been raised in a different environment and also some of
our cultural knowledge has gone to the grave with the custodians of the culture.
Knowledge of your family’s history or tupuaga, gafa and genealogy gives meaning to
your name and defines your place in your family and society. Many Samoans
especially young Samoans are having an identity crisis. They are confused and
unsure about their place in New Zealand society. Some feel they don’t fit into either
the Samoan or the mainstream society, resulting in feelings of shame, depression or
suicidal.
The solution to the identity crisis is not to just focus on rehabilitating young people.
As mentioned before, the solution must include family. To coin an expression: ‘you
can take a person out of the family, but you cannot take the family out of the person’.
We can’t expect young people to understand the family’s journey if story of their
journey has not been given to them. This can be done through the use of story telling
or fagogo. For many of us parents we also need to educate ourselves in terms of the
young person’s journey and the issues that they’re grappling with in this new
environment. When parents fail to tell their children their story and fagogo and to
educate them about their culture, then the only education they get is school, the TV,
the Internet and their peers.
Conflicting Paradigms
Mental Health system is based on western and medical paradigms. Samoan people
for example operate from a Samoan paradigm, the two often are in opposite
directions and don’t meet. To add to the complexity, Samoans have been colonised
and have been taught the western paradigm or have been taught that western
paradigm is superior, that palagi ideas are the right ones. To put it another way some
Samoans don’t understand the Samoan paradigm. We also have what some people
5
have referred to as the “fifteen minute experts” who think they know the Samoan
paradigm, culture and philosophy.
As a mental health practitioner I am faced with these dilemmas and conflicting
philosophies almost on a daily basis. Take privacy and confidentiality as an example.
In order to create a relationship with a person we need to find a connection with that
person. This in turn involves finding out information about his history and information
about his family. Usually this would involve talking with family and other community
people. This can sometimes not be possible due to privacy and confidentiality
concerns from the responsible clinician or agency.
Another dilemma is the issue of treatment and interventions. On one end is the
cultural argument that emphasizes the importance of disclosure and sharing of
information with the family so an appropriate care plan is developed to meet the
consumer’s needs. At the other end is the palagi argument that emphasizes
confidentiality guarding of individual information. Such a paradox is often conflicting
and restricts effective interventions and recovery.
Assessments
Accessing family homes for assessment is like going on a visit. First thing, is to find
out information about the person, their genealogy or gafa and faalupega, including
the genealogy of the spouse. The purpose for this is to use cultural references to
create rapport and appropriate connection with the person and family so that a
trusting relationship can be established. Understanding of the basic values of Alofa,
Faaaloalo and appropriate cultural references is crucial. This is because the
assessment requires the disclosure of personal information that is tapu and sacred.
Armed with the knowledge and information and using skill, ability and understanding
of the culture, you are ready to go to work. Samoans tread carefully, respectfully and
sensitively around issues; looking for the connection to build that bridge with the
person, only getting to the point when it is safe to do so. This process takes time. If
I’m continually looking at my watch or am rushing the process because I have
another appointment, it reduces the chance of a successful outcome.
I often volunteer information about myself, where I come from, village and family as
part of this process. Disclosing personal details about myself before eliciting
personal details from the person is a sign of goodwill and assists in building a
rapport.
Looking after Sick
Samoan people, especially the elderly, prefer that they be looked after by their own
aiga or family. One reason is the belief that outsiders (non-family members) lack the
personal insight that family members possess having lived with them and cared for
them before. Older people believe that it is the sacred duty of their children to care
for them, because that is where they get their blessings (manuia). The other reason
is they do not want outsiders to witness them when they may be in compromising
situations during their illness. It relates back to point made earlier that privacy is seen
in the realms of the aiga (family). There are no secrets within the family but family
secrets/ information should stay within the family. When Samoans refuse care from
health professionals, it is not a personal matter, nor is it about their knowledge or
skill. The family’s decision is based on motive. Until the family is satisfied that you are
sincere and genuine they won’t let you near them.
6
Example
To demonstrate this point, I refer to one of my colleague’s experience with health
professionals, in relation to her elderly father’s illness, which she found somewhat
daunting and challenging. When the father’s health deteriorated the assessors
concluded that the family’s house was not suitable for the care of her ill father. Her
father protested and clearly expressed resentment saying that he didn’t want
anybody caring for him but his own family members. While in hospital, the family
pleaded with doctors to stay with her ill father even after the visiting hours had
expired (sleepovers). The hospital administrators allowed the sleepovers of family
members but it meant sacrificing their jobs to look after their father. My colleague
opted to give up her job despite knowing that her family needed her income because
her Samoan values (reciprocity) were far more important to her. Her father had
provided for her needs when she was young and in the fa’a-Samoa, she has an
obligation to reciprocate. This reprocity is bound not just by a sense of obligation, but
by love and the understanding that it is the source of blessings (manuia) for her and
her family.
Conclusion
These examples highlight important cultural values and issues that the younger
generations of Samoa and pacific are required to articulate to the decision-makers,
who grapple with issues of privacy and confidentiality.
Decision-makers,
policymakers, bureaucrats as well as health providers should do all they can to
remove the barriers and anomalies so that family can be fully informed of the needs
and problems faced by their unwell family member. The mental health system should
have the flexibility to embraced paradigms other than the medical and Western
paradigms to allow this to happen.
Like the theme of this conference: “Every cloud has a silver lining.” While pacific
people have issues we have to grapple with, there are opportunities for us to reclaim
some of the knowledge and pacific processes and utilize it to formulate solutions to
some of the problems we face.
In New Zealand the context is different when compared to those of us brought up in
Samoa. We need to recognize the rituals are the essence of culture. The emphasis
should not be on how we perform the ritual but how we express the fundamentals
such as, reciprocity, respect and love which is what we should pass on to our youth.
Encouraging youth to participate and absorb our cultural practices is the
responsibility of parents and family. The important thing is the values, which will
endure; values such as family, our heritage and spirituality. If this survives from
generation to generation, then culture will live on. Our principal duty is to impart to
our youth cultural knowledge and cultural references. These cultural references are
relevant to our work especially as it impacts on the mind. Palagis will never
understand what disturbs or motivate the Samoan mind. You have to be Samoan to
understand how we think. The challenge for Samoans is to learn your culture and
understand the Samoan psyche.
I’d like to conclude by leaving you with the parting words of the Tuitoga as left
Samoa, after one of the many conflicts between Samoa and Tonga in ancient times.
These words is captured in one of our most prestigious Matai title currently held by
our Head of Sate, Malietoa Tanumafili 2nd, He said” Ua malie toa, ua malie tau. Ole ‘a
ou alu oute le toe sau ise ao uliuli tau, ae oute toe sau ile ao uliuli afo lau.”
7
You have been great warriors and you have fought a brave battle. I will go but shall
return, not to wage war, but I will navigate my journey back in the spirit of friendship
and brotherly love.
Soifua, ma ia manuia.
8