Devised by Samoan-born academic Fuimaono Karl Pulotu-Endemann, the Fonofale health model is a wellness system that recognizes and embraces Pacific perspectives. It was developed as a Pacific Island health model for use in the New Zealand context. According to New Zealand’s Ministry of Health (2008), the Fonofale model is named after Fuimaono Karl’s maternal grandmother, Fonofale Talauega Pulotu Onofia Tivoli.
It is a model built around a simple idea: the Samoan fale, or house. However, it includes elements from many nations, such as the Cook Islands, Niue, Fiji, Tokelau and Tonga.
Components of the Fonofale Model
According to the Health Workforce Advisory Committee of New Zealand (2002), the fale represents a person’s overall well-being and is composed of multiple individual elements.
The soil, or the foundations, represent the aiga, the family. Not only immediate relatives, but also extended family and anyone with whom one is linked by association or agreement.
The roof is your culture, your beliefs and your value system that provide you with protection and refuge. Pulotu-Endemann points out that these may be traditional beliefs linked to a specific Pacific identity, but it may also focus more on identity and palagi values.
These two parts of the structure of the fale are supported – figuratively and literally – by four pou (pillars). They represent the spiritual, physical, mental, and “other” aspects of your well-being. Additionaly, the others include elements such as sexuality, socioeconomic status and gender.
The foundations of the Fonofale represent the family, which is the basis of all pacific island cultures. In this regard, the family can be both a nuclear family and an extended family and forms the fundamental basis of the social organization of the Pacific islands.
The roof represents the cultural values and beliefs that constitute the refuge for life. These may include beliefs in traditional methods of healing as well as Western methods. Culture is dynamic and therefore constantly evolving and adapting.
In New Zealand, culture includes the culture of Pacific peoples raised in New Zealand, as well as that of Pacific peoples born and raised in their island homes. In some Pacific families, the culture of that particular family comprises a traditional Pacific Island cultural orientation in which its members live and practice the particular cultural identity of that group.
Some families may lean towards a palagi orientation in which those particular family members practice palagi values and beliefs. Other families can live their lives on a continuum that goes from a traditional orientation to an adapted palagi cultural orientation.
Between the roof and the foundations are the four pou, or poles. These pou not only connect culture and family, but are continuous and interactive with each other. The pou are:
Spiritual: This dimension is related to the sense of well-being that derives from a belief system that includes Christianity or traditional spirituality related to nature, language, beliefs, and history, or a combination of both.
Physics: this dimension refers to biological or physical well-being. It is the relationship of the body – which comprises anatomy and physiology – with physical or organic substances, such as food, water, air and medicines, which can have positive or negative effects on physical well-being.
Mental: this dimension refers to the health of the mind, which involves thought and emotions, as well as expressed behaviors.
Other: this dimension refers to variables that can directly or indirectly affect health, such as gender, sexual orientation, age, social class, employment and educational status.
Dimensions of the Fale
The fale is encapsulated in a cocoon whose dimensions have direct or indirect influence on each other. These dimensions are:
Environment: This dimension addresses the relationships and uniqueness of Pacificers with their physical environment. The environment can be rural or urban.
Time: This dimension refers to the current or specific moment in history that affects the peoples of the Pacific.
Context: This dimension refers to the where/how/what and the meaning it has for that particular person or people. The context may be related to people raised in the Pacific Islands or in New Zealand. Other contexts are political and socio-economic.
Relationship between the elements of the Fale
No part of this fale is isolated: they all depend on and support each other. Then, around the fale, there is a circle, boundary or cocoon containing the last three elements:
The environment surrounds the fale and focuses on the physical scenario, regardless of where it is located.
Time and context refer, respectively, to a point in time that affects pacific people and the socio-economic, political, legal, or personal context around you that shape who you are.
For many people, this can be a new way of looking at well-being. Normally, we only consider two or three elements when we analyze how we feel or what we can change to improve our situation. But in times when we must take maximum care of our well-being, models like Fonofale show us a different way of approaching ourselves.
Evolution of Fonofale’s health model
According to the Ministry of Health of New Zealand (2004), a description of the Fonofale model first appeared in 1995 in the Ministry of Health’s report Strategic Directions for Mental Health Services for Pacific Island People. However, the development of the model dates back to 1984, when Fuimaono Karl taught nursing and health studies at the Manawatu Polytechnic. The model underwent many changes before 1995.
The Fonofale model incorporates the values and beliefs that many Samoans, Cook Islanders, Tongans, Niuans, Tokelauans and Fijians had told Fuimaono Karl during workshops related to HIV/AIDS, sexuality and mental health from the early 70s to 1995.
In particular, all these groups stated that the most important thing for them was family, culture and spirituality. The concept of the Samoan fale, or house, was used as a way to incorporate and represent a Pacific form of what was important to cultural groups, as well as what the author considered important components of the health of Pacific peoples.
Why is the Fonofale Model relevant?
It is relevant because you can use your knowledge of Fonofale to improve teaching. As with Te Whare Tapa Whā, this knowledge is not limited to working only with the groups of people it represents.
This approach is also relevant because it will help create a learning environment that is culturally safe for Pasifika students.
What does it mean for teaching?
If a teacher identifies as pasifika, the fonofale is a framework that allows him to talk about how he probably already works with his students.
If you are not pasifika, the framework allows you to see your students, particularly those from the Pacific islands, in a different way, perhaps closer to how they see themselves.
Some questions to ponder
Below are some questions from the student’s point of view to help you focus on each part of the Fonofale model:
Do I have the support of my family? (Family).
Does this course connect to my cultural values and beliefs? (Culture).
Do I have the necessary resources? (Physicists).
Do I think I can do it? (Spiritual).
Can I cope with the workload? (Mental).
Is there anything that gets in the way of my goals here? (Others).
Is my environment, including home and work, going to help me achieve this? (Environment).
Can I afford to do so at this time? (Context and time).
Implications of the Fonofale Model
It may not always be possible to cater to all dimensions of the Fonofale. But a big implication is that if there are students with difficulties, or who are not committed, then the Fonofale can help you discover where the problem is and how to treat it.
But a big implication is that if you have students with difficulties, or who are not engaged, then the Fonofale can help you figure out where the problem is and how to solve it.
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Building Pacific health workforce capacity Health Workforce Advisory Committee, NZ, 2002
Pacific health and disability workforce development Plan Ministry of Health, NZ, 2004
Pacific cultural competencies: A literature review Ministry of Health, NZ, 2008
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