Young women's perceptions and experiences of sexual risk in Suva, Fiji

This paper explores young iTaukei (Indigenous Fijian) women's perceptions and experiences of sexual risk. It draws on qualitative data collected in Suva, Fiji in 2011 and 2012. Participants included iTaukei female university students aged 18-29 years. We describe nine forms of sexual risk identified by young iTaukei women, and group these risks into three clusters - social risks, physical risks and intimate relational risks. We discuss how young women prioritise these risks differently depending on context, location and relationship. Findings point to a critical mismatch between current public health risk priorities and those risks identified as most important in the lives of young iTaukei women. Findings have important implications for strengthening sexual and reproductive health policy and practice in Fiji.

A Qualitative Exploration of Fijian Perceptions of Diabetes: Identifying Opportunities for Prevention and Management

Rates of diabetes are high in many communities of Pacific Island peoples, including people from Fiji. This qualitative study explores knowledge and attitudes towards diabetes among i-Taukei Fijians to facilitate the cultural tailoring of diabetes prevention and management programs for this community. Fijians aged 26 to 71 years (n = 15), residing in Australia, participated in semi-structured interviews; 53% (n = 8) were male. Interviews were audio-recorded, transcribed verbatim, then thematically analyzed. Diabetes is recognized as an important and increasing health problem requiring action in the i-Taukei Fijian community. Widespread support for culturally appropriate lifestyle interventions utilizing existing societal structures, like family networks and church groups, was apparent. These structures were also seen as a crucial motivator for health action. Intervention content suggestions included diabetes risk awareness and education, as well as skills development to improve lifestyle behaviors. Leveraging existing social structures and both faith and family experiences of diabetes within the Fijian community may help convert increased awareness and understanding into lifestyle change. Ongoing in-community support to prevent and manage diabetes was also regarded as important. We recommend building upon experience from prior community-based interventions in other high-risk populations, alongside our findings, to assist in developing tailored diabetes programs for Fijians.

Pacific students undertaking the first year of health sciences at the University of Otago, and factors associated with academic performance

AIM

To describe Pacific students in the first year of health sciences at tertiary level, their academic performance, and factors associated with academic outcomes.

METHOD

Routinely collected data for students who enrolled in the Health Sciences First Year (HSFY) programme at the University of Otago between 2007 and 2011, including their school National Certificate in Educational Achievement (NCEA) results were obtained in anonymous form. Descriptive statistics were calculated and regression analyses were undertaken using SAS v9.2 software.

RESULTS

A small but increasing number of Pacific students are enrolling in health sciences at tertiary level. Pacific students had poorer performance compared to non-Pacific students in both NCEA and the HSFY programme. Factors associated with academic performance were gender, NCEA results, school decile, accommodation type, ethnicity, international status and disability.

CONCLUSION

Pacific students are under-represented in health sciences and would benefit from better preparation from school. Pacific solutions are required to improve academic outcomes over and above mainstream policy solutions. Tertiary institutions need to engage prospective students earlier to ensure they are well informed of requirements, and are appropriately prepared for study at the tertiary level.

Targeting cyclone relief within the village: kinship, sharing, and capture

This article investigates the targeting of cyclone relief within villages in Fiji. It focuses on how relief allocation is linked with informal risk sharing and elite capture, both of which are directly related to kinship. The results are as follows. First, food aid is initially targeted toward kin groups according to their aggregate shocks and then shared among group members. Right after the cyclone, when aid is scarce, households with damage to their housing and with greater crop damage are allocated less aid within the group. Instead, they receive greater net private transfers in other forms, especially in labor sharing. Consistent patterns are found in village, cropping, and housing rehabilitations. Second, there is no elite capture of food aid in the kin group, and instead, traditional kin leaders share food with others; however, non-kin-based community leaders capture aid when it is allocated across kin groups. Third, distinct from food aid demanded by all, tarpaulins demanded by victims only strongly target individual housing damage at the village level—not the kin group—independent of social status. As with food aid, victims with greater crop damage are given a lower priority. Implications for relief policies are discussed.

Export quality: representing Fijian bodies and the economy of war

Fijian bodies have become a valuable commodity in the economy of war. Remittances from workers overseas are Fiji's largest income – exceeding that of tourism and sugar export. This essay examines historical and contemporary representations of the black male body that perpetuate the exploitation of Fijians by inscribing the Fijian male body as warrior, criminal and protector. Taking a multidisciplinary approach informed by sociology, cultural theory, Pacific studies, visual culture, feminist and post-colonial theory, my practice is the vehicle through which I address issues of neocolonial commodification of Fijian bodies. Through an analysis of my own staged photographs and vernacular images taken by Fijians working for private security military companies and British and US armies, I hope to challenge audiences to consider their own perceptions of Fijian agency and subjectivity. By theorising the politicisation of the black body and interrogating colonial representations of blackness, I argue that we can begin to create links between the historical and contemporary exploitation of Fijians and that at the essence of both is an underlying racial hierarchy and economic requirement for cheap and, arguably, expendable labour.

Youth health-risk behavior assessment in Fiji: the reliability of Global School-based Student Health Survey content adapted for ethnic Fijian girls

OBJECTIVE

The Global School-based Student Health Survey (GSHS) is an assessment for adolescent health-risk behaviors and exposures, supported by the World Health Organization. Although already widely implemented - and intended for youth assessment across diverse ethnic and national contexts - no reliability data have yet been reported for GSHS-based assessment in any ethnicity or country-specific population. This study reports test-retest reliability for GSHS content adapted for a female adolescent ethnic Fijian study sample in Fiji.

DESIGN

We adapted and translated GSHS content to assess health-risk behaviors as part of a larger study investigating the impact of social transition on ethnic Fijian secondary schoolgirls in Fiji. In order to evaluate the performance of this measure for our ethnic Fijian study sample (n=523), we examined its test-retest reliability with kappa coefficients, % agreement, and prevalence estimates in a sub-sample (n=81). Reliability among strata defined by topic, age, and language was also examined.

RESULTS

Average agreement between test and retest was 77%, and average Cohen's kappa was 0.47. Mean kappas for questions from core modules about alcohol use, tobacco use, and sexual behavior were substantial, and higher than those for modules relating to other risk behaviors.

CONCLUSIONS

Although test-retest reliability of responses within this country-specific version of GSHS content was substantial in several topical domains for this ethnic Fijian sample, only fair reliability for the module assessing dietary behaviors and other individual items suggests that population-specific psychometric evaluation is essential to interpreting language and country-specific GSHS data.

Othering and being othered in the context of health care services

Othering is a process that identifies those that are thought to be different from oneself or the mainstream, and it can reinforce and reproduce positions of domination and subordination. Although there are theoretical and conceptual treatments of othering in the literature, researchers lack sufficient examples of othering practices that influence the interactions between patients and health care providers. The purpose of this study was to explore the interactions between health care providers and South Asian immigrant women to describe othering practices and their effects. Ethnographic methods were used involving in-depth interviews and focus group discussions. The analysis entailed identifying uses of othering and exploring the dynamics through which this process took place. Women shared stories of how discriminatory treatment was experienced. The interviews with health care professionals provided examples of how views of South Asian women shaped the way health care services were provided. Three forms of othering were found in informants' descriptions of their problematic health care encounters: essentializing explanations, culturalist explanations, and racializing explanations. Women's stories illustrated ways of coping and managing othering experiences. The analysis also revealed how individual interactions are influenced by the social and institutional contexts that create conditions for othering practices. To foster safe and effective health care interactions, those in power must continue to unmask othering practices and transform health care environments to support truly equitable health care.

Men who kill their own children: paternal filicide incidents in contemporary Fiji

OBJECTIVE

Filicide, or parental murder of offspring, constitutes a major portion of lethal violence perpetrated against children worldwide. Despite the global nature of the phenomenon, researchers have focused their studies on the developed industrialized societies with the consequent neglect of small, developing societies. Second, there is a paucity of empirical data on child homicide committed by fathers. This study therefore explores the nature and extent of paternal filicides in Fiji, a non-Western society, and the social and cultural forces underlying them in order to enhance our knowledge of the phenomenon.

METHOD

Information was obtained from a number of sources, including (a) a police homicide logbook, (b) newspaper reports of homicide, and (c) detailed interviews conducted with criminal justice and medical personnel. Information from these data sources were consolidated to construct case histories of paternal filicides. These cases were then analyzed for dominant themes. Case illustrations are presented in the text.

RESULTS

Several of the study's findings are congruent with other studies of paternal filicides: poor, working class fathers were the offenders in all cases. As a corollary, their victims were from low socioeconomic backgrounds. Regarding location, paternal filicides occurred in the home of the offender and victim. The filicides were the culmination of stresses and strains associated with marital disharmony and excessive corporal child-control strategies.

CONCLUSIONS

The general conclusion of this study is that further research in non-Western societies has the potential to increase our understanding of the social factors and processes involved in paternal child murders. We will then be better positioned to craft effective intervention strategies.

War, emergency and the environment: Fiji, 1939-1946

When World War Two broke out, Fiji's colonial administration assumed emergency powers to marshal the civilian population to produce goods and services for the war effort, particularly the support of American and New Zealand military personnel based there during 1942-43. This context of emergency framed land legislation revision, enabling the government at times to deal in a high-handed manner in resuming Fijian leased land for native reserves, mainly from Indian tenants. The added population and wartime construction placed extensive demands on Fiji's resources, inducing environmental changes. The government as well as the various racial groups in Fiji were largely unconcerned with this unless the degradation was obvious, threatening the well-being of the human population.

Maternal infanticides in Fiji

OBJECTIVE

This essay contributes to the cross-cultural literature on childhood homicides by examining 16 infanticidal homicides that occurred in Fiji over an 11-year period. The results are compared with infanticide studies conducted in other societies.

METHOD

Official police data recorded in a Homicide and Manslaughter register are analyzed. These are supplemented by newspaper reports of infanticides and semi-structured interviews conducted with key criminal justice and medical personnel intimately associated with infanticide cases.

RESULTS

The findings show that most infanticide defendants were young, poor, Fijian, with little formal education, living with nonparental kin at the time of the crime. The infanticides were precipitated by unwanted pregnancies brought on by nonmarital and extramarital sex. Pregnancy is carried to full gestation without knowledge of family, friends and neighbors of offenders and the infant is killed immediately following birth.

CONCLUSIONS

The current findings demonstrate that the patterns of maternal infant killings in Fiji are congruous in many significant ways with those in advanced industrialized societies. It is concluded that additional research in non-Western, nonindustrialized nations is imperative to contribute to the development of sound conclusions about, and remedies for infanticide.

Moving experiences: a qualitative analysis of health and migration

This paper describes a qualitative analysis of the health and health care experiences of South Asian Fijian women now living in the lower mainland area of British Columbia, Canada. A particular focus is put on the health impacts of the migration experience. A thematic analysis of in-depth interviews informs the discussion of individual women's, as well as service providers', views of health meanings, physical and emotional health concerns, experiences with the health care system, and women's roles as care-givers. The findings have implications for how health and illness are conceptualized, and how health services are provided to particular groups in particular places.

Epidemiology of cutaneous leishmaniasis at a focus monitored by the multinational force and observers in the northeastern Sinai Desert of Egypt

A longitudinal epidemiologic study of cutaneous leishmaniasis (CL) transmission was conducted between July 1989 and June 1991 in a 1,200-km2 sector of the northeastern Sinai Desert monitored by the Multinational Force and Observers (MFO), an international peace keeping mission between Egypt and Israel. The occurrence of human cases, sand fly density, rodent collection, and isolations of Leishmania confirmed only one of four surveyed locations as a significant focus of CL transmission. Phlebotomus papatasi, the only anthropophilic sand fly species encountered at this focus, comprised more than 96% of the sand fly population and attained human landing densities exceeding 100 sand flies/person/hr during 1990. Seasonal activity of this species ranged from April to November, with highest densities occurring during the period May-September. A peak promastigote infection rate of 2.4% (13 of 534) was observed in P. papatasi during July 1990. Twelve of the 60 (20%) persons at risk during the six months of intense sand fly activity at this site developed lesions consistent with CL; L. major was isolated from nine (75%) of these cases. Leishmania major infection was acquired by two of 22 (9%) sentinel hamsters used during the same period. More than 97% of the 897 wild rodents trapped at this site were desert gerbil species. Leishmania major was the only Leishmania isolated from human, sand fly, wild rodent (Gerbillus pyramidum), and sentinel hamster infections that originated at site Check point 1-Delta, the focus of CL transmission within jurisdiction of the MFO. The altered ecology of this area, created by construction of a dam, may contribute significantly to the transmission dynamics of CL at this focus.

Bacterial synergy of Treponema denticola and Porphyromonas gingivalis in a multinational population

Treponema denticola and Porphyromonas gingivalis have been associated with human adult severe periodontitis. In this study, we quantified these putative pathogens in subgingival plaque samples collected from 74 Fijians, 74 Colombians and 73 U.S. Americans stationed at the Multinational Force and Observers encampment in the Sinai Desert, Egypt. A contingency table of T. denticola and P. gingivalis frequency revealed a highly significant synergistic relationship. We discovered that the occurrence of T. denticola apparently requires the presence of P. gingivalis. This represents the first observation of a synergistic relationship between these putative oral pathogens associated with adult severe periodontal disease.

Cutaneous leishmaniasis acquired during military service in the Middle East

BACKGROUND

Cutaneous leishmaniasis is endemic in much of the Middle East. Personnel from more than 55 nations are currently participating in Middle East peacekeeping and military activities.

OBSERVATIONS

Twenty-three Fijian members of a military observational force in Sinai, Egypt, acquired cutaneous leishmaniasis. They were treated successfully with 1-month courses of ketoconazole.

CONCLUSIONS

Soldiers who acquire cutaneous leishmaniasis may return home to nations where cutaneous leishmaniasis is unknown or rarely diagnosed. Cutaneous leishmaniasis, caused by Leishmania major, may be treated with ketoconazole rather than antimonials.

Campylobacter pylori infection in patients undergoing endoscopy in Fiji

Forty two patients (20 Fijian and 22 Indian) presenting for endoscopy at the Colonial War Memorial Hospital, Suva, Fiji, were biopsied to detect Campylobacter pylori infection. Detection of the organism's urease activity in biopsy material or seeing the organism in Warthin-Starry silver stained histology sections were used to diagnose infection. Thirty-nine patients (93%) were infected; 19 of 20 Fijians (95%) and 20 of 22 Indians (91%). Of the 39 infected patients, 37 (95%) had chronic active gastritis and 24 (62%) had active peptic ulcer disease. The implications of these findings in relation to the management of endoscopy patients in Fiji are discussed.

Leprosy in Auckland

The purpose of this paper is to alert practitioners to the possibility of leprosy by giving practical points from local experience together with a modicum of background information. Local experience of 45 patients is described in the form of a recent survey done in 1979 in Auckland together with illustrative records.

Bisalbuminemia. A new molecular variant, albumin Vancouver

Of 18 members of a Fiji Indian family investigated, eight of the 12 males and two of the six females had an electrophoretically slow-type bisalbuminemia (alloalbuminemia). The albumin was characterized by the hiterto unique ratio of the two bands (Al A 35%: variant 65%), and by dye-binding studies and electrophoretic mobility in different media. The data suggest that this is a new variant, which we propose to call albumin Vancouver (Al Va).