The teaching, academic, strategic and diplomatic powerhouse Faumuina Fa’afetai Sopoaga has won the $30,000 award at Ako Aotearoa’s recent Tertiary Teaching Excellence Awards.

The Associate Professor and Division of Health Sciences’ Associate Dean (Pacific) was also the first recipient of the Endorsement for Supporting Pacific Learner Success.

Faumuina Fa’afetai Sopoaga

The award was in recognition of the huge difference Sopoaga has made to how Pacific Health is taught at Otago Medical School and across all the health sciences at the University of Otago, as well as helping all medical students to ‘better doctor’ in our multi-cultural society.

Otago Medical School dean Professor Peter Crampton described her contribution to Pacific curriculum development and to the academic and pastoral care of Pacific students as “truly exceptional”.

Born in Samoa, Sopoaga describes herself as “bright-eyed and bushy-tailed” when she arrived in New Zealand in the 1980s to start her medical studies.

She was intent on becoming a paediatrician and returning home to work, but her health had different plans for her. While she was studying as an undergraduate, she discovered she had lupus. Her doctors said her body could not cope with such a strenuous workload and suggested other specialities, so she studied general practice and, later on, public health.

It was while studying public health that she was encouraged by her teachers – Emeritus Professor Sir David Skegg and Emeritus Professor Charlotte Paul – to give her first lecture and countless students, medical school staff and patients in New Zealand and the Pacific have benefited ever since.

She says she teaches because of her Pacific communities. “Our communities are disproportionately represented in poor health and education outcomes. These communities have encouraged and enabled me to teach and inspire the hearts and minds of the next generation of health professionals in New Zealand, and to support the aspirations of Pacific students and their families for success.

“I teach medical students throughout their six years of study at the Otago Medical School. My goal is to teach them how to work with Pacific fanau in a way that supports best clinical practice and improves health outcomes.”

One of her many strengths is her ability to notice the small things – “because sometimes the small and simple things are the most profound” – right through to her ability to work strategically with the top brass in universities and governments.

Pacific immersion programme response to crowded curriculum

Sopoaga says when she arrived “fresh off the boat” in the 1980s there was no teaching on the health of Pacific people at medical school.

Now, in part due to the work of her and her team, there is teaching in Pacific Health across the six year programme at the Otago Medical School.

One of her most powerful initiatives has been an immersion programme where every year 80 fourth-year medical students spend a weekend living with a Pacific family. More than 600 students have taken part since the programme’s inception in 2010.

The programme followed Sopoaga taking a year out from work in 2008, when she was diagnosed with breast cancer. She returned to find a curriculum review had taken place and to discover there was no room left to teach Pacific health.

“I see obstacles as opportunities. So I looked at what space was NOT allocated and it was the weekend. And that’s how the immersion programme came about.”

In preparation, students are informed about the learning objectives and provided with immersion guidelines, including information about their host families and host community, cultural protocols and dress code. Students begin their learning through observations, listening to stories, engagement in family and community activities, and by being in an environment where they are welcomed and made to feel at home.

During the immersion, students transition from being entirely clinical in their approach to including humanity in their engagements, she says.

“For many of the students it is the first time they sleep in a state house. It’s the first time they see a house with crying windows, you know, windows with water running down them with condensation.

“Our communities have been very happy to host it. A lot of students have no idea how other people are living then they get to share the family and community space and get to see how out people actually live day to day. They reflect on the connectedness of those communities which are very rich in relatability, and are very fun. The surroundings are not as opulent, but the communities are.”

Teaching students about feeling vulnerable

The ripple effects of a weekend which sees students sleeping in the parents’ bed while the parents bunk down in the lounge, and other students take part in an a Tongan talent quest, cannot be underestimated.

“What happens is they are teaching these young people their hospitality, and what it feels like to be vulnerable … the students are out of their comfort zone, feeling a loss of power and feeling vulnerable and how it is to not have the language or being in charge, so they may know how that feels when they are dealing with patients in hospital.”

She says that some students tell her in a debrief that they were apprehensive about their weekend because they had only ever seen Pacific Island communities represented badly in the media.

“They often cry when they come back about what they saw and experienced and their realisation of a lack of community in their own lives growing up.”

As well some medical students have gone on to tutor children from the Pacific communities in maths and science, she says.

“Our families come to New Zealand for the future of their children. They love their children getting to know the students and seeing what can be. A student in turn taught a family to cook without meat – a vegetarian meal – which is cheaper.

“When the med students graduate those families line the streets to cheer them on, they are fanau.”

The programme was extended to Otago’s campus in Christchurch this year and begins at Wellington’s Otago campus in 2019.

Connecting to the Pacific

With her eye always to the future while being grounded in the present and firmly rooted to her culture, Sopoaga is keen for more New Zealand doctors to be connected to the islands.

“Often in the Pacific Islands, Americans or Scandinavian final year medical students come to work, but that is usually only a one-off.

“It’s vital for New Zealand and Australian medical people to work in the 21 Pacific island countries and territories nearby because they can build a real ongoing relationship. We are connected if there is an outbreak of measles; for example’ in the islands it will be in New Zealand in 24 hours. Some of our staff and students came over to help in Samoa in 2009 when there was the tsunami.

“It also means our staff can connect with the medical schools in Fiji and Samoa. And what medical students learn is good for Pacific communities, can be applied to other groups in New Zealand who need our help like Maori, and our Asian and refugee communities.”

Supporting Pacific students to succeed

The institutional changes she has been part of at the medical school include incorporating Pacific curricula across health sciences programmes, enabling Pacific communities to contribute to health professional training and establishing effective programmes to support Pacific students’ success.

“In 2016, through the initiatives I have led, 25 Pacific students were accepted into the medical programme.

“To enable our Pacific students to thrive in the tertiary environment, I seek to make the university look and feel welcoming for them and their families. To do this, there are visible Pacific cultural symbols in our work environment.

“We get the Pacific community to be involved in the work of the university – in teaching, research and service. For example, the Cook Island mamas decorate the venue where we have our Pacific welcome for HSD students every year. This makes them feel connected and welcomed in the university environment.”

She uses the Fonofale model – an holistic approach to the health and wellbeing of Pacific people as in her teaching. Within this learning context the expectation is for all students to develop an understanding and appreciation of the importance of Pacific health; to develop relevant knowledge, skills and attitudes to work effectively with Pacific patients/fanau; and learn how to navigate Pacific cultural processes within unfamiliar contexts.

“My teaching utilises a strength-based approach. For example, it highlights strengths within communities, affirmative health promotion messages, and approaches that value Pacific culture and cultural context. How messages are framed is critical.

“I ensure there is no blame or stigmatisation of Pacific communities in the teaching of our curriculum.”

Sopoaga developed a successful programme for strengthening students’ clinical skills when working with Pacific patients. The Pacific Health Day has enabled 80 fifth-year medical students to conduct basic screening health checks for the Pacific community.

And in a world first, she led developments resulting in a division-wide Pacific health curriculum endorsed in 2016, with the same learning outcomes for medicine, physiotherapy, dentistry, pharmacy and across health sciences programmes.

I am not an individual – Ou te le tu to’atasi na o a’u. This is the essence of my sense of belonging – O le fatu tonu lea e fa’amatala atili ai, po’o ai lava a’u.

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