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Mental health initiative in Tonga informed by the voices of local communities
Updates / News, 23 Sep 24
As the sun begins to set on the western side of Tongatapu, villages in the Hihifo district gather people together to meet at their local community halls and churches, trickling in with their children as the early August breeze slowly settles on their shores. The purpose of their fakataha (meeting)? To have an important talanoa (discussion) about mental health and wellbeing – mo'ui lelei faka'atamai – especially as a coastal district who were directly impacted by the Hunga Tonga-Hunga Ha'apai volcanic eruption and tsunami in 2022.

As the fala (mat) is laid out for the kāinga (people) to share, stories of resilience, hope and faith arise from vivid memories, echoed by the reactions of their grandchildren when a sudden noise is heard in the distance. Tears recall the impact of the waves, laughter softens the memories of fleeing – but it is here, in these spaces, where we also understand just how important mental health education, literacy and initiatives are, as reflected by the words being shared.     

The Pasifika Medical Association (PMA) recently announced their partnership with the Australian Government to deliver a three-year programme, the Ngalu Fānifo Regional Project, in Tonga and Vanuatu, aiming to improve mental health and wellbeing by strengthening the capacity of health and community providers to provide mental health care.  

To understand the landscape of delivering this programme, PMA deployed a team on inception visits to both countries in August, spending time with local agencies, organisations, communities and families. The community focus in Tonga was Hihifo, which is set to be the pilot district for the delivery of the programme.   

The team included New Zealand-based Tongan mental health experts and clinicians, Dr Sione Vaka, Dr Etuini Ma'u and Dr Staverton Kautoke, PMA's Regional Services team, and led by PMA Director of Language & Culture, Honourable Alematea Vaha'i.   

From the villages of Te'ekiu through to Ha'atafu, groups shared about mental health challenges and solutions within their communities. A women's koka'anga (tapa-making) group shared that while fulfilling their duties to church and family were mostly helpful for their mental health, sometimes sacrificing time for themselves would take a toll. A church group shared the mental health impacts on their grandchildren from constantly playing games on cellphones. The group from the village of Kanokupolu shared how their experiences during the volcanic eruption and tsunami were still very raw, and that the memories of fleeing in their cars and on foot continue to stay with them two years on. 

The team also heard from young children in local schools, who were old enough to remember the eruption and tsunami. Although clinical terms were foreign to them, they were quick to express their feelings and point out challenges that could affect the mental health of their families.    

Among these challenges were also solutions, with village kava clubs providing a space for men to congregate and share with each other, women's groups providing a haven for collective creativity and a platform for offloading daily stresses – simple solutions that are community-led.   

The inception visit highlighted to the team the importance of co-designing the programme with communities to ensure its sustainability and success. As New Zealand celebrates Mental Health Awareness Week for 2024, the theme speaks volumes to the work undertaken collectively to deliver the Ngalu Fānifo Project: "Community is what we create together."   

With this in mind, an exciting endeavour has begun in both Tonga and Vanuatu, where the fala will continue to be laid out as long as the kāinga need to talanoa about improving mental health and wellbeing within their communities.