<p>This research examines in-depth the health and wellbeing experiences of 30 Kiribati migrant women navigating their way to achieve New Zealand permanent residency under the Pacific Access Category (PAC) policy. The political and economic rationality underpinning PAC was to meet New Zealand’s labour demand for industrial growth. It also provides successful applicants with the opportunity to work, live and study in New Zealand indefinitely. The purpose of the research was two-fold. Firstly, to assess the health and wellbeing experiences of migrant women who travelled to New Zealand under the PAC scheme, using Kiribati women as a case study to comment on issues of responsibility for healthcare and wellbeing. Secondly, to identify gaps in personal and policy-related aspects of healthcare and wellbeing, and determine how access to appropriate healthcare and social services for PAC migrant women can be facilitated. The experiences of these migrant women indicated shortcomings in provision of health and social services that this thesis terms the ‘PAC gap’. Although the PAC policy offers them the opportunity to live permanently in New Zealand, the current state of the PAC policy features gaps in service provision that result in gender and health inequality, financial hardship and stress, poor housing, unemployment and poverty. The health and wellbeing impact of the existing conditions of the PAC policy was exacerbated by the contrasting influence of neoliberalism as a policy, ideology, and a form of governmentality in the New Zealand environment (Larner, 2000a; Suaalii, 2006), and the markedly different maneaba system that is central to the social and political life in Kiribati (Tabokai, 1993; Uakeia, 2017; Whincup, 2009). Te maneaba is a traditional meeting hall, where communal meetings take place, and unimane (male elders) make decisions for the governing and wellbeing of the village people (Tabokai, 1993). It is a form of governmentality that shapes and influences how an I-Kiribati thinks and acts (Foucault, 1991). This system is at odds with a neoliberal approach that stresses self-responsibility and individualism. These contrasting forms of governmentality ‘talk past each other’ or are totally different (Metge & Kinloch, 1984). I recruited 30 I-Kiribati women who were successful PAC migrants: six from Auckland, six from Hamilton, and eighteen from Wellington. These women were selected in different years from 2012 through to 2015. To identify the PAC gaps, I employed an indigenous research method called te maroro/talanoa (to exchange ideas and experience freely and openly), complemented by the use of the feminist oral history method that transfers the needs and voices of women from the margin to the centre. This thesis draws on Foucault’s governmentality theory, a critical discourse on neoliberalism, and research on migration and the colonial history of Kiribati. It also draws on work by both Pacific and non-Pacific scholars that articulate how health and wellbeing are rooted in our lived culture and values. This thesis also stresses the need for cultural competency and integration of policy, service provision and community engagement. These materials have all guided my analysis to unpack the women’s health and wellbeing experiences. The research findings on the drawbacks of neoliberal governmentality and maneaba governmentality, and understanding of te maneaba system in a new way, strengthen Pacific studies. These contribute to the literature on Kiribati’s indigenous knowledge and cultural values and Kiribati migration as well as to the impact and effectiveness of the PAC policy for Kiribati and Pacific migration. This thesis demonstrates the need to extend the engagement of Pacific indigenous knowledge and values to the design and implementation of policies at national, regional and global levels. This thesis recommends a hybrid neoliberal-maneaba residential model to address the issues of the current system, such as stress and difficulty finding a job offer, and close PAC gaps. The new model entails a more open and transparent communication between both the New Zealand and Kiribati governments when designing a cultural competent and coherent strategic framework. By working in the best interests of all parties (i.e. New Zealand and the Kiribati governments and PAC migrant groups) this would support future successful PAC applicants to settle well in New Zealand. This would contribute to improved health outcomes for these women, their utu and kainga, without undermining the richness and values of Kiribati’s culture rooted in te maneaba system. These stories articulate a consistent requirement for a hybrid neoliberal-maneaba system, to create a residency model that works for successful PAC applicants, the government of New Zealand and Kiribati, and Kiribati families living in both countries. This would avoid repeating the stress and pain most of these PAC migrant women had experienced because of lack of government support as perceived under te maneaba system. The recommended residency model would also benefit other eligible countries (Fiji, Tonga, and Tuvalu) participating in the PAC scheme.</p>
The Role of Research in Guiding Treatment for Women’s Health: A Qualitative Study of Traditional Chinese Medicine Acupuncturists
