New Zealand Autism Spectrum Disorder Guideline - Ministry of Health

Part 8: Pacific peoples’ perspectives
Part 8
8.1 Pacific concepts of health
Common values across Pacific nations are ideals
such as respect, reciprocity, communalism,
collective responsibility, humility, love, service
and spirituality 421 . Pan-Pacific concepts of
family emphasise collectivity and encompass
the immediate and extended family as well as
the wider community – it is not uncommon for
children to be raised or parented by aunties,
uncles or grandparents.
Traditional Pacific concepts of health are
holistic, where well-being is defined by the
equilibrium of mind, body, spirituality, family
and environment. Traditionally, Pacific people
view disturbed behaviour or mental illness as a
manifestation of an external spiritual force that is
usually caused by a breach of a sacred covenant
between people or between people and the gods
– hence treatment was sought from a traditional
healer 422 . Accordingly, traditional explanations
of disability have been based on cosmological
and spiritual connections such as punishment
from God or a curse due to a family wrong.
Pacific people have historically had low access
and utilisation rates of disability support
services in general 423 . One contributing factor
is thought to be the high degree of stigma
attached to disability in Pacific cultures, so that
the presence of disability is seen as shaming for
the family 131 . The shame is often associated with
beliefs around breach of tapu and punishment
for wrongs. Entrenched traditional beliefs
and stigma issues inherent in most Pacific
cultures, with regards to relating to people
with disabilities, act as a major barrier to full
acceptance and participation in society and to
accessing disability services in particular.
Duty of care for loved ones is sacrosanct in most
Pacific cultures where ultimate responsibility
for the sick or disabled traditionally falls on the
immediate and extended family. This may be
a tremendous support and strength of Pacific
families; however, it could act as a barrier
to accessing services 131 and, as regards ASD,
may prevent severe difficulties from being
identified early 130 . Furthermore, the guilt and
shame associated with an inability (or perceived
unwillingness) to bear the full burden of care
increases the chances that services may not
be accessed.
Qualitative information suggests that ASD
may not be acknowledged as ‘ASD’ in Pacific
communities where a child that is ‘different’
may just be accepted as ‘an odd one’ and
medical help and other supports may not be
seen as needed or a priority. Moreover, there
may be perceptions that a Pacific child with
ASD may ‘grow out of it’, or may be seen as
just ‘a naughty child’ 130 . Compounding the
situation further is the fact that Pacific people
are disproportionately over-represented in
most negative socioeconomic indicators when
compared to the general population. Poverty
itself is a barrier to accessing services and there
may simply be ‘more pressing needs’ related to
surviving, rather than dealing with a ‘problem
child’ 130 .
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New Zealand Autism Spectrum Disorder Guideline