Sept. 22, 2022

Pacific Islanders—What does erasure of a community mean? (Joseph Seia, S1, Ep 4.2: )

Pacific Islanders—What does erasure of a community mean? (Joseph Seia, S1, Ep 4.2: )

This is part II of our conversation with Joseph Seia.  Joseph is the Co-Executive Director of the National Association of Pasifika Organizations (NAOPO) and the founder of PICA-WA (Pacific Islander Community Association of Washington). To hear the introduction to this topic and the full guest intro, please listen to the previous episode. 

In part II, we dig deeper into several topics: 

  • decades of erasure and policy that have led to health disparities like the high rate of police killings ad homelessness
  • his focus on organizing and gaining the power to make changes in governmental policy
  • programs that PICA-WA offers, such as the cultural weavers program to support their elders and offer a space of dignity and connection, and the youth wayfinders program that offers an intergenerational space that helps youth thrive
  • Joseph's identity as fa' fa fine and what we can learn about gender identity from the Samoan culture 
  • The importance of the messenger as well as the message when communicating about health to the community
  • the consequences of viewing someone as just a fat body that needs to lose weight and not acknowledging their humanity 

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Transcript

History:

Demographics:  Consider the erasure that can occur if a population is a minority population in the US. PI group represents about 0.4 percent of the U.S population.  

When you're less than 1%, often you're communicated that you don't matter because your population is too small. So I think there's just a historical under investment in our communities under investment in the capacity of our communities to really build up the infrastructure that we need to build up to facilitate the work of rectifying a lot of the injustices that our communities are facing

Background: Ask which island they are specifically from 

When they disclose that their Pacific Islander you ask them what Island are you from? And so familiarizing yourself with Yeah, Samoa, Tonga, Fiji, we're not all native Hawaiians. I think some words are a little bit more popular than other islanders because of the athleticism of our people, that other island groups that people don't care to ask like who they are. And I think it matters for Pacific Islanders for somebody to know where they come from and who they

Social History:

  • Context: Given the high rates of homelessness and other social risks, ensure a full social history is taken. 

Pacific Islanders have the highest killing rate with police departments, nine times more likely to experience homelessness. They have high expulsion rates, the dropout rates, suspension rates

so we acknowledge it as the path between the male and the female.\ we don't just arrive anywhere, we continue to be on a path. So it doesn't matter where you're at on the path. It doesn't exclude you from belonging to that identity. And they think that is something that we offer from the Pacific that might not necessarily be something that is offered within the larger LGBTQ community. For Pacific peoples, we say, wherever you're at, you belong, you don't meet your own letter, you are a female.

Referrals: 

  • Uprise: Increase the community's role in supporting Pacific Islander high school clubs and Savannah College students to be within the high schools
  • Cultural Weavers: Cultural Weavers is PICA-WA’s elderly engagement program that focuses on providing our treasured Pasifika elders with a space to engage in thoughtful programming in an environment that provides love, dignity and safety.

 And it's such a beautiful thing to be able to offer a space of dignity for elders to access.

  • Pasifika Food Networks:Our Pasifika Food NETworks was established to combat the devastating impacts of food insecurity experienced by our NHPI communities through providing region-specific access to culturally appropriate foods throughout Washington State.

It's hugely successful. I think we're one of the very few ethnic assigned food banks in the state of Washington because we are a designated Food Bank as a partner with the food distributors. I think black and brown communities are now looking to reform some of our food systems to make sure that it shifts away from white Christian Saviorism culture, where it's you eat what you get, and you smile, and you say, thank you versus now we're shifting to a place where we're like, No, we're not eating that trash 

  • Wellness Navigators: Our Family Wellness Navigation program is modeled after the Community Health Workers model in understanding that the health of our Pasifika communities is linked not just to accessing healthcare, but also in addressing the social determinants of health which includes access to housing, transportation, food, social belonging, employment & education

So we have a wellness navigators that are bicultural, bilingual, that families are able to access and enrolled folks in COFA. Insurance, they connect folks they go with our families to appointments is half of the battle is actually to have an advocate with you

  • Pasifika Wayfinders: Pasifika Wayfinders celebrates the leadership of our Pasifika youth through honoring their traditional roles as Wayfinders. Like our Oceanian ancestors, instead of wayfinding through the Ocean to find our Island homes or to return home, our Pasifika youth are supporting our Pasifika Diaspora in wayfinding through societal challenges by creating spaces for their peers to find belonging

Our school system now are contributing to the school to prison pipeline, where if there are issues that are happening in the school, a lot of the schools now are referring our young people to the prosecutor's office, as opposed to maybe when I was going to school, which is a long time ago, a lot of the restorative work was done within the school

Community Advocacy: Understand what it means to be an advocate in the community

But how do we as a community, work towards sovereignty and create our own tables and figure out ways for wealth to be redistributed to our own solution tables so that we're facilitating the work of improving our own health, it's also get a sense of power of how to organize and how to come together, and really believe that their lives matter that their grandparents lives matter, their kids lives matter.

Redefine Belonging: Consider the expansive definition of belonging to kin to culture, to place, to the nation, to the soil creatures, the cosmos, ancestors

You know, once we start to understand where our food comes from, once we just understand the personhood of the soil, the personhood of the waters, the personhood of the mountains, Native Hawaiians are not just wanting some old mountain back, they actually believe that Mauna Kea is a living being right. And they're fighting for the dignity that is moment here that is a sacred place that their ancestors have always considered a person.

Incorporate Indigenous Ways of Healing: Advocate your system to incorporate multiple ways of healing without creating a dichotomy. 

So it's not this western versus indigenous sort of dichotomy, but that our indigenous ways are also preserved alongside you actually had a story where there was a woman that had really bad diabetes, and she had went to a doctor and the doctor was telling her you need to take this medicine, you need to do this and that otherwise, you're gonna die for diabetes.

The Message and the Messenger: Consider the importance of representation when creating healthcare system. 

For indigenous people, it actually is not enough, because everything for us as embodied healing is embodied. So what does it mean to have Pacific healers, specific people to be able to facilitate that body of health and that work with us. “E fofo le alamea le alamea.” The spiny starfish has both the poison and also the remedy for the poison.

Respect Cultural Traditions: Respect cultural traditions and honor it even when they conflict with medical recommendations etc. 

I say paying attention to the humanity of people, like when extended families are coming to say goodbye to their loved one in the hospital, do not make it a hostile environment and do not do the right thing of only two people at a time, like how do you extend hospitality and also space for people to do their cultural protocol around grieving somebody that's transition. We have so many cultural protocol that we have to do that matters just as much as what doctors think matters.

Cultural Understanding: Consider teach-back method to clarify understanding and review if a cultural advocate is needed even if an interpreter is not needed. 

A lot of islanders do come off as comprehending English. The truth of the matter is we might comprehend English, but we're not comprehended cultural. And so it's very important that people eat they're going to advocate in the room when they're working with their families, not just for linguistic matters, linguistic access, but also because you want to facility and make sure that you're understanding the needs of the families. And just because the family is shaking their head like this doesn't mean that they know exactly what they're consenting to. And just to interrogate it a little bit further. Knowing where somebody's from their island is very important. 

 

  • Timespan: 30:11 Min
  • Transcription Type: Cleaned Verbatim
  • Speakers: 2 (Joseph Seia & Raj Sundar)

00:00

Joseph Seia:  I think black and brown communities are now looking to reform some of our food systems to make sure that it shifts away from the white Christian Saviorism culture where you eat what you get. You smile and say thank you versus shifting to a place where we could choose to say, "no, we're not eating that trash."

00:21

Raj: Hey, everyone. Welcome to the healthcare for humans podcast. The show is dedicated to exploring the history and culture of Washington's diverse communities. So, clinicians are equipped with the right knowledge to care for all patients.

This is part two with Joseph Seia on Pacific Islanders in Washington. Please listen to the previous episode to hear the introduction to this topic and the full guest intro

Joseph Seia is the CO Executive Director of the National Association of Pacifica organizations and the founder of PICA-WA, a social service organization for Pacific Islanders.

In part two, we dig deeper into several topics. We discuss the decades of erasure and policy leading to health disparities, like the high rate of police killings and homelessness. He focuses on organizing and gaining the power to change governmental policy. The programs that PICA offers, such as the cultural Weaver's program and the youth finders program. It offers intergenerational space that helps youth thrive. Joseph's identity as Faʻafafine, what we can learn about gender identity from the Samoan culture, and the consequences of viewing someone as just a fat body that needs to lose weight and not acknowledging their humanity. Here's Joseph Seia again.

I started by saying the theme is land displacement, colonialism, and environmental racism because I want it to link back to the health of the Pacific Islander community. And some staggering stats you highlight on the PICA website about Pacifica youth suffering from the highest rates of suspension and expulsions. The Pacific Islanders in the state of Washington are five times more likely to experience homelessness than their white peers. That's based on the one-night count in 2020. Then there are the health care disparities because of COFA and that chronic low wages from being recruited to these factories in the state. So, there are a lot of prominent systemic causes for poor health in the Pacific Islander community. I'm unsure what you would like to highlight because I want to flip the perspective of talking about your work rather than just emphasizing all the harm done to the communities here.

02:39

Joseph Seia: Yeah, thanks for watching. We're talking about decades of erasure and policy, especially in equity policy, in serving Islanders who have not had a specific Lane even to the governor not to be able to advocate on behalf of their policy priorities. And so, it's been hard because of the lumping with our Asian brothers and sisters. But our community is less than 1%, similar to the Native American Alaskan Native community. When you're less than 1%, often you're communicated that you don't matter because your population is too small. So, I think there's just a historical under-investment in our community's investment in the capacity of our communities to really up the infrastructure that we need to build up to facilitate the work of rectifying a lot of the injustices that our communities are facing. Because of all of that, the decades of erasure sharing, we see now in multiple systems the impact subsidy gunners have had to face and things like we have the highest killing rate with police departments. When you disaggregate Pacific Islander shooting police involve killings, you see that Pacific Islanders have suffered at the intersection with the policing system more than all other communities. If you look at the rates, specifically for every other community, as well as. It is five times more likely to be homeless. I've checked in with the King County Regional homeless authority with the work of screen with the lived experience coalition. They have some newer numbers, as they were nine times more likely to experience homelessness as they're just aggregating Pacific Islander data from everybody else. And this is replicated in a lot of different systems. We started organizing to turn the boat specifically in the K to 12 system when we did that study about ten years ago that looked at the gap. That meant the gap between Pacific Islanders compared to their white Asian peers and saw the suspension rates, the expulsion rates, the dropout rates, and the Pacific Islanders' absenteeism from school all those four things we feared the worst. And after that initial study 10 years ago, we needed to prioritize the Pacific Islanders within school systems. We need to figure out ways for parents to get more involved. And so, for ten years, we've been offering student conferences for Pacific Islander use called uprise. We've also increased the community's role in supporting Pacific Islander high school clubs and Savannah College students to be within the high school's system so that there are pathways for students to go directly to the college or at least consider College as the next step. Besides graduating high school, you work somewhere just so your family can pay for the switches, which normally happens with our Pacific Islander youth. So, we've seen some improvements in the educational field. Now we're trying to go into the other systems and places where our numbers are pretty dismal. And recently, Pete has been working with health care providers with the Department of Health with King County Public Health and making sure that they are hearing us and we are at the table, and that we're co-designing solutions. So, many of our staff and community members are trying to ensure they're at all these tables that they weren't at previously. But not just that, because it's not enough to be at all these tables. But how do we, as a community, work towards sovereignty and create our own tables and figure out ways for wealth to be redistributed to our solution tables to facilitate the work of improving our health? It also gives a sense of power to unite and believe that their lives matter. That their grandparents' lives matter and their kids' lives matter. And it shouldn't be that you're going to the hospital to die. The rate of our mothers giving birth is pretty bad because of the setup that is right now. And then carrying that life all the way through to when they're aging. Other than aging, elders receive the care they deserve within these institutions. We've put up our cultural levers program because we learned from the pandemic that Pacific Islander elders had nothing to look forward to. They were isolated at home; sometimes, they were forced to wash the kids. So, there were the de facto babysitters for these families. And a lot of them were depressed and didn't feel honored. back home, it's the exact opposite. They are worshipped and treated with so much love and care. And there are people in our families that are specifically given a duty, a lifetime duty, to care for them. And that was a very sacred role in Pacific communities. Over here, it's the exact opposite. And so, at PICA, we've been building space for the elders to come to be here twice a week, to be tended to culturally, to be tended to, and they're held to socially so that they are less depressed and can access a network of care. And they're here. They're speaking their languages; they are singing in their language. And it's such a beautiful thing to offer a space of dignity for elders at their access.

07:36

Raj: Yeah, I love just finding ways to resist. I hear many things you're doing are ways to find belonging again. I liked how you defined belonging because when we think of belonging, we just think about ourselves and maybe our family. I want people to reflect on their cultural identity when listening to this. Because when you say belonging, I think it's also to kin to culture, to place, to the nation, to the soil, creatures, the cosmos, ancestors, all of that, right? This belonging is like part of Pacifica culture connected to all these aspects. I don't think we think of that.

08:12

Joseph Seia: Yeah, that's it, belonging. And you know, once you deeply understand belonging, you also have a deep commitment to indigenous solidarity, right? The native people here have belonged here for 1000s of years. We understood the sense of belonging and did not continue to live as if there was nothing here before us. And we're just here to get a nice paying job so our families can climb up economically; anybody can do that. But that's living a life where you just literally are not accounting for the history of a place. Until you're able to respect indigenous technology and wisdom in indigenous people in the ways that they have held on to the 1000-year-old wisdom traditions of stewardship. We're going down Doomsday if we are going down to Doomsday as a human race as a planet because we've adopted violent ways of being on earth where we are overly consumed and very transactional about the resources around us. And we did not allow our resources to have the time to be able to be restored, and things just get used until you can no longer use it anymore. I think the opposite. You know, once we start to understand where our food comes from, once we just understand the personhood of the soil, the personhood of the waters, the personhood of the mountains. Native Hawaiians are not just wanting some old mountain back. They believe that Mauna Kea is a living being, right? And they're fighting for the dignity of Mauna Kea, a sacred place their ancestors have always considered a person. And you have to respect that.

Similar to many of the Coast Salish people and how they respected their waterways and mountains here. Mount Tahoma is  a source of fresh water and to understand places having a deep commitment to a history of a place and also for you to be able to teach that to us. So, I have the same responsibility to steward this place as a Co-Salish person has since I am home on their land, right? So how do you take that on as well as somebody that is a guest?

10:16

Raj: Yeah, exactly. And I want listeners not to just think about how we understand this community so I can convince them to take medication for diabetes. I want people to be more effective and advocate for the community, especially with their power in thinking about land stewardship. What does it mean to think about all these other ways of healing? How do we get systems to provide that for folks? I also wanted to highlight this other program that you have directly helped folks with family wellness, navigation, and delivering food to folks, especially in times of food insecurity. How do people get connected to that when they're in need? And how do you identify those folks?

10:53

Joseph Seia: Yeah, so right now, our clientele is in the seven hundred; we serve about 700 families facing food insecurity. We did three food deliveries twice a month and packed boxes with culturally relevant food items. And we work in partnership with DoorDash to deliver within 10 miles of our location in South King County. But we also have vehicles that transport food from Snohomish to Pierce, the Thurston to Clark County. We believe that traditional food bags do not offer anything of value to a lot of our communities. And so, we're like; there's this free resource we can engage with. And we can work directly with the food distributors to ensure they listen to our communities. And if our communities have the highest food insecurities, why are they serving food for white families in the amounts that white families have for their households? If you know anything about Pacific Islander communities, you would know that we are intergenerational in our households, and there are at least 10 Plus in every home. And so, how do you account for all of the people that are living there? The types of foods that we eat as a people and make sure that is what's going out there. And so, we've taken on that body of work, we've heard nothing but praises from our people as to how that feed box has allowed them to save a week-long worth of costs for their families. If you're thinking about it, if we're doing it twice a month, that's two weeks of us covering hundreds of dollars that now these families can see so that they can do something else with it. So, it's hugely successful. We're one of the few ethnic-assigned food banks in the state of Washington because we are a designated Food Bank partner with the food distributors. Many know that the Latino community has its system set up through my friend Roxana Garcia, who's doing tremendous work with Ottoman Tondo, or just land-specific food bank. Still, I think black and brown communities are now looking to reform some of our food systems to make sure that it shifts away from white Christian Saviorism culture, where you eat what you get. You smile, and you say thank you, versus now we're shifting to a place where we’ll have a choice to say, “no, we're not eating that trash.” Secondly, how do we make sure that the tax dollars that these food distributors are using end up in black and brown?

We need to make sure that our people know that these are all tax stock or set is why these entities are stood up and that they have to do their job of closing some food insecurity within all of us. And then, on top of that, we have wellness navigators in our wellness navigation body of work. They speak Hushmayn, Chukkese Marshallese, Lonnie, and West Papua. They speak Chamorro. So, we have wellness navigators that are bicultural and bilingual, and families can access and enroll folks in COFA insurance. They connect folks who go with our families. Appointments are half of the battle actually to have an advocate with you.

When you enter the DSHS., have an advocate with you when you go to that court system. As when our families go by themselves, they fold. When wellness navigator or youth navigator is specifically there to advocate for them, they can stand a little bit taller in many of these spaces where they would naturally fold and cannot advocate for themselves. It's a great thing that we have. We take everybody that comes in; we don't say, " Oh, if you qualify, then we'll work with you. If you walk into our doors, right then and there is a start of the relationship. Our wellness and youth navigators work with clients for six months to a year. They ensure that they are developing service plans that are very clear to the goals of that particular family and that our resources are being relegated to support our families navigating the system's success.

14:37

Raj: Yeah, yeah. I think you mentioned the Pacific way finders. Is that the youth navigators?

14:43

Joseph Seia: Yeah, I watched the videos you did on COVID. I think there's a series of six videos.

14:48

Raj: Yeah.

14:18

Joseph Seia: Yeah. They were not well done. I wanted another videographer to look at the story of the flag say, but it looked good at the music and the audio. Everything was excellent. You know, the funny part is Raj is that the music was music, that word developed by the wayside. Like they went into studios. They produced their rap songs and their reggae songs. And so, much of the content was made by our young people. And it was targeting our young people. Yeah, I'll connect you to the videographer. Yeah, they're pretty gifted. Our week by this program was trying to create places where young people don't feel judged, where they can come and learn their culture and learn it from wherever they're at, to create a space where they can just exist and be able to access support, whatever that is outside of the school system. Our school system is now contributing to the present prep line, where issues are happening. Many schools now refer our young people to the prosecutor's office. as opposed to maybe when I was going to school, which is a long time ago, a lot of the restorative work was done within this. But many schools are now referring our young people to the prosecutor's office. Once it gets there, like a couple starts to get criminalized, you betray the school to present a prep line that we have been working for the last two decades to resist and counteract. And so, I think schools are not necessarily the safest place for kids to exist now. So, we're hoping that in the creation of the Way finders program, there are alternative spaces where young people can access that mirror them back in their culture and also mirror them around, seeing them as these people with capacities to change the world as opposed to somebody with all these problems that we need to help them fix. So, it's been an honor to offer intergenerational space here at PICA. We have staffed here in Stockton County, we have staff in Vancouver and Spokane, and we're hoping to continue to build up the infrastructure to continue to create these spaces, these cultural spaces of influence. And people can access and feel like they're part of a big community that's holding good luck.

16:53

Raj: Yeah, thank you. Okay, a few more questions. I wanted to make sure we covered identity, as I mentioned because it's another self-reflection on our culture here in Western culture. We view gender as binary, either or, I think, goes back to assuming what you said about the perspective of holding multiple ideas simultaneously. I think specifically in some of our cultures; there's a third and fourth gender. And I think you identify as a Puffafine, right? Can you just tell us more about that?

17:28

Joseph Seia: Yeah, I know, the Samoan community, we have Faʻafafine which are different genders that are actually recognized by our community, culturally, and also politically, when there was a lot of significant backlash about ten years ago that was coming out of Fiji,  prime minister at the time, released a letter internationally that says that Samoa will continue to honor its indigenous identities that is a Puffafine, Taney that is afforded to us from our ancestors, and we continue to honor them as a community at large. And I think we can offer up some of that wisdom to support other communities because our indigenous culture continues to inform who we are. Either retrieve their identities lost to colonialism or create spaces for them now. And so, you see what Puffafine are like at the fore of the movement around ensuring that black and brown queer people have a room that is not just dominated by white queer folk, that we are creating space for ourselves that is very culturally rooted. That is embedded within the family, a clan, the village, and the people. But there's also racism that, as queer people of color, we have to deal with within the queer community and our family in the larger community. So different priorities happen for us. But yeah, I identify as Puffafine; I'm on the bearded side of our Puffafine identity. So, for Pacific people, it's immediately the path, right? So, we acknowledge it as the path between the male and the female. And for Puffafine, we don't just arrive anywhere; we continue to be on a track. So, it doesn't matter where you're on the path. It doesn't exclude you from belonging to that identity. And they think that is something that we offer from the Pacific that might not necessarily be provided within the larger LGBTQ community, which is why it's so many letters because everybody's too busy trying to divine every location. But for Pacific peoples, we say you belong wherever you're. You don't need your letter; you are a Faʻafafine. And that's it. Our communities will continue to offer that up. And for us, there's a cultural location that we belong in. And we know we're part of that cultural fabric too. And we're not trying to run away from that cultural fabric. I also give a lot of credit to my Mahu brothers and sisters that have been fighting in Hawaii to stand up for the traditional understanding of markup as it relates to native Hawaiian culture and history. And so, there is a beautiful short movie called Goodbye Magoo that talks about the relevance of Magoo healers within native Hawaiian culture as they were traveling from the South Pacific, from Tahiti to Samoa. And they brought that culture to Hawaii and established it within native Hawaiian cultures.

20:20

Raj: Thanks for sharing that. Okay, some more complex questions. Let's see what you have. We know healthcare institutions have consistently let the Pacifica community down. But what does it mean for you for health care systems in the way they're set up right now to show up for the community?

20:37

Joseph Seia: Yeah, there are designated community health clinics that are federally funded. And I will say that none of them have learned how to serve the other communities well. But we know from looking at the Native Hawaiian Health Care System, the community health benefits that are set up for them, such as the native project in Spokane, and also the Seattle health Indian board, that they do exactly what they are set up to do, which is very beautiful because they get to determine what health looks like, what health care should look like the hospitality that's offered within their healthcare system—and also not just thinking about hiring doctors and nurses and Western practitioners but also pay our medicine peoples alongside to do the work of health within their health care system. So, it's not this western versus indigenous sort of dichotomy, but that our indigenous ways are also preserved alongside.

I had a story where a woman had gone to a doctor with really bad diabetes. The doctor told her to take medicine and that she needed to do this or that; otherwise, she would die of diabetes. And she told the doctor that she was going back home and seeing a Samoan medicine person in Tele Sia. So, she went back home; she came back six months later, and she was completely healed. And the doctor was like, what did you do? She told the doctor I went and saw a medicine person who told me what to do, and I got better. And then the doctor was like, what did they tell you? And she said that I had to walk up this mountain three times a week and that I could only eat from the fruits of the land. There are always prescriptions that they get from the medicine person. And as the doctor heard her talk about all of the medications she got from the Tele Sia, it was the same thing that doctor told her. But it was just told to her by a Samoan medicine person. That just goes to say that the message doesn't matter for Samoans or an Elian Pacific Islander; it's the messenger that matters. And for Western medicine, they need to avoid thinking that the message is of knowledge. But for indigenous people, it actually is not enough.

Because everything for us is embodied, healing is embodied. So, what does it mean to have specific healers, specific people to facilitate that body of health and that work with us? And we have a saying in our tradition, that “E fofo le alamea le alamea.” The spiny starfish has both the poison and also the remedy for the poison But it's this specific belief that the only people that can heal us are us. That the healing already exists within our DNA, our technologies, our language, and our wisdom traditions, that all of the healing is embedded in there. We only need to look inwards to understand the pathway to healing. And that's the same with food, right? There was a massive study that was done in Hawaii, where they surveyed native Hawaiian Pacific Islanders where they put them on indigenous foods; they can only eat foods that our ancestors ate. At the end of the study, they were cured of diabetes because they returned to indigenous foods that were more aligned with their body. So, we know from that study and all of the other ways that once we have reflective space to bring back practices that our ancestors had, and to have the ability to integrate back into our lives, to shift away from the toxic stress of capitalism, and to have a lifestyle that is centered in meditation, and centered in understanding your food sources—and also understanding that relationships are important and nurturing those relationships in your life and recreating the village, right, the town of health that needs assistance with for 1000s of years. How do we bring that back here so we have it and can shift to healthier states as a community?

24:29

Raj: Yeah, that's something we need to aspire to. No wonder you keep talking about the exit plant. Like yeah, I want that.

24:35

Joseph Seia: I'm telling you, Raj, I'm trying to get away from this toxic stress.

24:40

Raj: Well, until we get to a place for the Pacific community is trained as clinicians who care for the community, you're going to show up to a clinician, and they're going to be American, or they are going to be me (I'm Indian), anyone? Do you have a story of somebody in that context that's made you feel seen and cared for, despite their identity? And what does It look like for you,

25:01

Joseph Seia: I am a bad person to ask Raj.

25:04

Raj: You're like, you don't go to the doctor.

25:05

Joseph Seia: The last time I went to see the doctor, I could already feel the hostility that he had. And all he could see was a fat body of a Pacific Islander person, and his only prescription to me was, “you need to lose weight.” And that was four years ago when I saw him and never returned. As much as I talk about health and our engagement with the healthcare system, I have to do some work on my own to think about how to engage with the provider. As a matter of fact, we have one Pacific Islander doctor that works out of Skagit County. I call him for support. He's a good friend of mine, I call him, and he'll sometimes prescribe stuff over the phone. But he talks to me respectfully, and that is the only person who goes for medical assistance. But I'm very privileged that I have a relationship with a Pacific Islander doctor, and others do not.

You know, I say paying attention to the humanity of people, like when extended families are coming to say goodbye to their loved one in the hospital, do not make it a hostile environment and do not do the right thing of only two people at a time, like how do you extend hospitality and also space for people to do their cultural protocol around grieving somebody that's transition. We have so many cultural protocols that we have to do that matter just as much as what doctors think matters for us. It's the dignity that matters. Even when you transition the dignity of the person and the fulfillment of a family that survives on all issues, we don't give up on our families when they're dead. It's not that we think they died, and that's it. We are very much committed to the next world, whatever that is. And that's in our indigenous practice, and in my Christian practice, that they're going to a different place. And so, protocol very much matters. And if you come to the Islands, especially Samoa, you'll see that all of our relatives that have moved on are right in front of our homes or on the sides of our homes. We continue to commune with them even in their death; we connect with them, and it's very peculiar that Islanders do that. I don't think other communities do as much.

I think the Latinos celebrate Hill, Dia de Los Muertos, once a year; we celebrate it every day. Pacific Islanders, all their shirts have their relatives that have passed on. They'll make shirts out of them. There's a lot of memorabilia within the community to honor those that have passed. But that's sad, too, for Pacific Islanders, at least. There are so many disparities in health that we're constantly going to funerals. It would be nice not to have a culture that's constantly accommodating for funerals at such fast rates. So how do we work to keep our people alive and living longer and healthier lives versus seeing them go to the grave, too?

27:39

Raj: Okay, anything; any other final advice? So, I want this to be a resource for all clinicians.

27:45

Joseph Seia: A lot of islanders do come off as comprehending English. The truth is we might comprehend English, but we're not comprehending culture. And so, it's essential that people either get an advocate in the room when they're working with ethnic families, not just for linguistic matters and linguistic access, but also because you want to facilitate and make sure that you understand the needs of the families. And just because the family is shaking their head like this doesn't mean they know exactly what they're consenting to. And just to interrogate it a little bit further. Knowing where somebody's from their Island is very important. It's easiest when they disclose that they are Pacific Islanders; you ask them what Island are from. And so, familiarizing yourself with Samoa, Tonga, and Fiji, we're not all native Hawaiians. I think Samoans are a little bit more popular than other Islanders because of the athleticism of our people, that other island groups that people don't care to ask who they are. And I think it matters for Pacific Islanders for somebody to know where they come from and who they are.

28:48

Raj: Thank you. Joseph, you know, I got you. You can call me too; I can get your prescriptions. I hope you trust them.

28:54

Joseph Seia: Okay, Raj, I've been following you for an alternative plan and prescription.

29:00

Raj: Thank you. Thanks so much for spending this time. I think it'll be really helpful to many people to broaden their perspective of what it means to care for the Pacific Islander community or the Pacifica community until we reach this aspiration of giving sovereignty to the Pacifica people and giving them resources to care for themselves.

29:21

Joseph Seia: Yeah, thanks, Raj. I appreciate the time. Appreciate you reaching out.

29:26

Raj: Thanks for joining me. I’m Raj Sundar, in this health care for humans podcast episode. If you enjoyed this episode and would like to support this work, please share it with others and leave a review. As always, show notes can be found over at healthcare for humans.org. Feel free to contact me for feedback or show ideas through the website or email at healthcare for humans@yahoo.com Thanks again, and I'll see you next time.

Disclaimer:

This podcast is intended for educational and entertainment purposes only. Views and opinions expressed in this podcast do not represent any of the participant's past, current, or future employers unless explicitly expressed, so always seek the advice of your physician or other qualified healthcare providers concerning your personal questions about medical conditions you may be experiencing. This Healthcare for Humans project is based on Duwamish land and makes a regular commitment to Real Rent Duwamish.

The transcript ends here.

 

Joseph Seia Profile Photo

Joseph Seia

Executive Director

Joseph Seia is the Co-Executive Director of the National Association of Pasifika Organizations (NAOPO) and the founder of PICA-WA (Pacific Islander Community Association of Washington). He has 15 years of experience in direct service, youth development work, and nonprofit leadership & administration. He labors against the political erasure of Native Hawaiian & Pacific Islander (NH/PI) communities in data and policy by re-envisioning what it means for Pasifikans to feel cultural belonging in the U.S. Diaspora.