"At times I may not need lisinopril. At times I may need my land back."
There is a Samoan proverb — E fofo le alamea le alamea. The remedy for the sting of the crown-of-thorns starfish is the starfish itself. A community already holds what it needs to heal.
In the final episode of the Roots of Care series, Raj Sundar sits down with Ponipate Rokolekutu and Joseph Seia to talk about what colonialism did to the body, and why so much of what shows up in our exam rooms can't be diagnosed by the system that's looking at it.
The conversation starts with land: not as property, but as custodianship, identity, epistemology, relationship. What happens to a people when that is taken. How the fracture gets carried across generations until the person in front of you is sick now from a harm done two hundred years ago, with no way to point at it. Along the way: a Samoan grandmother who is a taulāsea, dismissed in a single sentence by her grandson's specialist. Why nutrition and exercise advice lands as blame when land, wages, and hours are the actual constraint. Bikini, Kili, and the imported food that started a generation of diabetes. And what a clinician can actually do — harm reduction, trusted messengers, and the community as the authority on its own health.
Some of what we cover
-Land as custodianship rather than ownership, and vanua as a whole way of being.
-Colonialism as a project of land, capitalism, and racial denigration — and the sickness that follows dispossession.
- Community illness that can't be diagnosed in an individual.
-Diagnosis as blame.
-Dignity measured by relationship, reciprocity, and responsibility rather than accumulation.
-Healing that belongs to a village, not a patient.
-Why "I've been to Hawaii" is not a response to "I am Pacific Islander."
-Harm reduction as the honest offer clinicians can make.
- Trusted messengers and community-stewarded care. Indigenous and food sovereignty.
Guests
-Ponipate Rokolekutu, PhD — Assistant Professor of Critical Pacific Islands and Oceania Studies, Department of Race and Resistance Studies, College of Ethnic Studies, San Francisco State University.
-Joseph Seia, MPA — Executive Director, Oceania Northwest, and founder of the Pacific Islander Community Association of Washington (PICA-WA). Of Samoan and Tongan ancestry.
Terms used in this episode
-Vanua (Fijian) — land, and with it people, custom, identity, and relationship. Cognates across Oceania: fanua (Samoan), fonua (Tongan), honua and ʻāina (Hawaiian), whenua (Māori).
-iTaukei — Indigenous Fijian.
-Mata ni Vanua — literally "eye of the land"; the chiefly spokesperson.
-Taulāsea — Samoan traditional healer.
-Fofō — to treat or remedy; also traditional Samoan massage.
-Talanoa — a Pacific form of conversation and inquiry.
-Dalo — taro.
-E fofo le alamea le alamea — the remedy for the crown-of-thorns starfish is the starfish itself.
Referenced in this episode
-Oceania Northwest and the Oceania Healers Initiative
-US nuclear testing in the Marshall Islands (67 tests, 1946–1958, 23 of them at Bikini Atoll) and the displacement of the Bikinians to Rongerik, Kwajalein, and finally Kili
-Urban Indian health organizations and federally qualified health centers as community-stewarded care models
-Research on the return to indigenous diets and diabetes remission
About Roots of Care
A four-part series on whole-person, trauma-informed, and community-centered primary care, produced as part of the Healthcare for Humans podcast. Ep. 1: How Trauma Shows Up in Primary Care Visits. Ep. 2: Illness, Disease, and the Whole Person. Ep. 3: Safety, Threat, and the Nervous System.
