Navigating Health Practices for I-Kiribati Immigrants in New Zealand

There is a rapidly growing number of I-Kiribati migrating to New Zealand and the New Zealand health care system must be prepared for this growth. There is a prospect of total migration of I-Kiribati to host countries like New Zealand due to climate change making the Kiribati islands uninhabitable. However, there are no studies examining the health beliefs and practices of I-Kiribati in New Zealand. This study sought to understand the health practices of I-Kiribati immigrants in New Zealand using a Kiribati cultural research framework that I developed, called te kora, modelled on the Kiribati cultural practice of making te kora: a Kiribati string made from two soft dried coconut husk fibres called binoka. I recruited thirty first generation I-Kiribati from the lower North Island and throughout the South Island of New Zealand through the anoiko maroro recruitment process, an approach suited to the Kiribati culture and etiquette that is similar to the concept of snowballing; in this case using a maroro (discussion) as the method and karaki (stories) as the data. The participants’ karaki were audio-recorded, translated into English, and a copy of the summary of the transcript was sent to each individual participant for verification. Subsequent maroro were organised as required. Thematic analysis was used to analyse the participants’ karaki but within that framework viewing one binoka as the Kiribati health practice and the other binoka as the western health approach. Six key organising ideas emerged from the participants’ karaki: 1) health and illness perceptions; 2) the value of traditional practices; 3) traditional health practices; 4) foods and their products; 5) beauty and wellness; and 6) the use of a western health approach. This study revealed that I-Kiribati traditionally maintained their health heritage, and persistently practise their traditional health practices of maintaining their mauri (health). However, at the same time participants accommodated a variety of different health practices including western, Māori, and ‘other Pacific’ health practices. From the study, Te kuan model of te mauri for I-Kiribati immigrants in New Zealand emerged. This is a model that transfers health beliefs and practices from Kiribati into a New Zealand context. Te kuan model of te Mauri explains how I-Kiribati navigate between health practices to establish the balance between empirical-cultural knowledge, lived experiences and available resources to meet their physical, mental, spiritual, social, environmental, and cultural needs, and how their health practices are implemented in the New Zealand context. Te Kuan Model of Te Mauri can also contribute to making sense of how I-Kiribati practise health in other host countries. This model acknowledges Kiribati traditional health beliefs and practices, improves Kiribati cultural understanding, cultural sensitivity, and cultural protection among health professionals, and at the same time may contribute to improving access to western health care services for I-Kiribati in New Zealand. Future interventions to benefit the health systems of New Zealand, other host countries and other immigrant populations must take into consideration Te Kuan Model of Te Mauri.