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Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
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Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat
Lalotalie River Retreat

‘They’re patients, not criminals’

By Taina Kami Enoka

‘They’re patients, not criminals’ Leota Dr Lisi Petaia is a psychiatrist with a vision. Her dream is to improve the facilities at the mental health unit of the Tupua Tamasese Meaole Hospital to help the growing number of mental patients in this country.

Mental disorders are very common. They can happen to anyone and need proper care and treatment. They are no different from any chronic disorders such as diabetes or asthma.

 They are all biological and genetic disorders that require appropriate treatment and care, provided by a team of people adequately trained in this area. Leota is at the Canterbury District Health Board, Christchurch, to gain clinical experience.  

There, she has worked with some of the top psychiatrists in Australasia.  But back home in Samoa, she’s kept in close contact with consultant psychiatrist, Dr Ian Parkin and three registered nurses.

“They work so hard in the Mental Health Unit to try and deal with these issues. It’s a big and complex issue but at least we’re trying to do something about that now.” This year, she wants to bring back experts in this area to treat patients and assist with services.
Leota also wants to work towards a well-trained workforce. She aims to encourage other doctors to be interested in this area so they can have the proper training to address these issues and have confidence to treat patients when presented with mental problems.

Often, mental patients who get out of hand, are sent to Tafa’igata Prison or put in Police cells. “They are patients. They are not criminals. They need proper treatment and care. We have a very strong family support, but not every family is able to cope with that.

“We all know there are people walking around town now and they do need proper care and help.”
Such care and help, Leota says, requires biological treatment and also the support of the family and others to look after them.

“They are vulnerable people, they can be abused and for me it’s very challenging. I see the need to advocate for the rights of these people and that’s what I’d like to do. “

Leota is optimistic and confident that Samoa will develop the current services to another level. This is with the support of the Prime Minister Tuilaepa Sa’ilele Malielegaoi and the Minister of Health.

“They are very aware of these problems and very supportive in terms of ways to help develop mental services in Samoa.  At least were starting to talk about these issues. It’s an area that’s been neglected for years, not only in the Pacific but all over the world.

“And Tuilaepa and the HRPP and government always believe that what’s good for koaa is good for Apia. It’s that kind of concept. What’s good for New Zealand and the Samoan people in NZ is good for the people in Samoa.  And that’s why I want to help develop this.”

Leota wants to see the hospital with proper resources, facilities and a workforce that caters for these people. Especially at the acute stage, when families can’t cope with them, when they become violent or aggressive. “People are at risk not only as patients but to their families as well.

So we need a proper place to settle them down and then we can put them back in their families for support where they are able to settle.”
Leota stressed that violence and aggression is part and parcel of the illness.

“It’s not their fault that they’re becoming like that and I think that’s why mental issues are stigmatized because the symptoms are such that they’re ‘behaviourily’

disturbed.” It all comes down to the priority put into mental health. This is a priority for the World Health Organization, Leota says, who now have a budget to resource mental health.

In Samoa, the construction of the new hospital is in its second phase. There are hopes for a house or a building, with safety specifications for patients and for the staff to care for them.

While in the country, Leota, who returns to New Zealand today, visited the local pharmacies and found that they have the medication, similar to those available in New Zealand. 

It was now a matter of training local doctors to be confident to identify mental health problems and treat them accordingly. Like TB and leprosy, they too were stigmatized until treated. But Leota says, stigma comes with misunderstanding and not being aware about what they are and how to cope with it.

“It’s the people’s anxiety in not knowing how to deal with them. That’s the root of stigma is you don’t understand or have any insight on why these people behave the way they do or why they do what they do when they are unwell.”

“We cannot just raise awareness and not have the necessary resources to cater for the need when people scream out that they need this and that”
Within mental health are a lot of sub specialties. Alcohol is a major problem in the Pacific, mainly in Samoa.

There is the social burden of alcohol and the physical problems. At the Outpatient and Emergency at the hospital at night, there are always people who are there for alcohol-related reasons. Violence, motor vehicle accidents, abuse and so on.

Pastoral care at churches deal with a lot of today’s social stresses. The Mental Health Unit needs to form strong consultations with NGOs and churches, partnership with all the NGOs, dealing with social issues.

In New Zealand, Leota treats a lot of Samoan patients. They live normal lives and function well.  “I don’t want our Samoan people not to take the proper treatment they need and all they do is walk around the streets because they don’t have the care they need.”

Leota was born and bred in Samoa. She did all her education here. In Year 2000, she returned and worked at the hospital on completion of her medical degree.

It was then that she realized that there was no back up service available to the doctors in hospital when such disorders came through.
“That started to increase my interest. Psychiatry is always fascinating ‘cause its very challenging and very difficult to bring your mind around.”

With for example pneumonia, it is easily detected on an x-ray.
“If you have somebody who’s sitting in front of you who’s not functioning because their brain is not functioning very well, it’s very difficult.

You don’t have tests to test what exactly it is. You kind of have to sit down and do a formal assessment and go through all the issues impacting on their mental and physical health.”

Leota’s mother, Melenaite Aiafi is also a registered nurse who looked after TB and Leprosy patients for years. When HIV was brought into Samoa, she was asked to look after them.   “She has always been looking after the neglected and difficult patients. |

I guess I’d grown up seeing her doing that kind of job which made it easier for me to advocate for these people.”
Her mother in law, Iokapeta Petaia, is also a Registered Nurse and has had much of an influence on Leota’s life.

“I’ve chosen this area because I see that it’s very challenging and there’s a great need because we are all vulnerable.There are genetic problems…
“I believe we can be on par or better than what we have in [NZ]. It’s the advantage of being a small country, one culture, one language… geographically we’re not scattered.

“I do not understand the substandard level of care forever. But I do understand that it doesn’t happen overnight. It’s something we can gradually improve. We need to be aware, need more resources, basics to run the system,” Leota said.





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