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A Socio-Cultural Investigation of Indigenous Fijian Women's A Socio-cultural Investigation of Indigenous Fijian Women’s Perception of and Responses to HIV and AIDS from the Two Selected Tribes in Rural Fiji Tabalesi na Dakua,Ukuwale na Salato Ms Litiana N. Tuilaselase Kuridrani MBA; PG Dip Social Policy Admin; PG Dip HRM; Post Basic Public Health; BA Management/Sociology (double major); FRNOB A thesis submitted for the degree of Doctor of Philosophy at The University of Queensland in 2013 School of Population Health Abstract This thesis reports the findings of the first in-depth qualitative research on the socio-cultural perceptions of and responses to HIV and AIDS from the two selected tribes in rural Fiji. The study is guided by an ethnographic framework with grounded theory approach. Data was obtained using methods of Key Informants Interviews (KII), Focus Group Discussions (FGD), participant observations and documentary analysis of scripts, brochures, curriculum, magazines, newspapers articles obtained from a broad range of Fijian sources. The study findings confirmed that the Indigenous Fijian women population are aware of and concerned about HIV and AIDS. Specifically, control over their lives and decision-making is shaped by changes of vanua (land and its people), lotu (church), and matanitu (state or government) structures. This increases their vulnerabilities. Informants identified HIV and AIDS with a loss of control over the traditional way of life, over family ties, over oneself and loss of control over risks and vulnerability factors. The understanding of HIV and AIDS is situated in the cultural context as indigenous in its origin and required a traditional approach to management and healing. The informant’s responses are constrained by their socio-cultural status, cultural meanings and beliefs of illness. The findings also reveal that there remains a big gap between cultural knowledge and what people know, what people need to know and what is currently provided by the health ministry to address HIV and AIDS in Fiji. In addition to gendered constraint to their decision-making, health seeking choices included accessibility, availability, affordability and quality of care provided in the formal health sector. The analysis highlights that health planners, policy makers and health promotion messages are not addressing these factors. The research findings highlight the importance of understanding, recognising and valuing gendered cultural beliefs, indigenous knowledge and perceptions of HIV and AIDS in developing responsive strategies for prevention and control. i Declaration by Author This thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. I have clearly stated the contribution of others to my thesis as a whole, including statistical assistance, survey design, data analysis, significant technical procedures, professional editorial advice, and any other original research work used or reported in my thesis. The content of my thesis is the result of work I have carried out since the commencement of my research higher degree candidature and does not include a substantial part of work that has been submitted to qualify for the award of any other degree or diploma in any university or other tertiary institution. I have clearly stated which parts of my thesis, if any, have been submitted to qualify for another award. I acknowledge that an electronic copy of my thesis must be lodged with the University Library and, subject to the General Award Rules of The University of Queensland, immediately made available for research and study in accordance with the Copyright Act 1968. I acknowledge that copyright of all material contained in my thesis resides with the copyright holder(s) of that material. Where appropriate I have obtained copyright permission from the copyright holder to reproduce material in this thesis. Ms. Litiana Naibukabai Tuilaselase KURIDRANI 31st October, 2013 ii Publications during Candidature Conference Abstracts Kuridrani, L. (2010) ‘How the Fijian cultural groups responding to HIV and AIDS in Fiji’, Research Higher Degree Conference, School of Population Health, University of Queensland, 10th November. ---------- (2009) ‘HIV and AIDS in Fiji; issues and challenges’, International Conference on Population Development, (ICPD); USP, Suva, 23-25th October. ---------- (2009) Indigenous Fijian women HIV and AIDS in Fiji, International Conference on HIV and AIDS for Africa, Asia Pacific (ICAAP), Nusadua, Bali, Indonesia, 13th - 17th August. ---------- (2009) Women, HIV and AIDS in Fiji, Pacific Institute of STI, HIV and AIDS, Fiji School of Medicine, Suva, 29th – 30th July. ---------- (2009) Indigenous Fijian women, HIV and AIDS, Asia Pacific Week Conference, State, Society and Governance project in Melanesia, ANU, Canberra, 24th – 31st Jan. ---------- (2008) Women, HIV and AIDS in Pacifica: Issues and challenges, Institute of Pacific Health Research, Fiji School of Medicine, 13th August. Publications included in this thesis ‘’No publication included”. iii Contribution by others to the thesis “No contribution by others” Statement of parts of the thesis submitted to qualify for the award of another degree “None” iv Acknowledgements I dedicate this thesis to my dearest mother, Bulou Mereoni Radiverata Vunakece, my best friend and my source of inspiration. Your words of encouragement still echo in my heart today. Joshua 1: verse 9,” Be strong and courageous for I am with you wherever you go”. Maleka vakalevu Na1. I greatly acknowledge the academic advice and support rendered by my Principle Supervisor, Professor Maxine Whittaker with co- supervisors Dr Chi-Wai Lui and Dr Lisa Fitzgerald at the School of Population Health, The University of Queensland. Further acknowledgment and gratitude to Dr Deidre Maclaughlin, Mrs Mary Roset and Mrs Alison Manley for all the administrative and secretariat support. The Fijian government, Fijian Affairs Board scholarship for the financial support during the course of my candidature. The UQ fellowship support in 2011 Special acknowledgement to the two tribes in rural Fiji for the wealth of contributions which has provided valuable insights to this thesis.My special acknowledgement to the three women elders that have passed on. Thou, you have gone to rest in peace, your voices still echo today as food for thought and priorities for change for Indigenous women, HIV and AIDS in Fiji. My brother Tu Lagi and my sisters Di Lakai and Olive Grace, who boldly sign to be my scholarship guarantors. Thank you for having faith in me. To my dear husband Lavo Inosi, my children: Shilo & David Kikau, Bulou Alitiana Seru Tuakilufe (also known as Esther), Ratu Tevita and Ratu Samuela Taraivalu Baleiverata Kuridrani with Love. 1 Maleka is a word in my dialect that means thank you. Vakalevu meaning heaps. Na is a word for mum. Maleka vakalevu Na meaning thank you so much mum. v Keywords Women, HIV, AIDS, gender, culture, indigenous health, policy, health services. Australian and New Zealand Standard Research Classifications 111715 Pacific People’s Health, 35% 111799 Public Health and Health Services, 35% 200205 Culture, Gender, Sexuality, 30% Fields of Research Classification 1117 Public Health and Health Services, 35% 1601 Anthropology, 35% 1699 Other Studies in Human Society, 30% vi Table of Contents ABSTRACT ................................................................................................................................................................ I DECLARATION BY AUTHOR ..................................................................................................................................... II PUBLICATIONS DURING CANDIDATURE ................................................................................................................ III ACKNOWLEDGEMENTS ........................................................................................................................................... V KEYWORDS ............................................................................................................................................................ VI TABLE OF CONTENTS ..................................................................................................................................... VII LIST OF FIGURES .................................................................................................................................................... XI LIST OF TABLES .................................................................................................................................................... XIII LIST OF MAPS ................................................................................................................................................... XIV LIST OF ABBREVIATIONS ............................................................................................................................... XV GLOSSARY OF FIJIAN WORDS..................................................................................................................... XVII PREFACE .......................................................................................................... ERROR! BOOKMARK NOT DEFINED. CHAPTER 1 OVERVIEW OF THE STUDY ........................................................................................................... 1 Introduction......................................................................................................................
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