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The Spinoff
4 days ago
- General
- The Spinoff
Pacific profiles: Pioneering health practitioner Aseta Redican
The Pacific profiles series shines a light on Pacific people in Aotearoa doing interesting and important work in their communities, as nominated by members of the public. Today, Aseta Redican. All photos by Geoffery Matautia. Aseta Redican (ONZM) was the first Pacific person to become a New Zealand-qualified physiotherapist and went on to pioneer significant initiatives for Pacific peoples in the health sector, including being the first General Manager of Pacific Health for the Auckland District Health Board (ADHB) from 2001 until her retirement in 2009. Aseta, now in her eighties, is a proud great-grandparent who remains active and involved in her community. Please introduce yourself. My name is Aseta Redican. I was born in Samoa, and I'm one of 11 siblings. My father's name is Okesene which means oxygen because he was a breath of life for his community. My siblings' names are Karaponi (carbon), Naitorosene (nitrogen), Osone (ozone), Okesaita (oxide), Aseta (acid), Kuripitone (krypton), Sioutu (CO2 or carbon dioxide), Alakalini (alkaline), Atimosefia (atmosphere) and Neone (neon). I came to New Zealand in 1956 when I was just 14. I got a scholarship through the Samoan government along with a handful of other students. We left in January on Teal Airline and cried on the plane all the way to Auckland. We were all so overwhelmed! Early the next morning, another girl and I were dispatched to a boarding school in Stratford, Taranaki. Went down via train and cried all the way! We hardly spoke any English, and we weren't allowed to speak Samoan. I remember that everyone spoke so fast. Our teachers used to say, 'Why are these girls so slow?' but they didn't realise we were trying to interpret it all in real time. It was hard. We weren't allowed to go home to Samoa during the break, and we couldn't spend the holidays with any family in New Zealand. We had to go wherever they sent us. The only way to keep up the [Samoan] language was by writing letters. Were you interested in sports at school? I loved sports in Samoa, and I found that was the one thing I was good at here. I dedicated my time to sports. My schoolwork wasn't doing well, but I was in all the teams – tennis, basketball, hockey. Playing sports helped me gain confidence. What sparked your interest in pursuing physiotherapy? I can only assume it wasn't that mainstream back in the 1960s. As I came to New Zealand on a scholarship, the Samoan government had to approve what work we could pursue once we left school. They wanted us to become doctors, lawyers, accountants and teachers, but none of that was for me. I wanted to be in health because I saw my parents do that, but I didn't want to be a doctor or nurse. I asked if I could be a physical education teacher, and the Samoan government refused. I only discovered physiotherapy because a notice went up at the school that our former head girl had topped a physio course. I remembered her being a great sportswoman and that's when I decided to find out what physiotherapy was. It combined my two loves, sports and health. Physiotherapy had been around for some time, but it was definitely new for us as Pacific peoples. Tell me what it was like to study in Dunedin at the time. It was difficult. Everything was strange. You were on your own, and I always felt that everyone there was so much smarter than me. I was surrounded by all these farmers' daughters, lawyers' daughters and so on. There were no other Pacific Island students in my course, and only three non-Pākehā students. What happened once you graduated? When I graduated, I spent a year in Auckland Hospital, then I returned to Samoa. I thought I was going into a physio department but that didn't exist. No one was sure what to do with me. I didn't want to just be wandering around, so I got to work on creating my own space. I became friends with the matron, and she helped me find a room and team up with two ladies who had worked in the physiotherapy department in Hawaii. Together, we got ourselves some equipment and put systems in place. The problem was that everyone who came into the hospital was sent to me. You have to remember there were no GPs in the islands. If you fell sick, you went to the hospital. I had to put my foot down and say my department is not a dumping ground! So, I set up a referral system like we have in New Zealand. I got some kick back from the clinicians, but little by little they came round once they realised it was a good way of doing things. You were awarded an Order of the New Zealand Merit for your services to Pacific peoples and healthcare in 2020. Could you tell me about some of the initiatives and roles you helped spearhead? I worked at the National Women's Hospital in the antenatal unit, then at Cornwall Hospital, and then I set up my practice within a private hospital. In these spaces, I saw some of the wider issues affecting our Pacific peoples in the healthcare system. I'd often get asked why Pacific people would overrun our emergency departments, and I had to explain that in Samoa, and I'm sure in other islands, families didn't have GPs. I also saw that departments were getting our cleaners and orderlies to act as interpreters for Pacific patients. I took these issues to a Pasifika organisation to get them to follow through to get interpreting services in our hospitals. Physiotherapy allowed me to know how to navigate the system, and I wanted my community to know how to do that. I changed my focus from treating an individual to working with communities. Fortuitously, a role at the Heart Foundation came up to lead the Pacific Island Heartbeat programme. I got the role, and my team and I engaged with our community to talk to them about heart health, exercise and diet. Later on, there was another major healthcare restructuring, and I became the first General Manager of Pacific Health for the Auckland District Health Board (ADHB) when hospital boards were dismantled. I saw this as an opportunity to establish more Pacific providers in our healthcare system so that we could be in the driver's seat. We ran courses for people to come along and learn how to become a provider. Within that, we helped set up groups such as South Seas Healthcare, Fono Health, the Tongan Health Society and the Pacific Medical Association. I didn't want our people to be left behind. What's funny, though, is how much things still hadn't changed. When I got that role in 2001, I remember being in a senior management meeting and people asked why we needed a general manager for Pacific Health! You retired in 2009, but are you still involved in the healthcare space? Also, how do you like to keep active? I love walking, and I like to get out into the garden. I now have two great-grandchildren who keep me active because they're always running around. Having my family around helps a great deal. I'm still involved with the Pacific Physiotherapy Association, and I've been assisting them with their organisational strategy, building their visibility, and getting them a website so more people know about the work they do. It's given me a new lease of life and I thank the Lord for bringing me back to where I started. *After the interview, Aseta's granddaughter told me that their family is doing a step challenge and that Aseta regularly gets in more steps than anyone else. This is Public Interest Journalism funded by NZ On Air.
RNZ News
05-05-2025
- Health
- RNZ News
'Fresh eyes' investigation finds systemic failings in case of stillborn baby
The Commissioner ordered the Auckland District Health Board to apologise to the parents. Photo: After initially refusing to investigate, the Health and Disability Commissioner has found systemic failings in the care given to a woman whose daughter was stillborn. The woman, who suffered three bleeds during what was deemed a "high risk" pregnancy in 2013, made a complaint to the HDC after the death of her child. The HDC decided to take no further action, but after a review by the Ombudsman, reopened the complaint in 2021 and took a "fresh eyes" approach to the investigation. The baby's family said it had continued to strive for change, rather than place blame, and would do everything in its power to prevent this tragedy from falling upon another family. In her findings, Commissioner Morag McDowell said the inquiry highlighted the importance of monitoring an unborn baby's movements. She found the lack of an ultrasound at Auckland Hospital after the woman's admission for a third bleed was not a failure in care, but several failings by Auckland District Health Board (ADHB) amounted to a breach of the Code of Health and Disability Services Consumers' Rights - including the woman's early discharge, a failure to communicate with the midwife and not arranging follow-up care within an appropriate timeframe. The lead maternity carer - a community-based midwife - was found to have given the woman incorrect information about what to consider normal movement from the baby and the Commissioner was also critical of the midwife's documentation. Noting the changes already made at ADHB, such as providing patients with information about foetal movement monitoring and implementing a discharge checklist, McDowell recommended it apologise to the family and assess its treatment guidelines on antepartum haemorrhages. She recommended the midwife provide evidence of training on monitoring foetal movement. The woman - known as Mrs A - was healthy, in her 30s and the pregnancy was her second. It was classified high risk, after she developed preeclampsia in her first pregnancy and underwent a caesarean section at 37 weeks. At 16 weeks pregnant, she had a bleed and an ultrasound found a haematoma on the wall of her uterus. A few weeks later, following a second bleed, a scan did not find a haematoma and the cause of the bleed was not identified. At 30 weeks, Mrs A suffered a "significant" bleed - according to independent expert Dr Michel Sangalli - and was transferred from a secondary hospital to Auckland Hospital, a tertiary institution. She was observed there for two days, while her bleeding stabilised, but no source was identified and monitoring showed the baby's heartbeat was normal. The plan was for her to remain in hospital for another 24 hours and undergo a second urinary protein-to-creatinine ratio test - an indicator for preeclampsia, but she was discharged after a few hours, without being tested. Ten days later, Mrs A and her husband had an appointment with her midwife. Two days after that, at 32 weeks, Mrs A went into early labour and monitoring showed the baby had no heartbeat. She was induced and gave birth to a stillborn daughter. A post-mortem found no evidence of a recent bleed in the placenta, but the placenta showed signs of tissue death. The Commissioner investigated Mrs A's care in the context of her suffering the three pregnancy bleeds before her daughter was stillborn. With regard to ADHB, the inquiry considered whether an ultrasound should have been performed at Auckland Hospital after Mrs A's third bleed to assess the baby's wellbeing, and the information and communication provided on discharge. McDowell also looked at the information provided by the midwife on fetal movements during pregnancy and the care to Mrs A immediately after she was discharged from hospital. In his advice to the Commissioner, Dr Sangalli said the single most important mishap in the case was the lack of an ultrasound after Mrs A's third bleed at 30 weeks pregnant and he believed this to be a breach of the profession's standards. However, McDowell said there was no consensus on whether an ultrasound should have been given, noting two clinicians - including Dr Sangalli - said a scan was warranted, whereas eight clinicians (six from ADHB) did not. Noting that Dr Sangalli said the lack of an ultrasound was only a mild breach, the Commissioner found that the failure to undertake an ultrasound at Auckland Hospital did not amount to a breach in the standard of care. McDowell did find Mrs A's care at the hospital fell below the accepted standard and the several failures amounted to a breach in the code by ADHB. In particular, she noted Mrs A was discharged without a clear reason, despite the plan to remain in hospital for a further 24 hours and undertake a test that could indicate preeclampsia. McDowell said follow-up appointments were scheduled too late - outside the appropriate timeframes - her discharge information was not given to her midwife or local hospital, and she was told she could leave without being given advice about monitoring her baby's movements. Mrs A and her husband said they raised their concerns about their baby's "significantly" reduced movements in an appointment with the midwife 10 days after leaving hospital. The midwife said, while foetal movement was discussed, she said Mrs A stated she was "unsure" about the baby's movements, not concerned. The Commissioner was unable to make a finding about what was discussed at the appointment. However, she said the midwife's advice about expecting "at least 10" movements from the baby per day was incorrect and she was critical of the midwife's documentation, but the failures did not amount to a breach. She found the care immediately provided by the midwife after Mrs A's discharge from hospital was acceptable. ADHB and the midwife accepted the Commissioner's provisional findings. In addition to changes already made by ADHB - including providing patients with information about foetal movement monitoring, sharing discharge notes with lead maternity carers and other DHBs, and a discharge checklist - McDowell recommended the DHB review its guidelines on investigating antepartum haemorrhages to see whether further clarity was needed and writing a letter of apology to the family. The midwife said she now asked for discharge papers from Auckland Hospital and advised clients to call her, if they had trouble getting an ultrasound. In addition to this, the Commissioner recommended the midwife provide evidence of training she'd undertaken about foetal movement and how she provides that advice to patients. Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
