IHP 501 Module Four 4-2 Project Prep

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1 4-2 Project Preparation: Ethnographic Analysis Jennifer Morales Southern New Hampshire University IHP 501: Global Health and Diversity Dr. Carolina Baldwin March 24, 2024

2 4-2 Project Preparation: Ethnographic Analysis A thorough understanding of Kiribati’s culture population is necessary before setting out on a journey with them. This paper will discuss important research aspects like Kiribati’s ethnicity, stakes, meaning of health illness, social stressors, and the impact these factors have on Kiribati’s population. It's also important to get ready for possible interactions with people whose customs or beliefs are foreign to you. To ensure a peaceful and courteous encounter, in Kiribati, it's critical to adjust to and incorporate the customs and expectations of both the local culture and our own. Ethnicity Known as a sovereign state in the center of the Pacific Ocean, Kiribati gained its independence from Great Britain in 1979 (Sawe, 2019). The I-Kiribati people are an ethnic group that is indigenous to the island and considers itself to be a Micronesian people (Sawe, 2019). One of the earliest populations on the island was Austronesians, but when Samoans, Tongans, and Fijians invaded in the fourteenth century, new ethnic groups emerged (Sawe, 2019). The Gilbertese language, which is taught in elementary and secondary schools, is spoken by the I- Kiribati people, despite English being the island nation's official language (Sawe, 2019). The island's smaller ethnic groups, known as Tuvaluans and I-Kiribati/mixed, make up about 2% of the total population (Sawe, 2019). In Kiribati, there are other ethnic groups such as Chinese, Australians, New Zealanders, and Europeans (Sawe, 2019). Stakes The island of Kiribati is experiencing a global warming crisis because of sea levels rising at a rate of 3.3 mm year (Smith, 2020). Many people suffer from malnutrition, but women and

3 children are disproportionately affected, which puts them at even greater risk (Cauchi et al., 2019). The "multiplier effect" of weather change on the island is affecting food insecurity and the residents' health (Cauchi et al., 2019). Due to resource shortages and extreme weather brought on by climate change, people are dying from starvation, drowning, and brutality (Blaser & Blaser, 2021). Rising sea levels are one of the biggest threats to Kiribati's island and people (Blaser & Blaser, 2021). Despite the island's population moving inland, significant flooding has continued to occur, destroying crops and land (Blaser & Blaser, 2021). Meaning of Illness For people in Kiribati, infectious and non-communicable diseases remain a concern (Cauchi et al., 2019). According to estimates made by the World Health Organization in 2012, 40% of the 38 million deaths from noncommunicable diseases were preventable (Cauchi et al., 2019). In Kiribati, malnutrition can manifest as underweight, stunting, or wasting, which raises the country's high infant mortality rates (Project, 2021). NCDs are responsible for about 75% of deaths in the Pacific Islands (Cauchi et al., 2019). Because of the dirty water in Kiribati, diarrheal illnesses are extremely common (Project, 2021). As a result, one in twenty babies pass away before turning one (Project, 2021). Although there are four hospitals on the island, there are only thirty health centers and seventy-five clinics where people can receive free medical care for minor ailments in Kiribati (WHO, 2020). The government of Kiribati is still working to develop policies to help with the healthcare crisis and enhance population health and health equity (WHO, 2020). With the actions outlined in the regional action framework, Pacific Healthy Islands Framework of Action, and Universal Health Coverage: Moving Towards Better Health, as well as a national effort to improve the performance, efficiency, equity, accountability,

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4 sustainability, and resilience of the health systems, the World Health Organization Country Cooperation strategic agenda was developed (WHO, 2020). Social Stressors The tiny economy of Kiribati is highly vulnerable to debt, hardship, and inequality ( Republic of Kiribati, n.d.). One of the least developed nations, Kiribati has a high percentage of poverty (WHO, 2020). Gender inequality persists in Kiribati culture, where women are still subservient to men in all spheres of life ( Republic of Kiribati, n.d.). Due to their low political participation and the fact that two out of every three women have experienced gender-based violence, women do not have equal rights ( Republic of Kiribati, n.d.). Pengpid & Peltzer's (2021) conducted a study aimed to investigate the prevalence and associated factors of psychological distress in a community-based study among persons aged 18–69 years in Kiribati. Pengpid & Peltzer's (2021) study showed out of the 2,165 participants, 18.1% said they experienced psychological distress daily in Kiribati. 16.4% of respondents said their family had alcohol issues, 63.4% had been around passive smoking, 9.6% had experienced heart attacks, angina, or strokes, 73.3% ate less than one fruit or vegetable per day, 40% engaged in little to no physical activity, 49.% used tobacco daily, and 8.4% spent more than six hours sitting still (Pengpid & Peltzer, 2021). According to this study, women who have less education also experience noticeably higher levels of psychological distress (Pengpid & Peltzer, 2021). Impacts Given the information above, the population of Kiribati is being significantly impacted by the high and rising prevalence of NCDs and infectious diseases. It is thought that the two most vulnerable groups affected by disease and climate change are women and children. To

5 guarantee that treatment is given before conditions worsen, it would be crucial to deliver supplies to the island on time. Due to poverty and restricted access to healthcare, more than 22% of the population does not have access to necessities (Thelwell, 2020). People on the island find it challenging to get medical attention before their conditions worsen because of where the hospitals are located (Thelwell, 2020). The island's enormous need for care is exacerbated by the lack of qualified healthcare personnel (Thelwell, 2020). Due to a shortage of qualified professionals, many severe medical conditions are treated outside of the island (Thelwell, 2020). Pneumonia, diarrheal illnesses, and perinatal diseases are the main causes of the rising infant mortality rate (Thelwell, 2020). It is practically impossible for women and children to be seen because of these challenging circumstances (Thelwell, 2020). While their nation is expanding, Kiribati is still working to lower its rates of poverty and enhance its healthcare system, but there is still more work to be done (Thelwell, 2020). Conclusion In conclusion, it is essential to fully comprehend Kiribatian culture before setting out on a journey with its people. This covers things like their ethnicity, morals, views on health and sickness, and the social pressures they encounter. It's also critical to be ready for encounters with unfamiliar customs or beliefs. To guarantee a civil and amicable interaction, we must adjust and meld the traditions and norms of the host culture with our own.

6 References Blaser, R., & Blaser, R. (2021, June 15). Kiribati: The first country the Ocean will claim | The Journal of Diplomacy and International Relations . Journal of Diplomacy. https://blogs.shu.edu/journalofdiplomacy/2021/06/kiribati-the-first-country-the-ocean- will-claim/ Cauchi, J. P., Correa‐Velez, I., & Bambrick, H. (2019). Climate change, food security and health in Kiribati: a narrative review of the literature. Global Health Action , 12 (1), 1603683. https://doi.org/10.1080/16549716.2019.1603683 Pengpid, S., & Peltzer, K. (2021). Prevalence and correlates of psychological distress among a national population-based sample of adults in Kiribati. Journal of Human Behavior in the Social Environment , 31 (7), 941–950. https://doi.org/10.1080/10911359.2020.1829242 Project, B. (2021, June 22). Common diseases in Kiribati . The Borgen Project. https://borgenproject.org/common-diseases-in-kiribati/ Republic of Kiribati . (n.d.). United Nations Micronesia. Retrieved March 21, 2024, from https://micronesia.un.org/en/about/republic-kiribati Sawe, B. E. (2019, August 19). The ethnic composition of Kiribati . WorldAtlas. https://www.worldatlas.com/articles/the-ethnic-composition-of-kiribati.html Smith, A. (2020, October 14). Kiribati’s Warning to the World: The threat of rising sea levels . USC Global Policy Institute. https://uscgpi.com/2020/10/14/kiribatis-warning-to-the- world-the-threat-of-rising-sea-levels/ Thelwell, K. (2020, September 14). 5 Facts about healthcare in Kiribati . The Borgen Project. https://borgenproject.org/seo-key-term-healthcare-in-kiribati/

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7 WHO. (2020, August 24). Kiribati . World Health Organization. Retrieved March 21, 2024, from https://www.who.int/countries/kir

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