Breaking boundaries: First Pacific physiotherapy PhD candidate defends thesis in community

A New Zealand-born Samoan academic has become the first student of Pacific Island heritage to be awarded a PhD in physiotherapy, defending his doctoral thesis outside a formal university environment.

Otago University's Lilo Oka Sanerivi defended his thesis at the Samoa High Commission in Wellington earlier this month.

According to the university Samoan delegates, his extended aiga (family), physiotherapy professionals, academics, and members of his Samoan church communities were all in attendance to celebrate the oral examination of his PhD.

Sanerivi told Otago health sciences communications adviser, Kelsey Swart, Eurocentric worldviews are pervasive in physiotherapy, often shaping how the practice is theorised and performed.

"Physiotherapy has not been contextualised by other people groups in our corner of the world, and so I'm grateful to be playing my part in breaking that mould," Sanerivi said.

Stepping outside the traditional university setting, Sanerivi embraced his heritage, blending Pacific cultural practices with academic rigor and delivered his presentation to his panel of examiners.

Sanerivi's thesis is titled 'Le taualuga o tausiga (The epitome of care): In search of Samoan cultural safety in physiotherapy', explores the intersections of cultural safety and physiotherapy for Samoan communities.

"The Fauolo Framework is a conceptual model developed through the PhD research. It is a model for culturally safety designed to guide physiotherapists with engaging with Samoan families in ways that a culturally dignifying and honouring," he said.

His presentation opened with an 'ava ceremony, a traditional Samoan ritual.

Members of the community gathered around symbols of Samoan culture like siapo (bark cloth), woven mats, and nets.

"The presentation culminated with the Taualuga dance, which embodies the pride and dignity of Samoan identity," he said.

Sanerivi's thesis model is inspired by the traditional Samoan Taualuga dance, with roles that represent various aspects of Samoan society.

• Taupou: Embodying dignity and service, this figure represents core Samoan values in healthcare and the potential public vulnerability that Samoans can face within western health service interactions.
• Matai: Symbolising chiefs, who uphold family lineage and history, reinforcing the role of genealogy in well-being.
• Matua: Elder figures emphasizing the central role of family in Samoan health.
• Aiuli: Clinicians focused on dismantling healthcare barriers and delivering quality, culturally dignifying, services.
• Au mū afi: Policymakers, often unseen, who shape healthcare environments and ensure accessible systems.

The relationships between and across each of the characters are governed by cultural imperatives to 'teu le vā' or to actively and dynamically nurture the relational space.

Sanerivi's work draws from over 46 hours of interviews within the Samoan community, bringing forward a Pacific model for culturally safe healthcare.

"I presented before a panel of academics, including Professor Peter Crampton from Otago, Professor David Nicholls from AUT, and Dr Fuafiva Fa'alau from the University of Auckland, surrounded by my community.

"We had siapo (bark cloth), woven mats, nets-everyone dressed according to custom. The event culminated in a Taualuga dance, symbolising our heritage and sense of place here in Aotearoa."

Pacific Community Engagement head at Otago Tofilau Nina Kirifi-Alai praised Sanerivi's groundbreaking approach as a fitting reflection of the university's strategic framework, which follows the Samoan concept of Tofa Sa'ili, a wisdom that encourages context and relevance.

"Times and communities have changed, and so must the ways we engage.

"Sanerivi's defence brings us closer to our Pacific community, highlighting the need for culturally resonant engagement." Tofilau said.

Sanerivi, whose heritage is rooted in both Samoan and Tongan lineage, acknowledged his Māori colleagues, who had held their PhD defences on marae, as instrumental in paving the way for his culturally anchored presentation.

"I really had to advocate for this to the university and Thankfully, I had the support of my Maori colleagues.

"So it just expressed our cultural Observations and imperatives in Aotearoa, which hadn't been done before.

"Their support was crucial,"

He explained that his research resonates with the dual approach Samoans often take to healthcare, incorporating both Western and traditional methods.

"Samoans might see their general practitioners and physiotherapists, yet they also consult taulāsea, or traditional Samoan healers, who deliver care in our language and embody respect and hospitality," he said.

Sanerivi graduated with a Bachelor of Science in 2007, Bachelor of Physiotherapy in 2010 and began his Master of Physiotherapy in 2020 which was extended into this PhD.

He has also blazed trails professionally becoming the first Pacific clinical leader of a physiotherapy department at Waitematā DHB a role he took on during New Zealand's Covid-19 crisis.

Sanerivi and his wife Deborah also champion Pacific language and culture through self-published children's books aimed at nurturing a love of Samoan heritage among young readers.

Reflecting on his journey, Sanerivi expressed his hopes for the next generation.

"I want Pacific students to have the same opportunity to bring our work back to the communities it comes from," he said.

"It's time to break boundaries."