COMPETING CONCEPTS AND APPROACHES TO ‘HEALTH’ AND ‘EDUCATION’

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Health and Development

Like education, health is an important aspect of development. The ‘health of any nation is the sum of the health of its citizens, and the communities and settlements in which they live’ (Mukhopadhyay, 2010, p. 72). An unhealthy person is less able to function normally within, and contribute constructively to, his or her community. As a result, health is a priority in the eyes of local communities, governments, and the UN. The predominance of health-related goals in the MDGs reflects the significance of health.
Of course, there is a high demand for funds to achieve the health-related MDGs, but Freedman (2005, p.19) has argued that ‘the answer is not just money; it is the entire way in which we think about the connection between health and development – and the priority actions that result’. If money is only part of the answer to achieving these health goals, what provides the rest of the answer? As I have argued above, part of the answer lies in understanding what health means in particular contexts, as well as in understanding what development means and how health links to development.
Sen (2001), for example, believes that health enables people to achieve the end goal of development, that is, the freedom to achieve what they value. Moreover, some economists argue that being healthy is a preliminary condition for economic growth, which is considered important for development as a whole (Commission on Macroeconomics and Health, 2001). Health – as an ideal state and the ability to function satisfactorily – is therefore seen as a precondition for individual and social development, whether development is understood as primarily economic or primarily in terms of freedom.
According to MDGs 4, 5, and 6, countries have to deal with reducing child mortality, reducing maternal mortality, reversing the spread of HIV/AIDS, and reversing the incidence of malaria and other major diseases. The UN (2008) reports that in developing countrie there is still a high child mortality rate, a high maternal mortality rate, and that every day about 7,500 people become infected with HIV and 5,500 die from AIDS, mostly due to lack of HIV prevention and treatment services. Promoting health is essential if we want to achieve the aforementioned MDGs.
Moreover, health is widely recognised as contributing to human development. Having good health, for example, means having access to the basic requirements for life such as food, shelter, safe water, good sanitation, and security. Gani (2010, pp.108-109) writes: ‘Human health and development is reciprocal. Economic development tends to improve human health while better health contributes to economic development’. It is clear that health, like education, is important in the process of development. Good health allows mothers to have healthy children, which leads to longevity and healthy families. Good health gives people a better chance of resisting diseases or recovering from infections. On the other hand, Gani (2007, p.21) adds that ‘health contributes to development in a way that better health for workers can provide direct and immediate benefits by increasing their productivity and that better child health and nutrition promotes future productivity growth’.
In other words, poor health outcomes negatively affect employment rates, which strengthen the poverty cycle. The important point here is that good health is linked to societal, human, technological, and economic development.

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Challenges to Education and Development

Sadly, many countries, especially in the third world, will likely fail to achieve universal primary education. Miles and Singal (2009, p.11) concluded that ‘the enormity of the challenge of providing universal primary education in countries of the South can seem overwhelming, and the analysis presented by many international agencies tends to adopt a deficit approach’. Enormous efforts have been made, both nationally and internationally, to achieve universal primary education in developing countries. However, these attempts are often thwarted, with proponents ‘struggling to cope with poorly trained teachers, inadequate budgets, large class sizes, and more recently the HIV/AIDS crisis’ (Miles & Ahuja, 2007, p.133).

CHAPTER 1: INTRODUCTION
1.1 Introduction to the Research
1.2 Health Promotion & Ola lei Conceptual Framework
1.3 Research Aims and Significance
1.4 Tuvalu Context
1.4.1 Geography and Population
1.4.2 Historical Background
1.4.3 Development of Tuvalu
1.4.4 Education and health
1.5 Research Design and Methods
1.5.1 Research Context and Stages of Fieldwork
1.5.2 Stages of Field Research and Research Particiants
1.5.3 Methodology
1.6 Structure of the Thesis
CHAPTER 2: COMPETING CONCEPTS AND APPROACHES TO ‘HEALTH’ AND ‘EDUCATION’
2.1 Introduction
2.2 Health
2.2.1 Ola Lei Conceptual Framework
2.2.2 World Health Organization’s (WHO) Concept
2.2.3 Communities’ Conceptions
2.3 Development Context – Education and Health
2.3.1 Education and Development
2.3.2 Health and Development
2.3.3 Challenges to Education and Development
2.3.4 Challenges to Health and Development
2.3.5 Development?
2.3.6 Education and Health: Making the Link
2.3.7 Development Links to Education and Health
2.4 Conclusion
CHAPTER 3: OLA LEI – TRADITIONAL CONTEXT OF ‘LIVING WELL’
3.1 Introduction
3.2 What is Ola Lei
3.2.1 Filemuu (Harmoniousness and Peacefulness)
3.2.2 Fiafia (Happiness and Contentment)
3.2.3 Malosi (Fitness)
3.2.4 Ola Leva (Longevity)
3.3. How to Achieve Ola Lei?
3.3.1 Meakai e lava & lei (Food Abundance and Quality)
3.3.2 Tuu-maa (Cleanliness)
3.3.3 Toka (Readiness)
3.3.4 Galue malosi (Hard Work)
3.3.5 Maumea or Maukoloa (Wealth)
3.3.6 Poto faka-Tuvalu or Logo (Traditional Skills and Knowledge)
3.3.7 Talitonu & Fakatuanaki ki te Atua (Belief and Faith in God)
3.3.8 Lei a te masaki (Recovery from Illness or Diseases)
3.4. Ola Lei Conceptual Framework
3.5. Conclusion
CHAPTER 4: TAUSI TE VASIA: GOVERNMENT, NGO, AND EXTERNAL AGENCIES’ RELATIONSHIPS WITH HEALTH
4.2 The Government’s Health Initiatives
4.2.1 Policies: Theories of the Government
4.3 Services: Practices of the Government
4.3.1. The Princess Margaret Hospital (PMH)
4.3.2 Health Centres and the Situation on the Outer Islands
4.3.3 Referral Scheme (Tuvalu Medical Treatment Scheme)
4.3.4 Health Education and Awareness Programmes
4.3.5 Training of Medical Doctors in Cuba and Other Countries
4.3.6 Fighting Against Diabetes
4.4. The Non-Governmental Organisations (NGOs)
4.4.1. Tuvalu Association of Non-Governmental Organisations (TANGO) and its Members
4.4.2. Tuvalu Family Health Association (TuFHA)
4.4.3. Tuvalu Red Cross Society (TRCS)
4.4.4. Collaboration of NGOs with the Department of Health
4.5. Donors & External Agencies
4.6. Education
4.7. Conclusion
CHAPTER 5: COMMUNITY PERSPECTIVES AND NEEDS
CHAPTER 6: DEVELOPMENT GAPS AND TENSIONS