The findings presented bring valuable information regarding the use of medical systems in iTaukei villages. The use of the medical systems depends on how the iTaukei perceive the causes of various illnesses.

The results of the study concur with those found by author (2010), citing author (and subreferenced in author, 2001). In this study, author found that the Hispanic attribution of illness is believed to be caused by imbalance in the body (this imbalance refers to the disease of hot and cold) of the affected person. These imbalances are experienced through physical malfunction of organs in the body similar to what is described by the iTaukei people in the villages; illness happens when the body does not function well and when there are imbalances of heat and cold in the body system. There is also mention of illnesses caused by supernatural agents and diseases caused by envy or illness with emotional origins. Regarding cultural–spiritual illnesses, however, the healing methods are only negotiated within the iTaukei people in the villages. Cultural practices need a traditional space for their cultural continuity and survival, and it is within this unique context of customary beliefs and practices that iTaukei healing elements reside. Authors (2016) emphasize the role of culture as health and illness are “culturally conditioned” (p. 86). For partners, people’s illness means disharmony and imbalance of the “living body with its surrounding” (p. 86), and they see that the “landscape is animated, as having soul” (p. 86). Authors (2004, reported in author, 2010) found that Vietnamese–American children and adults’ illnesses were attributed to biological and supernatural agents. Authors (1994) reported how individuals from culturally diverse groups related the causation of their illness to upsetting emotions (envy and jealousy). This is similar to the iTaukei’s responses that some illnesses are caused by wrong food choices and other illnesses have supernatural connotations (mate ni Vanua, witchcraft, and curse) attributed in general to breaking ancestral iTaukei protocols that “only the iTaukei knows”. Author (2008) explains how the Māori (indigenous peoples of New Zealand) are affected by “high rates in diabetes, respiratory infections, chronic heart disease, poverty, oppression, housing, eco-health, environmental health” (para. 9), and their healing (just as author pointed out) is embedded in their language, values, customs, and surrounding environment. This essentially highlights the importance of their TEK and the recognition of indigenous health and healing in integrated measures towards self-governance.

In response to RQ1, the study concludes that Western and traditional medical systems need to be complementary, amalgamating/integrating the efforts of healthcare authorities, primary healthcare workers (including CHWs), and healers/elders in rural Fijian settings. This brings to light the importance of considering the iTaukei’s perceptions and the need for more culturally safe assessments, interventions, and therapeutic approaches towards healing, especially in villages. The categories of practices are an outcome of how health perceptions play an important role in the lives of the iTaukei.

Partners were/are placed between two worlds: traditionalism and modernism. Unfortunately, the local health authority has not provided partners with a cultural safe space to negotiate these two realities: tradition and modernity. This results in the progressive disempowerment of community-based resilience and disengagement of the iTaukei people. This also coincidentally results in gradual sociocultural erosion and the loss of identity, along with traditional ways of knowing and healing practices. In many cases, modern Western science mission statements, visions, policies, and procedures take priority and are acknowledged and officially recognized and enforced.

These comparisons underscore the importance of the iTaukei belief systems that are necessary to be understood in order to support awareness of how to culturally proceed in villages. In addition, understanding and being empathetic towards how the iTaukei perceive and define health and illness is meaningful, in order to support them in addressing their health challenges/barriers. These personal health-driven perceptions were/are intertwined with villagers’ decision on what (to do), why (for what reason), and how (to do it). There is a real need for more culturally safe assessments, interventions, and therapeutic approaches when helping iTaukei (especially those living in villages). Therefore, all these procedures should be responsibly planned, taking into consideration the iTaukei customs and traditions.

Raising awareness of how healthcare professionals have to proceed is done basically by respecting and taking into consideration villagers’ values and beliefs, practices, and knowledge without condemning, ostracizing, or judging them. The local health authority pressures villagers to seek medical help from health centers or nursing stations in villages. This call, however, does not take into consideration the fact that there are prominent geographical barriers, such as location and lack of transportation, which are some of the major impediments of outreach programs in villages. Villages (for example) that are found quite a distance or are isolated from all the other villages have a different approach to healing.

3. Conclusions