International

Covid and stress: At the heart of the problem

The passing of tourism leader Sue Fletcher-Vea, who died of cardiac arrest at just 52, has highlighted a groundbreaking initiative to help Cook Islanders manage the stress and anxiety of Covid-19. Jonathan Milne reports.

The body of Cook Islands tourism leader Sue Fletcher-Vea arrived in New Zealand at the weekend.

The 52-year-old Tourism Industry Council president died last week in Rarotonga Hospital – her heart just stopped. She had gone in to see a doctor because she was feeling a bit puffed. Her ECGs were fine, but they admitted her overnight for observation.

Husband Tom Vea, sister Diane and sister-in-law Lotu were at her side the following afternoon when, suddenly, she went into cardiac arrest.

Those three, with close friend Mii Rongo and four of their children, all flew on the same flight as Sue’s body – and on Saturday night they got a waiver from the New Zealand Government allowing them to go straight from the airport into self-isolation at an Airbnb in Hamilton.

It will be up to seven days before they are allowed out to rejoin Sue and Tom’s daughters Ruby and Lile, and her parents Paul and Jane in Hamilton, and to hold the funeral.

Sue Fletcher-Vea was a tower of strength to hundreds of Cook Islands tourism operators. She always made time to listen. She had their back. She was a driving force in getting groundbreaking new stress and anxiety workshops off the ground.

And amid this, Sue had her own stress levels assessed, says Diane. They were “off the scale”.

That dedication was echoed by brother-in-law Richard Vinsen, in New Zealand, who spoke by video-link to the service held at their family resort in Rarotonga. 

Sue’s body lay in an open casket, surrounded by pink and yellow tropical flowers; the Cook Islands Prime Minister, the Queen’s Representative and hundreds more attended.

“Sue is truly an amazing lady.” Vinsen paused. He remembered her care first for her family, then for her staff, and for the people of Cook Islands. Her commitment knew few bounds. 

Friends agree: Tourism Industry Council vice-president Liana Scott says she carried a lot of responsibility, worrying about not just about her own family and 16 staff, but about tourism workers nationwide. “I think stress is a real thing, and we need to reach out and look out for each other – even the people in leadership positions who appear to be holding it all together.”

At a prayer service at the family’s Manuia Beach Resort, Sue Fletcher-Vea is remembered by her husband Tom Vea and sister Diane Fletcher. Photo: Jonathan Milne/Cook Island News

THE CORTISONE TRIGGER

Right now, with few planes and little money, Cook Islands and nations across the Pacific are in the calm before the savage tropical cyclone.

It’s sweeping its way south. In Fiji, the airline laid off 775 employees and the souvenir business Jack’s of Fiji laid off 500. In Vanuatu 70 per cent of tourism workers have lost their jobs.

Cook Islands is estimated to have experienced a 60 per cent drop in GDP in the past three months – already, 108 people have gone onto the new unemployment benefit (Cook Islands didn’t even have an unemployment benefit until March) and another 3820 have been kept in jobs only by the government’s wage subsidy.

That’s the vast majority of the country’s estimated 5000 private sector workers – and most of the working age population of about 7000 people. The threat of redundancy hangs heavy in the still air; some hopes are pinned on a miracle influx of returning Kiwi tourists; others contemplate a return to family plantations and village living.

Health ministry Te Marae Ora says the stress and anxiety is manifesting itself in about four new domestic violence cases a week; in drunkenness and drink-driving; in 15 to 20 new mental health referrals a week; in suicide attempts and suicidal ideations.

The stress has physical manifestations too: people coming into the health clinic with heart palpitations, stomach aches, headaches, migraines, sleep problems … but when they talk to a doctor or psychologist, the real problem emerges.

Amid the challenges facing these 7000 working age Cook Islanders, and the children and elderly relatives they support, is one truly astonishing statistic – and this one is good news.

Those stress and anxiety workshops that Sue Fletcher-Vea, Chamber of Commerce president Fletcher Melvin and Te Marae Ora clinical psychologist Dr Evangelene Daniela-Wong instigated have now reached more than 1000 people.

Turama Pacific tourism chief executive Robert Skews says Sue was unique, “a giver at all times – of her time, her wisdom, her love, her laughter, her passion for her people, her passion for the Cook Islands and our environment, herself.

“And, in retrospect, I wonder – if she had stepped back a little herself from the pressures she put on herself through this Covid challenge we face, would she still be with us today?”

It isn’t Sue’s passing, though, that has drawn the Cook Islands’ community’s attention to the dangers of stress and anxiety. It is her determined work to find and share solutions.

CALM BEFORE THE STORM

At the start of one workshop about managing the stress and anxiety of the Covid economic downturn, people were joking nervously – until the construction boss stood up.

“Some of you here are lucky,” he told the 36 people in the grey-carpeted Bank of Cook Islands conference room overlooking downtown Avarua. His frustration was evident.

“You have jobs. I don’t and I’ve been angry that I can’t support my family. We’re just living day by day, working other jobs to keep afloat which isn't enough but we make do.”

Everyone shut up. The rest of them in the workshop still had jobs – but that is changing fast, and everyone knows it.

Dr Evangelene Daniela-Wong. Photo: Jonathan Milne/Cook Islands News

Dr Evangelene Daniela-Wong and a small team of supporters have run 35 workshops in just seven weeks, teaching people how to recognise stress and anxiety.

They’re still going, with more workshops booked this week in Rarotonga, and next week in Aitutaki. Daniela-Wong’s husband Deon is stranded in New Zealand, she’s had to hire a nanny to look after her two sons and her five-year-old daughter – but she’s barely stopping to take breath. She’s determined to give people useful tools to help them manage these toughest of times.

“I think we want to be pragmatic and real about it,” Daniela-Wong says. “If we are continually focused on the negative, we will forget the good of things.”

Economists say the prognosis for Cook Islands is the worst in the Pacific, because of the country’s heavy reliance on tourism – but in the face of that storm is some of the bravest and most innovative work to build the resilience of this country’s people.

LOOKING OUT FOR EACH OTHER

Sitting outside Rarotonga Hospital in the sun, grabbing a rare break the day after attending Fletcher-Vea’s prayer service, Dr Daniela-Wong is keen to acknowledge all the people involved in making the stress workshops happen.

The first person she names is Sue Fletcher-Vea.

Fletcher-Vea and Melvin drove the idea, she says, initially just looking for support for their own staff – before setting a much bigger challenge.

”She was extremely supportive around recognising the need and making it happen,” Daniela-Wong says.

So, the next question is a delicate one: could stress have played a part in Fletcher-Vea’s passing?

Daniela-Wong doesn’t shy away: the scientific jury is out on whether stress causes cardiac arrests directly, she says, but it certainly contributes to cardiovascular disease.

“We need to look after the people who are looking after everyone else. Think of the nurses and everybody at the hospital, and they do it tirelessly, shift after shift after shift, and cop a lot of flak.”

These workshops are extraordinary sessions. People who don’t know each other, from different parts of the island, different industries, different nationalities, come together often begrudgingly to talk about that most awkward of topics, mental health.

Daniela-Wong has a doctorate in neuroscience – but she can talk to anyone. Soon, she has them laughing easily together. 

The 40-year-old spent some of her childhood on the outer island of Atiu, some moving from one rural South Island town to another. “In North Otago, we were the only brown kids in town.”

Her dad Nio was an Orometua (minister), her mother Margaret a mental health nurse. Daniela-Wong is no privileged private school girl; she saved to go to varsity by working in a Talley’s beans canning factory in Blenheim.

She had a colourful run through university. “I was certainly no angel. I have seen a lot of life that other people haven’t.”

She once returned home from university to find her parents had given her bedroom to a homeless man. It was from them she inherited her concern for social justice.

Her doctorate investigated how the effects of ecstasy compared to cocaine and speed. 

She and her family returned home to Cook Islands a few years ago to support their community, but she works closely with friends and colleagues in New Zealand and Pacific.

Some communities are struggling to remain resilient in the face of this new crisis, she says. Samoa lost 80 children to measles just months ago. And Tonga is fighting a torrid battle with meth – just last month drug counsellor Ned Cook, a friend of hers, was shot dead in Nuku‘alofa, allegedly by a young man he had been trying to help.

By comparison Cook Islands has strong family and community networks, she says, but less health infrastructure, less public sector resourcing, fewer safety nets for the unemployed and homeless and others who are struggling.

So she is turning this crisis into an opportunity, to learn as a community to talk about how we’re feeling, about how we’re struggling.

This is something that has taken other nations decades to learn; Daniela-Wong has won over one-seventh of the island’s workforce in just seven weeks.

She explains that all of us have fight/flight/freeze reflexes – and these are thrust to the fore at times of crisis, like a war – or the Covid economic collapse. She herself is of Atiu island warrior stock, she says; her first response is to throw herself at a threat, head down. She punches her fist into her palm, explaining how our blood can rush to our head and hands.

Daniela-Wong wants us to learn to recognise the signs of stress and anxiety in ourselves and others. She wants us to reimagine where we are going, to find new paths through the storm.

And she wants to share practical tools. Slow breathing. Exercise. Touching – which includes expounding on the benefits of sex. This is awkward: for the first six weeks she was inadvertently using a rather coarse Maori term for sex; she wondered why everyone was laughing!

But that brings us to one of the best tools of the lot: laughter. It’s a lively jolt that helps us gradually reduce the harmful cortisone in our system that turns stress into a killer.

Remember that construction boss, struggling to feed his family? By the end of the workshop, his anger has dissipated into a new, calm self-awareness.

“Coming to this workshop has helped me to be positive, and reframe things,” he says.

“And instead of being angry all the time, I’ll try to talk things out with my family as they get affected. It’s okay, we can get through this.”

* Made with the support of NZ on Air *

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