The Veituberi Approach Transforming RHD Through Patient Leadership and Lived Experience ^†

1. Background

Rheumatic heart disease (RHD), a complication of untreated Strep A infections, is a major global health concern. In Fiji, sub-optimal treatment adherence due to limited access and awareness has led to an increasing RHD burden. Heart Heroes Fiji (HHF) developed veituberi, a culturally based approach combining nurturing support and motivational interviewing. This patient-led approach uses lived experience to improve engagement and adherence, while working with existing health, indigenous community structures, and youth networks.

2. Approach

Veituberi, meaning “to guide and assist,” represents an indigenous concept emphasizing nurturing relationships and empowering growth. HHF implements veituberi through three interconnected pathways:

• Veisikovi: Advocates conduct structured home visits to build trust and allow space for confidential discussions about treatment, challenges, and family-specific solutions.
• Veitalanoa: Trained champions engage with newly diagnosed patients and families through culturally appropriate dialog to address fears, explain treatments, and share success stories.
• Veitauraki: Community-based workshops combine health education with cultural practices to facilitate talanoa sessions, skill-building exercises, and peer support.

The implementation of this scheme relies on a network of champions, volunteers, and family members with shared lived experiences. This approach emphasizes cultural connection and the awareness of community wisdom. The program includes regular upskilling for volunteers, coordination with local healthcare providers, and feedback from community members to improve effectiveness.

3. Significance

Veituberi demonstrates a culturally sensitive approach integrated with healthcare. Unlike Western medical approaches, veituberi builds trust by speaking the local language, both literally and figuratively. Veituberi uses existing community networks and seeks to build a sustainable system that can improve RHD prevention, management, health policies, and patient outcomes.