The Fono's 'Alert Level 4' Story


  • Sally Dalhousie The Fono, Aotearoa New Zealand



Pacific, covid, integrated model of care, food security, health, transformation


During the 1970s and 1980s, Pacific people tended to seek medical care from Accident and Emergency centres only when they were in an acute condition. As a result, Pacific mortality rates were high and Pacific people were unnecessarily suffering with poorer health outcomes. By 1987, a group of Pacific community leaders in Auckland came together and formed The Fono (originally known as Pasifika Health Care), to provide a Pacific community-led health practice and improve access to high quality, culturally appropriate primary care services. By 2020, The Fono had nine sites with four medical clinics, three dental clinics, a vast range of public health and social services, and a trades training academy.

Aotearoa New Zealand’s initial Covid-19 Alert Level 4 period was a time of intensive service delivery and significant innovation at The Fono. As a result, incubation projects were catapulted into life, transforming key aspects of the organisation. For The Fono, this transformation occurred on the following timeline:

         pre-Covid (time before Alert Level 4, before 26/03/2020);

         Covid (Alert Level 4 period, 26/03/2020–3/05/2020);

         post-Covid (the time after Alert level 4, 13/05/2020 onwards).


This viewpoint outlines the projects that contributed to organisational change at The Fono with the first Covid wave in 2020.


Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S., & Hahm, H. C. (2020). Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health. Psychiatry Research, 290, 113172.

Martin-Neuninger, R. (2021). The impacts of COVID-19 on food security: Emergency food systems (food banks) and policy responses. In S. Ratuva, T. Ross, Y. Crichton- Hill, A. Basu, P. Vakaoti, & R. Martin-Neuinger (Eds.), COVID-19 and social protection (pp. 55–78). Palgrave MacMillan.

New Zealand Government. (n.d). History of the Covid-19 alert system. response/history-of-the-Covid-19-alert-system/.

New Zealand Treasury. (2001). Reducing Māori and Pacific inequalities, Vol. 1/30.

Rush, E., Puniani, N., Snowling, N., & Paterson, J. (2007). Food security, selection, and healthy eating in a Pacific community in Auckland New Zealand. Asia Pacific Journal of Clinical Nutrition, 16(3), 448–454.

Tanielu, R. (2021). Food for thought: Disrupting food insecurity in Aotearoa. Salvation Army.

World Health Organisation. (2022, 27 April). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide [Press release]. https://www.




How to Cite

Dalhousie, S. (2023). The Fono’s ’Alert Level 4’ Story. Aotearoa New Zealand Social Work, 35(2), 41–46.



Practice Notes