Ma¯ori need more than luck coping with pandemic: expert
LUCK and community checkpoints stopped Ma¯ ori from facing the worst of the coronavirus, but a Ma¯ ori health expert says better planning is needed to prevent a high death rate in future.
When Covid-19 first started to affect New Zealand, there were fears the Ma¯ ori community would be the worst hit, said Professor David Tipene-Leach.
‘‘We saw it do this overseas; in Italy it hit older people and poor people, in the States it hit black people,’’ said the chairman of Te Ohu Rata o Aotearoa (Te ORA), the Ma¯ ori Medical Practitioners Association.
Ma¯ ori were also hit hard by recent outbreaks of measles in Auckland and Northland, rheumatic fever and meningococcal disease in Northland.
‘‘Also bird flu and swine flu,’’ said Tipene-Leach. ‘‘Both of those smoked Ma¯ ori over like flies. They were not in big numbers but Ma¯ ori people had much higher death rates and much higher hospitalisation rates than the rest of the population.’’
The concern was so high that a national Ma¯ ori pandemic group, Te Ro¯ pu¯ Whakakaupapa Uruta¯ , was formed.
The latest Ministry of Health statistics show just 9 per cent of positive Covid-19 cases were
Ma¯ ori, compared with 16.5 per cent of the general population who are Ma¯ ori.
In Northland, where 36 per cent of the population is Ma¯ ori, the lack of positive cases has been celebrated.
Northland District Health Board chairman Nick Chamberlain said in his May board report that Ma¯ ori had higher testing rates than any other ethnicity and just 29 per cent of cases (eight out of 28) were Ma¯ ori.
‘‘This compares very well with the last pandemic where
Ma¯ ori fared terribly and had many times the death rate.’’
But Tipene-Leach said it was more down to luck and circumstance that Ma¯ ori had not been harder hit by coronavirus – such as Ma¯ ori not travelling to hard-hit countries, such as
China and Italy – rather than any good public health planning. ‘‘We had a run-down health system, a porous border with nothing in place, public health units that were understaffed for the last decade and contact tracing that could probably only do 10 cases a day.’’
The iwi-led checkpoints, which helped secure areas of the Far North and East Cape, made a major difference to those vulnerable communities, Tipene-Leach said.
‘‘It was a wonderful course of action taken by a group of people who are living in little communities that, when you go to the urupa [cemetery] you see the big empty section there and know that it is full of people who died in the 1918 pandemic and are now in unmarked graves.’’
Tipene-Leach would like to see inequities in the health system addressed, so Ma¯ ori, Pasifika and the poor can do just as well as the rest of the population.
He is encouraged by proposals to create a new health authority, Health NZ, but is concerned a Ma¯ ori health authority will sit alongside this, marginalising Ma¯ ori health.
‘‘What is suggested is a toothless wonder and absolutely impotent. It will be shoved into a ghetto and blamed for everything that doesn’t work with Ma¯ ori health.’’
Tipene-Leach said Health NZ should have a broad equitybased model, with dual CEOs and two-thirds of board members being Ma¯ ori.
Health NZ would also need to address one of the greatest determinants of poor health: Intergenerational poverty, he said.
The Black Lives Matter movement, alongside the Health and Disability Report and the post-Covid era, makes now a good time for change, TipeneLeach said.
The Government announced in March that it would spend more than $56 million on a specific Ma¯ ori response action plan. About $30m will be targeted directly to Ma¯ ori health services and a further $15m to Wha¯ nau Ora commissioning agencies to support vulnerable wha¯ nau.