Are M¯aori voices finally being heard in health?
As I stood with my¯wha¯ nau on my ancestoral land Takaparawhau, Ora¯ kei during Matariki earlier this year – the first as a national holiday, the sun rose and I heard my wha¯ naunga read out the many, many wha¯ nau who had passed away over the years. It was a time to weep for them together.
It also gave me a space to reflect on how I, like many Ma¯ ori, have experienced unnecessary death in my wha¯ nau at an early age. Losing my mother when she was only 45 years old from cancer within three weeks of her feeling unwell, was a trauma our wha¯ nau still find it hard to ko¯ rero about. Many times, I have thought about how she didn’t like going to the doctors because she felt that they never listened to her, she didn’t understand the “big” words, and they made her feel “stupid”.
Now, working in healthcare, I think about who else feels this way when they walk into the health system.
When I see changes happening and the voices of Ma¯ ori are heard, I feel hope for a healthy and thriving Ma¯ ori community.
Now that Te Aka Whai Ora – the Ma¯ ori Health Authority has officially launched, I see significant system and investment changes planned for Ma¯ ori to thrive. Health organisations from both Ma¯ ori and mainstream who have advocated for change have pivoted to embrace transformation, albeit with some uncertainty around what it looks like. Many Ma¯ ori are working tirelessly to ensure commitment to the kaupapa from governing boards through to our tangata/ patients.
As kaiwhakahaere (advocate for) Ma¯ ori my focus is to ensure Procare continues to look at ways to remove systems barriers that create massive inequities throughout primary health care, for Ma¯ ori and all those in need.
Mainstream general practices are still recovering from Covid-19 pressures and are looking at how they can work differently but my observations are that general practices are ready for change. They need us to advocate and challenge the systems to remove barriers for Ma¯ ori to access healthcare so they can carry on caring for people.
One example is advocating to reduce the age of flu vaccinations for Ma¯ ori to 55 years. Why? Because providing preventative healthcare reduces other risks for our long-term conditions tangata/ patient.
Another example was the Government excluding general practices from providing Covid-19 vaccinations until it was critical. By then the workload was enormous, especially for small practices. We knew we could do things differently so we partnered with Ma¯ ori providers, such as the ro¯ pu¯ Taumata Ko¯ rero and Te Pae Herenga o Ta¯ maki Makaurau, to provide tangata/patient data to connect the hard-to-reach communities. There was an immediate increase in vaccinations in our most vulnerable communities.
We know we need to do more and that we can achieve greater outcomes for Ma¯ ori by working collaboratively.
The responsibility I carry with my role not only as Kaiwhakahaere Ma¯ ori but mana whenua (Nga¯ ti Wha¯ tua O¯ ra¯kei) has driven my passion to ensure they we achieve milestones with authenticity to positively impact on my people’s health. We have developed integrated strategies for Ma¯ ori and also Pacific health that focuses on the priorities for Te Tiriti o Waitangi alignment and equity.
We also looked at how our team can represent the communities they serve, working with our people, culture, training and policies to give staff the knowledge and skills needed to confidently interact with all people. We’ve launched a cultural confidence tool in the ihi app; implemented an antiracism and unconscious bias policy; launched the “Achieving Equity for Pacific – A guide for General Practice”; and are developing a cultural competency online training course call Te Pu¯ heke (the flow).
Most recently, we’ve launched Ara Hauora – our mobile health service. Ara Hauora is familycentred, where a team of nurses and health coaches take mobile van services home to wha¯ nau, with a goal to build the relationship back with the GP and community groups required to support the whole wha¯nau.
I know that the mahi we and other healthcare organisations are doing will make amazing changes to our communities. We have work to do to navigate and understand how PHOS fit in. We know what we are good at and we can see how we can be an authentic partner to the networks of providers who want the same.
What do our future aspirations look like? We as Ma¯ ori need to be thriving and healthy with safe and welcoming care. We are determining our health picture because we can articulate our health and have access to it. So, let’s start the journey together.
Kia whakamana te tangata - We courageously embrace meaningful change.
For my future Matariki, let my tears only be for a few.