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(Image: Getty Images)
(Image: Getty Images)

OPINIONĀteaJune 8, 2022

The problem with the government’s ham-fisted ‘look after yourself’ message

(Image: Getty Images)
(Image: Getty Images)

By urging New Zealanders to do their bit to take pressure off an ailing health system, the Ministry of Health risks adding another barrier to seeking care for people who need it the most. 

I always feel slightly uncomfortable responding with “look after yourself” to someone who’s told me they’re unwell. The taken-for-granted phrase has become ubiquitous in email correspondence within pandemic times. While it’s not quite as blunt as urging your mate to fend for themselves or cope alone, imploring someone to look after themselves doesn’t really offer much comfort if they’re stuck in bed feeling absolutely lousy.

So I was especially unnerved to see that sentiment – in near-verbatim wording – being expressed by the ministry responsible for overseeing New Zealanders’ health. 

A piece of peculiar Ministry of Health comms shared to social media last week, headlined “Kiwis urged to look after themselves and alleviate pressure on health system this winter”, encouraged people across the country to “look after their health” and to “do their bit to reduce pressure on the health system through what will be a challenging winter”.

It went on to underscore the additional pressure being put on the health system across the board: GPs, pharmacies, community health clinics, ambulances and hospitals. 

A screenshot of the release in question from the Ministry of Health website.

What can be done to take the pressure off? The ministry made a plethora of suggestions that included getting vaccinated, self-care like eating well and getting plenty of sleep, stocking up on honey and boxes of tissues in case you do get sick, as well as hinting that medical care that isn’t urgent should be avoided. “There are many minor ailments that can be treated with over-the-counter medicines,” the press release said. “So people who are not seriously ill are encouraged to seek advice from their local pharmacist.” 

Fraying threads have appeared across the country’s health system recently. On May 23, Dunedin Hospital’s Covid-19 ward was at capacity, and the hospital has since closed all wards across the hospital to visitors because of these pressures. Christchurch Hospital is running at more than 110% capacity – with surgeries and cancer treatments being delayed daily. Community health providers and GPs have reported they are struggling to meet demands. Over the weekend, the Otago Daily Times reported that pressure on nurses has left some so stressed they’ve been reduced to tears in hospital corridors. 

This is all to say that the Ministry of Health isn’t crying wolf: our health system and the workers who keep it running are under massive pressure from widespread Covid-19 circulation and newly opened borders, which will not only let further Covid-19 variants into the country, but also flu and other infectious diseases. The potential for large numbers of cases of long Covid, which is thought to affect more than 30% of people who have had Covid-19, only adds another layer of complication.

Couple this immediate pressure with decades of underinvesting in our health system across successive governments, and you have a perfect storm. A storm we knew was coming.

But this message from the Ministry of Health is more than just a clunky admission of our current reality. 

There’s something deeply unsettling about our national health body urging us to second-guess whether we really need primary healthcare and hinting that we should perhaps rethink our planned GP visit. Asking people to alleviate pressure on the healthcare system will lead to people not seeking care when they need it.

For Māori and Pasifika, those barriers are especially concerning. Tangata whenua have the poorest health outcomes and highest mortality rate of any ethnic group in New Zealand. Although Māori experience a high level of healthcare need, they in turn receive less access to appropriate healthcare services. 

Our health system and the workers who keep it running are under massive pressure (Photo: Getty Images)

According to the 2021 New Zealand Health Survey, 15.7% of Māori adults and 15.2% of Pacific adults had not visited a GP due to cost in the past year, compared with 10.2% of the rest of the population. Māori and Pacific adults were respectively 2.8 and two times as likely as non-Māori and non-Pacific adults to not have collected a prescription because of the cost. It’s barriers like cost, transport or the inability to take time off work that often lead people to turn up in hospital emergency rooms with compounded and preventable health problems. 

It might not be the intention, but ham-fisted messaging like this discourages those of us who are already likely to dismiss health niggles and necessary screenings or who already have barriers to access  – especially in Māori, Pasifika, disability, rural and low-income communities. The Ministry of Health’s message isn’t far removed from the “toughen up” approach to health that you’d hope we were shifting away from.

Knowing the impacts of inequity around healthcare, it seems beyond belief that health communication would add another barrier to put people off seeking it. Messaging like this reinforces low trust in the health system. We’ve seen the impacts of that distrust crystallised throughout the pandemic – it’s a vicious cycle that leaves us all worse off.

The crux of the problem here, though, is that while our system is inarguably under immense and immediate pressure, the Ministry of Health and central government have access to meaningful tools that would relieve some of this. The situation demands genuine solutions, rather than offloading responsibility onto individuals as their notice seems to suggest: “We can boost our immunity against illness by eating healthy foods, staying active, and getting plenty of sleep. It’s important to look after our mental health too.” 

It is of course very sensible to do all of these things (even if this kind of self-care is easier said than done for many of us). But we can’t load a crumbling public health system onto the backs of five-plus a day and a good night’s shut eye. Abdicating responsibility to individuals to manage a public health crisis isn’t a solution. 

I find it immensely difficult to reconcile this kind of messaging with the loosening of restrictions around Covid-19 and the government’s shoulder shrug of disinterest in reinstating or creating new public health measures to slow the spread and reduce the strain on services. 

The responsibility for a public health crisis can’t fall onto the backs of individuals (Photo: Getty Images)

At the moment, beyond vaccines, our public health response to Covid-19 has been reduced to one remaining protection: masks. If that’s all we have, why not reinstate mask wearing in schools and hospitality venues? Should free respirator masks be funded? Perhaps we need campaigns and information around better-quality masks? There are immediate options beyond that too: indoor air quality standards, universal free flu vaccines, empowering Māori health providers, robust support for people who are isolating, campaigns around how Covid-19 spreads through aerosols or how to do a nasal swab properly. Or, I hate to be a killjoy, but perhaps areas with high transmission need to be upgraded to the red setting. The point is that we shouldn’t have let it get to a point where the ministry felt the need to ask us to back off. 

There were and are alternatives to the road we’re heading down. Responding to a pandemic cannot rely on individual responsibility – only a collective public health response will work. In this case it demands a recommitment by the government to public health measures and to the health and welfare of New Zealanders. We know this all too well from our earlier responses to the pandemic.

As we’ve seen before, a health system crumbling under the weight of Covid-19 isn’t inevitable. And rather than looking after ourselves, we’ll need to look after each other.

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Image: Archi Banal
Image: Archi Banal

OPINIONĀteaJune 7, 2022

Once were one colony: 501 deportations and the history of Māori in Australia

Image: Archi Banal
Image: Archi Banal

With a new Australian government comes revived hopes for movement on section 501 deportations, a policy that disproportionately affects Māori in that country. One big hurdle? Australians’ ignorance about the impact of colonialism in Aotearoa, says Mat Henderson (Ngāpuhi).

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I am descended from a Ngāpuhi shearer who migrated to Australia 110 years ago and share my kōrero with you today from the lands and waters of the Gadigal Nation where my whānau have lived for three generations. The first parcels of land stolen by Britain were granted to Royal Marines in 1792. 

I acknowledge sovereignty was never ceded. 

Always was. Always will be Gadigal land and waters.

Ka nui te mihi ki a koutou.

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The history of Māori migration to Australia is a long and spirited one. Māori were among the first migrants to say “not cool” to the white Australia policy. My tupuna was one of them. He came to Australia in 1910 as a shearer and alongside our Australian First Nations brothers and sisters worked in indentured servitude and built Australian colonial wealth (and fought in its wars).

The author’s great-grandfather came to Australia in 1910. His grandfather and father are pictured during the period they lived in a squatters camp under the Roseville Bridge near Chatswood, Sydney, circa 1950s (Photo: supplied)

Any story of migration is a story of push and pull factors. For tangata whenua, it’s mostly push.

Many of the early Māori migrants to Australia were pushed from Aotearoa by the jarring shock of dispossession, after the British interpreted the Treaty of Waitangi like a Choose Your Own Adventure book. Chuck in the effects of grossly unjust and erratic Native Land Court decisions, and it’s clear why so many set sail across the Tasman – and why it’s unconscionable to refer to those people as mere economic migrants to early Australia.

The same is true for all subsequent waves of Māori migration. The consequences of the original loss of possessory title to lands and waters in Aotearoa is a root cause of the intergenerational disadvantage experienced by Māori. Australia has always been a place where this unique class of migrant has sought stability and the chance to build a life.

Thing is, Australians have a weird thing about treaties with their own First Nations peoples. Many of them can’t quite grasp the following basic proposition: if ownership of land changes hands by way of guns, germs and steel, and not by way of contract and consideration, then the only way you can square away your occupation of that land is by way of a treaty. Or you can keep your head in the red sand for 234 years, as all past Australian governments have done.

Although hopes of a genuine treaty are now visible on the horizon with the election of the new Albanese Labor government, the vast majority of Australians can’t grasp the legitimate argument that Māori Australians were pushed here by the effects of another treaty, one where one party is in constant breach. Many Aussies genuinely think of Waitangi Day as a Kiwi version of Australia Day, commemorating nothing more complicated than Captain Cook crashing his dinghy into a New Zealand jetty sometime in the late 1700s.

The Villawood Immigration Detention Centre near Sydney, where many New Zealanders are held before being deported (Photo: Greg Wood/AFP/Getty Images)

Australians, overall, have similarly not cared all that much about section 501, the law that allows NZ-born residents of Australia to be deported back to New Zealand – a country they often left as children and do not know at all. Both major parties took a policy of maintaining the status quo to the recent election. Both parties also agreed that charging deportees the costs of their own detainment at AU$450 per day was a capital idea. If that sounds like lumping poor people with insurmountable debts as a future deterrent from ever seeking to enter Australia again that’s because it is.

The mass incarceration of people who wouldn’t ordinarily be (or remain) in detention has generated a bustling little micro economy. But it’s the money of 501s and their families who are feeding it under a very unfair set of circumstances.

Something is way out of balance in our collective spirit/wairua due to this mass deportation madness. It needs to be remedied. As part of the broader legal team now reviewing (and soon to act upon) the treatment of section 501/116 detainees within the rubric of Australia’s obligations under various international human rights treaties, we plan on remedying this imbalance. Many countries deport people who have been convicted of serious offences with no ties to their jurisdiction, but Australia has built up a process that is running on an industrial scale that mainly deals with people with minor offences and who have strong ties to Australian society. These deportations destroy families, often penalising the women and children left behind.

That’s the modern Australia that Māori are migrating to.

No matter how old or recent the Māori migration to Australia, the theme of being in Australia mostly out of necessity (or necessity of opportunity) holds true. You can’t gather the wealth of the land and waters if both were stolen, conned or extorted from your ancestors. In Aotearoa, sovereignty was fudged and massaged by people who spent a few days writing the Treaty of Waitangi, then decades selectively enforcing what its words mean at the end of a musket barrel or in the face of chronically disadvantaged tamariki.

Maybe those early Māori migrants to the New South Wales colony were simply trading one form of colonialism for another. In Australia, in the absence of pā and any land ownership borders discernible to the European mind, Captain Cook just nicked sovereignty from Australia’s First Nations, like a kid might walk into a dairy and pocket some Pineapple Lumps. The Brits didn’t even try to feign a good faith agreement with local mobs. With the Union Jack raised and sovereignty claimed, everywhere that Europeans went they owned outright with no haggle room over a mistranslation. These days things are changing, albeit very slowly. Outright ownership of Country is now subject to native title and you’re probably reading this soon after the 30th anniversary of the Mabo Decision, which overturned the legal fiction of early Australia as “terra nullius”.

First Nations Australians protest on Australia Day, or Invasion Day, on 26 January 2018. (Photo by Asanka Brendon Ratnayake/Anadolu Agency/Getty Images)

What’s certain in the age of section 501 visa cancellations and deportations is that it’s impossible to ignore the disproportionate number of Māori caught up in Australian immigration detention and deportation. It’s also undeniable that there is a great amount of misinformation about who is affected by the policy. New opposition leader Peter Dutton has bragged of using section 501 to “take out the trash”, by deporting thousands of seriously hardened and irredeemable criminals since the law was introduced in late 2014. In fact, many people are being deported for low level (but repeated) drug crime and driving offences. The 501 policy applies primarily to non-citizens who have spent at least 12 months in prison, but time spent sentenced to residential drug rehabilitation is being tagged onto actual time in prison, lowering the threshold for the types of offenders being captured by section 501 visa cancellation.

Australian society loves Māori while they have a good sidestep but if you get injured playing park footy or on a dangerous worksite, there is little aroha for you here – even less if your work injury requires surgery, which then requires painkillers. What if a person can’t get off those opioids and falls into addiction and crime? What if the squeeze of everyday financial pressures combines with addiction to the point where some stupid (but understandable) decisions are made which create a different life trajectory, one that eventually takes a person to prison? These are bad but desperate decisions with tragically disproportionate and inhumane consequences. Everyone deserves a second chance from a bad decision made under unimaginable life pressures.

The incoming Labor government has flagged some future flexibility in applying section 501, particularly regarding length of time spent in Australia and with special consideration being afforded to New Zealanders, as befitting the historical immigration ties between two parts of what was once the one colony. We await the tabling of the Migration Amendment Bill 2022 later this winter, all going well.

Whether for jobs in sheep shearing, like my own tupuna, the mining boom or beyond, Māori have continued to come to Australia, a country with close to zero sympathy for the historical wrongs inflicted on Māoridom by the British and their colonial descendants. Mainstream white Australia has had a hard enough time getting to grips with the attempted genocide that its ancestors dished out to our own First Nations people to worry about what happened in colonial New Zealand. Even for progressive Aussies, a Jane Campion-style shot of a black sandy beach and Harvey Keitel in brown face is about as close as most get to properly comprehending the reasons why there are so many Māori in Australia.

It’s because many have no choice.

Help us help Aussies understand this. Help us to help them shape laws based on aroha, not needless cruelty and punishment for punishment’s sake.

*Mat Henderson is the principal lawyer of Reparation Legal and is based in Sydney. He is a member of Filipa Payne’s Route 501 Advocacy legal team advised by Professor Patrick Keyzer in Melbourne and by Professor Kris Gledhill and barrister Sam Moore in Auckland.

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