One hundred and fifty Māori medical practitioners, doctors, nurses and medical graduates converged on Rotorua in April to discuss the Māori health Kaupapa Inquiry. Ātea’s rongoā expert Donna Kerridge made the case for Māori health framework before her peers.
“Rongoā Māori is a threat to the medical economy because it is about sharing knowledge, not selling it.” – Erena Wikaire, National Hui on Māori Health Issues, April 2018
Our health system is focussed on owning the problem rather than capitalising on it.
That said, there is a lot to be hopeful about amidst our current health system. We have a new government that is strongly advocating for improving Māori health outcomes. We have a growing number of Māori medical professionals, culturally appropriate research methodologies to guide our researchers and an ever increasing culturally competent workforce. Our leaders are more confident navigating our health system, despite the system. Yet health statistics for Māori continue to reveal shocking inequities.
We need to acknowledge, through action, that disease is a social issue before it is a health issue if we expect to see marked improvement in current health statistics. New Zealand’s healthcare system is premised by offering prescription before acknowledging a clear description (diagnosis) of what is really at the root of health issues for Māori and indeed many of New Zealand’s wider population. The only tools available to our medical professionals in order to respond to disease are surgery, drugs, health education and ongoing research. All of which are offered in isolation to the social issues that predicate our appalling statistics. How much of an effect do we really think drugs, surgery and health education will impact our health statistics? People are not eating the wrong foods because they are unaware these foods are not good for them, people are not missing health appointments because they would rather not take their children to the doctors. They are not embracing addictions because they want to be dependent on substances.
Those charged with the responsibility for improving New Zealand and in particular Māori health statistics need to clearly define and act on what is making Māori sick. When a wellbeing framework entrenched in te ao Māori is used it is obvious that the things that impact our health most are disconnection from people, place and purpose. That is, a world that values independence rather than a social structure based on the natural lore of interdependence.
Many in our population decline rapidly as a result of loneliness, hopelessness, homelessness and lacking a purpose beyond meeting their own immediate needs. These things are reflected in Māori over representation at the wrong end of our health statistics.
Māori can lead interventions and preventions that will deliver better health outcomes for Māori, based on a Māori framework. Understanding and acting on the things within a Māori framework that underwrite Māori health inequities is a good place to start. For example, how many people truly understand and value connections to wairua, whakapapa and to the whenua? How connected are they to their whānau and local community? Do they know where they belong, the place they belong to that no-one can move them on from, their tūrangawaewae? Do they have hopes and aspirations? Do they know their special gift to the world and how they contribute to their community?
A Māori health framework with a prescription that reconnects people to the whenua, tūpuna, community and their tūrangawaewae; that lifts the aspirations and hopes of people and reflects the special gifts individuals bring and contribute to their whānau and communities might be cause for excitement when hoping to turn around some of New Zealand’s most shameful health statistics.
Without a doubt, the prescriptions offered within the current health system have a role to play in improving hauora Māori but if it is traction we want then rongoā Māori completes the picture. A Māori framework for success would invoke lifting the mauri and mana of our whenua and her people; re-establishing a health system focussed on reconnecting people to land they live upon….as the whenua (placenta) is to the unborn child so too is the whenua (land) to the people. When we whakamana, lift the mana of the population by reconnecting the people to the land so that they can recognise within them the legacy of their tupuna, they will come to know that the blueprint for good health, the recipe for the healing and wellbeing of the land, is the same as the recipe for the healing and wellbeing of people.
To heal a whānau we first need to whakamana, heal our mamas, Papatūānuku me ngā wahine. Rongoā Māori is not about giving focus or energy to disease, it is about people caring for people.
Rongoā Māori is the framework for the wellbeing of our people based on matāuaranga Māori. It does not exclude the use of medical interventions, in fact it embraces them as and when most appropriate.
Over time, New Zealand’s health fraternity has somehow managed to mix things up. It tirelessly tries to operate in isolation from and outside of the influences that are the true determinants of our nation’s health and health equity. It is a system that is built on disease and injury rather than wellbeing.
Somehow, we have enabled a medical economy that is hell bent on wanting to captain the wellbeing waka. While the achievements of modern medicine and the natural health industry are truly amazing and warrant acknowledgement for all the suffering they save people, if we are to turn this very large ship that has resulted in the over representation of Māori in all the wrong statistics we must embrace and engage the Māori framework for health and wellbeing that is Rongoā Māori.