Image: Archi Banal
Image: Archi Banal

OPINIONPoliticsNovember 29, 2023

We’re done with being asked to justify our ‘privilege’

Image: Archi Banal
Image: Archi Banal

In casting a malevolent spotlight on Māori and Pacific medical school admission schemes, the new coalition government is making every tauira feel that a ‘you don’t deserve to be here’ target has been painted on their back.

“Would you ever run for parliament?” is one of those questions that I’ve always had an answer to. “Absolutely not.” 

Initially it was because, having worked for a Labour Party MP in my 20s, I had seen the way the sausage was made and it was not pretty. I didn’t fancy the spotlight, the binary good vs bad, the necessity of picking a side and having to adhere to a party line, and most of all, the endless meetings and having to be nice to people all the time.

Later, I got involved with Māori public health at Hāpai te Hauora and, through that work and my training in medicine, I saw that the most effective social change happened at grassroots level, when communities are given the chance to determine and achieve their own aspirations. My mum Colleen, who has known this for ever, having worked in the community all her life, didn’t say “I told you so”. 

One of the things that worries me most about the incoming government is how, in pursuit of benign-sounding slogans like “fairness” they will attempt to distract and position us against each other. They’ll do things like dog whistle to immigrants about how Māori get unfair privilege, while worrying loudly about the impact of immigration on public infrastructure and job availability. They’ll act as if rationing social services is fair, while hoping we fight among ourselves for the crumbs. 

I read about the formation of the new government over the weekend and I am writing today in support of the Māori and Pacific Admission Scheme (MAPAS) at the University of Auckland, and the University of Otago equivalent, the Mirror on Society. The threat to these social justice initiatives has been constant since their inception, so this is not new. But in the context of a health system at breaking point, widespread burnout and scary workforce projections, placing this malevolent spotlight on our aspiring and current tauira is incredibly cruel. 

The cohort of doctors who have come through MAPAS and the Mirror on Society feel this sting, too, but we’re done with the medical school hunger games now. As Māori psychiatrist Di Kōpua told me when we interviewed her for the Getting Better podcast on RNZ, “Once the tohu is awarded, it can never be taken back.” There’s some security in that, but it’s one that our incoming and current students don’t have. 

The author and her recent book (Image: Tina Tiller)

My community, mentors and colleagues are mobilising to fight for Te Aka Whai Ora, in opposition to the ridiculous suggestion that we repeal our commitment to the UN Declaration for the Rights of Indigenous People, against the white-washing of our public service, challenging the baffling inaction on climate change, and myriad other backward policies that remind us more effectively than any government to date that colonisation is an ongoing process. Who in their right mind thinks it’s a good idea to stall progress on tobacco control? It was a hard document to read, as each new bullet point held yet more negative, regressive, ideologically-driven intentions. 

As a relatively recent MAPAS graduate (three years that feel like 30), I want to mihi specifically to our students who have a hard three years ahead. 

It doesn’t matter that “policies” are being targeted, or “outcomes are being examined”. The positive outcomes from MAPAS and the Mirror on Society are well documented. The incoming government is being disingenuous in their characterisation here – they just want to incite prejudice. The real effect of this is that every trainee health professional coming through these programmes will feel that a “you don’t deserve to be here” target has been painted on their back. They will carry the hostility of this message into their exams, their assignments, onto the wards of our hospitals and into their homes. Have you ever tried to sit a medical school exam? Can you imagine how difficult they are? Then imagine that your right to exist in that exam room is being debated by our elected government who will absolutely encourage the media to participate in this attack while you’re trying to remember the Krebs cycle or the anatomy of the brachial plexus.  

It’s not about resilience (it’s never about bloody resilience) because those of us who make it to medical school have demonstrated resilience beyond belief to even get there. But how much should our trainee health professionals be asked to shoulder? Would anyone wish this on their children? It speaks to the heartlessness of the incoming government that they care nothing for this. In the face of tiny, incremental improvements in our workforce representation (currently 4.7% Māori doctors, 2.3% Pasifika, from 2.3% and 1.1%, respectively, in 2000) – what do they fear? They won’t articulate this in any official document, but they are driven by the fear that we will gain critical mass and actually start to achieve equity, maybe even rangatiratanga. Don’t believe anything they say about wanting to improve the health system “for everyone”. Their strategy for this is to take us back, homogenise everything towards a white norm, and then blame us as individuals for not thriving under a regimen that refuses to account for our differences; primarily the systematic, violent dismantling of Māori language, culture and economic resources including theft of our land, and the parallel social engineering which ensured we would be disadvantaged in education and health, and therefore socially and economically, to participate in colonised New Zealand. 

I’m so frustrated at having to quote our life expectancy statistics and our poor health outcomes to justify the need for equitable healthcare policies, including developing a representative and culturally safe health workforce. Performing our trauma to make people care is the most peculiar form of storytelling. I don’t want to talk about deficits that aren’t our fault. I don’t want to have to keep citing the evidence that we had to collect to convince this country that our poor health outcomes and early deaths aren’t because we’re lazy, stupid and make poor decisions, but because we have been systematically and intentionally disadvantaged and deprived of access to the fundamentals of health and wellbeing. Unfortunately, it’s the only story that we’re able to tell, because we keep getting asked again and again to justify our “privilege”. I’d quit my job tomorrow if someone promised me that it would relieve me of the privilege of watching my whānau die younger and sicker than non-Māori. Toni Morrison knows when she tells us “The function, the very serious function of racism is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being.”

We’re done with explaining our right to exist. If you don’t understand by now, that’s on you. The weight of the evidence and the truth of this country’s history should embarrass you if this is the first time you’ve taken the time to look for it. Being kind is out. Being strategic is in. In the words of my Tukorehe cousin, Anahera Gildea – author, artist and aunty – we don’t need allies, we need accomplices. See you on the protest line, e hoa mā. 

Keep going!