Turia - Health Care Aotearoa 13th Annual Hui
te-pati-maori
Mon Mar 26 2007 12:00:00 GMT+1200 (New Zealand Standard Time)
Turia - Health Care Aotearoa 13th Annual Hui
Monday, 26 March 2007, 10:15 am
Speech: The Maori Party
Health Care Aotearoa 13th Annual Hui
Akapuanga Kuki Airani Hall, Cannons Creek, Porirua
Saturday 24 March 2007
Tariana Turia, Co-leader, Maori Party
E nga mana, e nga reo, tena koutou. Ngati Toa Rangatira, tena koutou. Tena hoki koutou nga whanaunga aku tuakana o te puku o te wheke ara, o te Moana Nui a Kiwa. E nga kaiwhakahaere o tenei hui, tena hoki koutou.
Every week, when I make my journey from my home in Whanganui to Whanganui-a-Tara, I look out at the waters, stretching between Mana and Kapiti Island. I am reminded of a historic swim made in 1824 by Kahe Te Rau-o-te-Rangi, who carried her baby girl, Makere, on a tiny raft of raupo on her back, across the waters.
Kahe swam for survival – the survival of her Ngati Toa people on Kapiti who were facing the onslaught of attack. She powered on, believing she needed to warn her people about the imminent dangers awaiting them. Taking the risk, to invest in the future of her people. Taking the risks – as you all do, as health promoters.
Kahe Te Rau o Te Rangi's feat is immortalised today in the carving on the gateway at the northern entrance to the grounds of Kenakena Primary School in Paraparaumu.
Kahe Te Rau-o-te-Rangi was also one of the few women who signed Te Tiriti o Waitangi. Her heroic courage in fighting for her people, saw her also making an investment, to a Treaty partnership. A partnership she anticipated would hold great promise for her whanau, hapu and iwi.
Kahe Te Rau-o-te-Rangi was also the grandmother of Sir Maui Pomare; who in 1899, graduated as the first Maori medical practitioner.
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The Pomare whakapapa is well known here, amongst Ngati Toa, and amongst our health community. But I am motivated today, to talk about some connections between this man of medicine and this annual national fono, that may perhaps stimulate some talking and thinking about ways we can unite and work together.
In 1929, Sir Maui Pomare paid a visit to an Auckland jail, to visit high chief, Tamasese who was imprisoned as the result of political differences with the New Zealand Government’s administration of Samoa. Sir Maui greeted Tamasese in his own tongue.
His reflections are worth recounting, as I believe they speak to us of the shared connections we have as peoples of the Pacific.
“And so I looked into the countenance of a Tama—an Ariki—a prince indeed. He has given his all in the cause of his people— the emancipation of his race.
“I thought, and asked myself this question. What have we—New Zealand—done? In our blind blundering party wrangling and political humbug we put this man in gaol. That is what we have done. This man we deprived of liberty, hereditary titles, degraded, deported and imprisoned. Yet those titles will continue till the last drop of Tamasese blood ceases to flow.
“Degradation? An honour. Deportation? A privilege. Imprisonment? A crown of glory. And so we have made it! ‘la loto malosi, Tamasese’ (‘Be strong in heart, Tamasese’).”
That reaching out to each other; the shared history between Maori and Pacific, was also demonstrated when Sir Maui was elected to Parliament as the Taranaki candidate for the Western Maori seat.
From 1916 to 1928 he was the Minister of Cook Islands where he fought to secure funding to improve services and address development issues for the people of the Cooks. It was during his time that the Vote swelled from £7500 to almost £50,000.
For Sir Maui, like his grandmother before him, he took the risks of exploring beyond his own world, to invest in a future for this nation.
Another legacy I was thinking of with Pomare is, of course, his role in the Maori health revolution that occurred at the turn of last century. The revolution revived what was described as a dying race – to a population we celebrated this last week, as exceeding the half million mark.
Sir Maui Pomare, in his role as the first Maori medical officer of health, adopted a five point health promotion plan. In the time before the Ottawa Charter or Healthcare Aotearoa; Sir Maui placed his emphasis on the following:
1. Health leadership: including the vital role of community leadership as a key factor in health promotion
2.
3. The links between health and socio-economic adversity
4.
5. the relationship between cultural strength and health advancement
6.
7. political will
8.
9. workforce strategy.
10.
When I was asked to talk to you, I was given some starting points about Services to Improve Access and Health Promotion programmes: how they are resourced, the successes, the barriers.
But when I saw that the Minister of Health, and Hon Luamanuvao Winnie Laban had also been invited to attend, I'm sure they will have talked about the detail in looking at the connections between our contractual relationships and the promotion of wellness in our communities.
What I'd like to turn to, instead, is your theme of Surviving Storms and Realising Dreams that can be so readily applied to the debates that rage around programmes and specifications and meeting the needs of the people.
I want to focus on the epic swim of the kuia; the vibrant relationships and connections to communities that Sir Maui Pomare demonstrated; and our own situation today.
How can we ensure that the services we deliver; the health promotion programmes we design, actually achieve the goals of realising dreams - rather than being submerged by the storms of bureaucratic number-crunching and complying with DHB targets?
How do we remain focused on outcomes which represent a sense of vibrancy and wellness amongst our peoples?
As I talk to you today, my colleague Pita Sharples, will be delighting in the talents of the Polyfest at Manukau Velodrome where I dare say there will be an incredible sense of the passion and vitality of the life-force in action.
It is our challenge, here, within the comfort of the Healthcare Aotearoa community, to think about how that sense of resilience and vigour we see in our cultural performance can be translated into our cultural health and wellbeing as well.
And so, I come back to the ideas from Sir Maui – someone who knew that by drawing on the community energy and empowerment was the way in which health could be enhanced.
Health leadership
The challenge before us all, is how do we promote social responsibility for health; encouraging the full range of skills and influences across our community to be used to promote health?
Sometimes it might be something like bringing our leaders together, our mamas and our papas, ensuring their expertise is encouraged to make health make sense for our peoples. It is important to remember that leadership in health should not rest purely with health workers. The power of community leadership and autonomy must be utilised to make any of our campaigns effective in achieving health outcomes.
An example of that right here in this community, is the programme Te Mato Taokotaianga Ote Au Metua, which supports elderly Cook Islands people in Cannons Creek in everything from bowling to trips out. The focus is on bringing the people together –influenced by the great respect and care that is reserved for the elderly – who, according to both tikanga Maori and Cook Island ways, have reached a time in their life when they should be cherished.
The links between health and socio-economic adversity
The Maori Party believes that health is a right not a privilege. It is our view, that the key priority in health for all players in the health sector, must be to ensure there are affordable and culturally safe services and treatments for all.
Last year the Asthma and Respiratory Foundation released a report revealing that Maori and Pasifika children with asthma appear to be further disadvantaged when it comes to receiving acceptable asthma care. In particular, there were significant ethnic disparities in tuberculosis incidence rates for children aged less than fifteen years, with Maori children accounting for 15% of all cases of TB, and Pasifika children 17% - and these compared to 3% of European.
What was so disturbing about this report was that it confirmed that income is acting as an obstacle to receiving quality health care; but it also confirmed that institutional barriers such as racism were leading to Maori and Pasifika peoples receiving ‘sub-optimal care’.
It’s about political will – but it’s also about addressing racism in healthcare; and investing in wellbeing, te oranga, by initiatives to improve access; and to create opportunities for decision-making and ownership.
Good health will not be achieved if we are not the ones making the decisions about how we can best enhance the levels of wellbeing. Healthcare Aotearoa; Pacific Health Services; iwi providers must continue to be involved in ensuring our voices are heard; our feet our firmly placed at the tables in which decisions are made.
We have a saying – ko koe ki tena, ko au ki tenei, ki wai o te kete?
What is the best way of carrying the kete? Side by side.
The relationship between cultural strength and health advancement
When carrying that kete, we must recognise that mauriora comes from a secure cultural identity. An identity which is enrichened by our cultural environments and is drawn from our genealogy.
Sir Maui Pomare was able to trace his whakapapa back to his Polynesian ancestors some 800 years before him. The first eight names of the whakapapa are those of successive chiefs who lived in Tahiti. He knew his ongoing links with tribal land, his access to marae such as Hongoeka and Takapuwahia was assured; opportunities for his cultural expression to thrive were plentiful.
Twelve years ago in March 1995, this hall was transformed from a supermarket to a super gathering place – and in the years that have passed it has lived up to its name Te Akapuanga Kuki Airani, the gathering of the Cook Islands.
It is environments such as this gathering place – or our marae - which allow us to express our values, our language, our customs, our birthright. And they are intimately connected to our inner strength, our health, our cultural wealth.
Workforce Strategy
Finally, I want to bring us back to the commitment that HCA members are making to improve health access; to demonstrate health promotion; to share information; to remain firmly fixed on the promotion of wellness, rather than the management of disease.
When Sir Maui Pomare was still attending Te Aute College, he and two of his school friends went around the villages of Hawkes Bay passing on the message that Maori had to improve their longevity. In 1891 they formed the Association for the Amelioration of the Condition of the Maori race, which amongst other things, recommended that alcohol should be prohibited and so too “meetings deemed to be useless”. The Association met with a fairly hostile reaction and eventually dissolved.
Whilst I could probably agree with both those proposals, the point was that the boys were prepared to take risks in speaking out about matters of healthy lifestyle.
Today we may add to those lists the life threats posed by ‘p’, problem gambling, unprotected sex, tobacco use - as well as the broader impacts of colonisation, land alienation and confiscation, seabed mining, and so many of the other fierce political debates raging over matters of customary ownership and cultural survival.
But I better not get started……
Except to say, we must continue to get involved, to weather the storms, in order to truly realise our dreams.
I know when mentioning people I will have omitted some and run the risk of offending. I am aware I have not mentioned the other tuakana from Niue, Tokelau, Tonga, Fiji so to you and to others whom I have not mentioned my apologies. I stand before you as a willing student and learner, keen to hear about our whakapapa stories from your point of view. All of which I know will be true.
If I could leave a message for your fono it would be that daring to dream is only constrained by the boundaries of your imagination.
We must hold true to our Pacific vaka; to celebrate our cultural brilliance, and to remain confident that our epic swim for survival will enable us all to reach the shore.
ENDS
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