Maori

A health and wellbeing programme designed to support rangatahi to enhance their hauora and develop a sense of identity and belonging was successfully delivered by Te Korowai Hauora o Hauraki in Thames High School last term.

Phusion, which is a collaborative programme working alongside schools and various youth support services and other community health providers, is “interactive, challenging and fun”, says Mahinaarangi Skipper, Kaikōkiri – Iwi Health Promoter (Sexual Health).

 Ms Skipper says after participating in the programme Rangatahi will be able to demonstrate knowledge in Nga Taonga Takaro and participate in various traditional Māori practices such as mau rākau, karakia and pepeha.

“They will understand the importance of maintaining a good overall health, develop leadership skills and have ability to work in a team environment.

 She says Phusion also equips rangatahi with the information and strategies necessary to make safe choices.

“We strive to ensure our taiohi health and wellbeing is a priority and ensuring our tamariki gain skills to guide them through their journey into adulthood.”

 Ms Skipper adds that the students loved doing the programme. One thing they had to ensure she says was that “we found different avenues for our taiohi to express themselves without standing up, smaller group discussions worked out well for our rangatahi.”


ABOUT PHUSION

 Phusion was developed by Whakapai Hauora, Iwi health service based in Palmerston North and was developed to support rangatahi Maori to make heathier lifestyle choices.

 The fusion of physical activity, nutrition, Hauora, resilience and cultural identity supported rangatahi Maori to address specific health issues and promote awareness of ora and support the integration of traditional Maori practices.

The programme is still run by Iwi health services in Palmerston North. The name Fusion was created by those who founded the programme, Rachel Ngataki and Taylor Hakaraia-Woon who worked in their Public Health team. The programme was then gifted to Emma Hawkins, Te Korowai Hauora o Hauraki’s previous kaimahi who introduced it to Hauraki.

Te Korowai adopted the programme in 2019 to encourage key health messages in schools

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Professor Fran Baum, one of Australia’s leading researchers on the social and economic determinants of health has been quite vocal recently about the importance of a ‘social vaccine’ to rebuild a fairer and more sustainable world post Covid-19.

Hauora asked Prof Baum who is the Matthew Flinders Distinguished Professor of Public Health at Flinders University in Adelaide, Australia to explain about what the vaccine is and how it would work.

We also asked the foundation Director of the Southgate Institute of Health, Society and Equity about the role of health promoters in helping to rebuild a better world after Covid, as well as the role of good governance and leadership.


Hauora: I read in an article you wrote recently about when the Covid-19 pandemic eventually ends the inequities it has highlighted will remain, unless a ‘social vaccine’ is developed and applied. Can you please explain what a ‘social vaccine’ is and how this will help to shape the world post-Covid?

Prof Baum: A social vaccine comprises government and other institutional policies which aim to keep people well and mitigate the structural drivers of inequities in daily living conditions, which make people and communities vulnerable to disease and trauma. It also includes the importance of civil society groups who advocate for such policies. The target of the social vaccine is the conditions that underpin four basic requirements for global health and equity to flourish. These are: 1) A life with security; 2) Opportunities that are fair; 3) A planet that is habitable and supports biodiversity, and 4) Governance that is just.

Hauora: You also explain that ‘the delivery of public policies at the heart of a social vaccine require considerable civil society advocacy to ensure their development and effective implementation’. Can you please elaborate on this?

Prof Baum: I have always believed (supported by evidence) that civil society advocacy is vital in bringing about healthy public policy in all sectors. I have used the metaphor of a nutcracker (see illustration) to show that improving health and health equity requires both top-down policy action and bottom-up advocacy. Historical examples make this very clear. For example, in the cases of the abolition of slavery and franchise for women, civil society was vital in arguing for these changes and ensuring politicians listened to them. For an examples from Covid-19 I would give the People’s Health Movement which has launched a campaign to ensure equal access to Covid-19 Essential Health Technologies (EACT)  including vaccines (see here).

Hauora: What contributions do you think health promoters can make in helping to shape a better future?

Prof Baum: I think they can ensure that the debate about Covid-19 goes beyond the need for a vaccine to considering how the inequities that have been laid bare by Covid-19 can be reduced. For example, the pandemic has shown the weaknesses that casualised employment introduces. In India, many migrant workers did not have secure work and had to walk to their home villages often hundreds of miles away. On the way many become sick, had little food, were subjected to police brutality and some even died. In Australia workers in the gig economy have no sick leave or secure employment and have been shown to be a weak link in our defences against a pandemic.

On a broader scale, health promoters can look to the underlying causes of Covid-19 and point to the importance of taking an ecological view of health. There are an increasing number of emerging infectious disease and the evidence suggests that deforestation is a key way in which infectious agents jump from animals to humans.

Hauora: If there is one thing this pandemic has highlighted it is how crucial good governance and leadership is? What is your view on this?

Prof Baum: Yes, the politics of the pandemic are vital. Political will to accept public health advice is crucial. We have seen in the US how a leader who rejects this advice creates catastrophic consequences with Covid-19 deaths in the US topping a quarter of a million. By contrast other countries like Vietnam, Thailand, Australia, and New Zealand have had very low rates.

Hauora: Women leaders, especially, have been lauded for effectively guiding their countries through the Covid-19 pandemic. What common threads do you think have contributed to their success in responding to this crisis?

Prof Baum: In New Zealand you have, of course, the wonderful example of your Prime Minister Jacinda Ardern who has led with empathy, compassion, clear communication and also taken the hard public health advice. I think those characteristics of a political leader are the key to dealing with a pandemic.

Hauora: Is there anything else you would like to add?

Prof Baum: The most central thing for health promoters to keep emphasising is that we need to ensure that our political leaders govern for health not profit in each sector of society.
I argue this point in my book Governing for Health: Advancing Health and Equity through Policy and Advocacy.

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Grant Berghan brings a wealth of experience to his new role as CEO of the Public Health Association of NZ.

Mr Berghan who was in public health for 25 years is from the Tai Tokerau region with whakapapa links to Ngapuhi, Ngati Wai and Te Rarawa iwi. He has extensive experience in the health and labour market sectors, and more recently has been involved in regional economic development activity in Northland.

Hauora asked Mr Berghan who joined PHANZ in October about his decision to return to the public health field, what some of his priorities and goals for the organisation.

Mr Berghan who was a past member of the Maori Advisory Board (Public Health) with the Ministry of Health also discusses the leading role NZ has taken in responding to Covid-19 and how this can be extended to resolving other major issues such as poverty and racism.

Hauora: After 25 years working in public health, you have said this is a bit of a return to your roots. What prompted you to return to this field, and how much influence on your decision to apply, did Covid-19 play?

Grant: It’s interesting how these things play out. I had spent the last five years working in regional economic development, based in Northland. The role of the CEO for the PHA came up just as I was looking for a change, so I jumped at the opportunity. Covid-19 did factor into my decision to apply. Our “go hard go early” response has proven to be an effective strategy, and New Zealand is seen as a world leader in responding to Covid-19. I think we can easily leverage this success into other areas of public health.


Hauora:
What are some of your first priorities in this role?

Grant: There are a number of priorities, but they will revolve around the two big ones of climate change and addressing poverty. Everything else will fall out of those two. For us as an organisation, we’re going through a bit of a reset after a challenging year. I’m keen to build our capacity and capability at national office (so we can execute the work programme in front of us) and to grow our membership throughout the country. I’m waiting on Government’s response to the Simpson Review of the Health and Disability sector – that response will inform some of our tactics over the next three years. I’m keen also to work with others to provide a joined-up public health leadership response to the Review of the Health and Disability Sector.


Hauora:
What goals do you have for the PHA and how confident are you in achieving those?

Grant: The three big goals relate to growing our organisation, strengthening relationships with others, and executing a plan of action that address our priorities over the next three years. I’m confident we can achieve those goals but do not underestimate the challenges that we will face in doing so.


Hauora:
You said upon your appointment, that NZ has shown itself to be a world leader in responding to Covid-19, and that opportunity extends that leadership to include poverty, homelessness, racism, and other social and economic determinants of health. Can you elaborate on this please?

Grant: We have done really well managing Covid-19. There is absolutely no reason why we cannot be a world leader in resolving poverty, racism and the other big issues that confront us. What is required is the political will, ambition and courage to do so and the means to enable that. The Government has been given the mandate by this country to govern on its own. If ever there has been a chance to make a difference, now is that time.

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Community, News

“Otara Health (OH) walks its talk and strives to encourage the organisations in the systems across all the sectors to lower their barriers to work better together.”

OH’s Operations Manager Mark Simiona made the comment in an interview with HPF’s Hauora newsletter to discuss the impact the Covid-19 crisis has had on the organisation’s services and what are some of its current major collaborative projects.





Hauora:
Can you please tell us about one or two current ‘health promotion’ initiatives/collaborative efforts that Otara Health (OH) is engaging in to build a healthier community and how they are progressing?

Mark:
Te Ora Puāwai Collective – This is funded by Counties Manukau Health led by Otara Health. This is a collective of eight organisations to design with patients a model of care for people with long-term conditions. This collective is made up of Otara Health Charitable Trust (lead organisation), Health Promotion Forum, Manukau Urban Māori Authority (MUMA), The Heart Foundation, Disability Connect, Pro Care, ZOOM Pharmacy, Otara Family Christian Health Centre.

Once the design is completed and submitted it may become a model of care to deliver for the next five years.

Project NEMO – This is a collaborative initiative birthed as a Covid-recovery plan with the Thriving Otara movement for the Otara community by those who live, learn, work, play and pray in Otara. This will be a community hub made up of a collective of organisations serving to meet the needs of community impacted by Covid-19 by providing coordinated referrals to key agencies based on the need of people including a foodbank and wrap-around services including support with business, education, employment and getting connected.


Hauora
: How did Otara Health respond to the Covid-19 crisis and has this had much of an impact on how you now deliver your services?

Mark:
Throughout lockdown Otara Health adapted quickly to work remotely from home and continued to provide its services virtually. Staff attended daily online check-ins via ZOOM and utilised phone, Facebook and any other means to connect with participants. Now in level 1 OH is applying much of the learning to deliver services better providing a mixture of face-to-face and online delivery.


Hauora
:
Otara Health places a strong emphasis on building community leadership and advocacy skills to empower people to lead change within the community. Can you please elaborate on this?

Mark: Otara Health uses Twyford’s Power of Co and Results Base Accountability (RBA) for the delivery of its services, systemic influence and collaborative engagement. Our challenge to organisations is to look at what they can do differently to get a different and hopefully better result. OH continues its work through Thriving Otara to lead a change of thinking about how to improve delivery and who you need to work with to do it. This is also based on the principles of the Ottawa Charter.

In our frontline delivery OH uses strength-based, whanau-led approaches like, Fono Fale, Te Whare Tapa Wha and appreciative Inquiry to look at what is important to whānau when making contact and doing in-home assessments.

In short OH walks its talk and strives to encourage the organisations in the systems across all the sectors to lower their barriers to work better together.


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