Community, News

A project led by the Whangārei South healthcare locality, one of six localities being set up by HPF member Mahitahi Hauora across Te Tai Tokerau, is getting out in the community to help young people develop and be mentally well.

Whakapiki ake Taitamariki’s first community event for this year was held at the Onerahi Community Gardens on 10 February to help strengthen services and support for local young people. Around 30 Onerahi locals joined in the event, including whānau, young people, community group representatives, teachers, and nannies with their mokopuna.

Whakapiki ake Taitamariki Coordinator Sapi Iuliano said the project team wanted to connect with the community in their own space, especially whānau and young people, to build and strengthen relationships.

“We chilled over kai together and talked about our services and opportunities to collaborate with other stakeholders working to support local young people. We also got some of the local taitamariki involved in a youth group to mentor others and help organise events and activities by and for young people.”

Mahitahi Hauora Portfolio and Locality Lead Bernie Hetaraka said the Whakapiki ake Taitamariki project emerged from hui held in 2019 with communities in Raumanga, Onerahi, Bream Bay and Dargaville.

“Our communities told us our first priority should be to support the development of our taitamariki. They wanted more youth workers, support for young people to set goals and achieve milestones such as getting a driver’s licence, improved access to healthcare services for young people, and more recreational events and activities for young people,” she said.

“The collaborative way of working in a healthcare locality made Whakapiki ake Taitamariki possible. Localities bring healthcare practices and providers, community and social services, and local community and whānau together to deliver health and social care in partnership. Our projects are guided by the priorities of the community.”

Following on from agreement about what Whakapiki ake Taitamariki needed to focus on, Mahitahi Hauora worked with stakeholders to build a plan to start introducing some of those things, pulling the team together to make it happen and securing funding. The project then went to the Mahitahi Hauora Board for approval, which it received in March 2020.

In the Whangārei South locality, primary health entity Mahitahi Hauora is working in partnership with Whangārei Youth Space, healthcare providers, community groups and whānau on the Whakapiki ake Taitamariki project. 

Whakapiki ake Taitamariki is introducing youth workers to mentor young people and organise activities and events.

Further community events will be held approximately once a fortnight, and people can follow Whangārei Youth Space’s Facebook page for information about future events.

Banner photo from left: Allan Tipene, Senior Youth Worker at Whangārei Youth Space; Chaston Kay, member of the WAT (Whakapiki ake Taitamariki) youth group; Stormy Kay, Youth Development Worker at Whangārei Youth Space.










Experts, News

Dr Kate Morgaine has worked professionally in health promotion for about 15 or so years and is an academic (teaching and research) in Te Tari Hauora Tūmatanui at the University of Otago.

In this interview with Hauora Dr Morgaine gives some insight into why health promotion was so appealing to her as a ‘young feminist’ and the progression of her career from a high school teacher of physical education and health to her current role.

Wanting to share her experience with the next generation of health promoters prompted her move into academia and she gained a PHD focused on evaluating an occupational safety programme that had been rolled out nationwide.

She also discusses the advantages for health promotion that the National Accreditation Standards will have in Aotearoa and has some great advice for up-and-coming health promoters.

Hauora: You launched your career in health promotion in the mid-1980s? Can you tell us a bit about your early days in health promotion and what attracted you to this field?

Dr Morgaine:
What attracted me to health promotion, and public health more generally, was the call to social justice and to equity. I was already a young feminist and health promotion gave me a framework for thinking about and addressing social justice and equity issues. It was love at first sight, and a “long obedience in the same direction [that results in] something which has made life worth living” as Nietzsche put it, although in a somewhat different context.

I started my professional career as a high school teacher of physical education and health. At that stage, schools were only allowed to teach about menstruation and the basics of biology. Teaching about sexuality was restricted to Public Health Nurses and Family Planning educators. In my first year of teaching at a rural girls’ high school the Family Planning education team came to school for a week. I thought “that is what I want to do”, so I knocked on the FPA education door in Christchurch. Thankfully, they employed me to work in sexuality education with young people. As a 24-year-old, I was practically a peer. As we know, NGOs don’t have a lot of money, so that job was time limited. The training I received in developing teaching sessions and group work leadership was excellent and has stood me in good stead for my entire career. Two years on, and a job was advertised for a Health Education Officer (HEO) at a pilot Area Health Board (AHB). I was lucky enough to secure that job. In the 1980s most HEOs were employed in the district offices of the Department of Health.  All newly employed HEOs were formally trained through a one-year certificate at the Department of Health. Each region usually only had one person employed by the DoH or area health board. This was the case in my AHB; however, I was fortunate enough to have an NGO colleague to work alongside with. Although called an HEO, the work was what we now call health promotion. The Ottawa Charter for Health Promotion was published during this time for me. It was an exciting and heady time for all of us involved. My professional health promotion practice has been primarily in the areas of sexuality, and alcohol harm reduction; with a couple of years working in the UK in a sexual health clinic that included counselling and support for people with HIV in the time before treatment was available. On my return home, I worked in health promotion for a few years in Otago. Just before entering academia, I returned to the UK and did a short term (6 month) stint in Oxfordshire developing, writing and workshopping with the community, a rural health promotion plan for them. Rurality in southern England is a whole lot different than it is here.  

What prompted you to enter the ‘world of academia’ in the early 2000s and what universities did you start teaching in before you commenced your role as health promotion academic at the University of Otago?

Dr Morgaine:
After working professionally in health promotion for about 15 or so years, I decided that what I wanted to do was share my experience with the next generation of health promoters. The only way to really do that in New Zealand (and get paid enough to support myself) was to move into academia; and the only way to get a job in academia in the current climate is to have a PhD. So that is the path I followed. My PhD focused on evaluating an occupational safety programme that had been rolled out nationwide. Although occupational safety wasn’t something I had done previously, evaluating the development, implementation and impact of a health promotion/education programme was definitely in my wheelhouse.

During that time, an academic position in public health opened up in the Faculty of Dentistry in Dunedin. There are precious few academic health promotion jobs across the country, so I jumped at the chance. Teaching public health and health promotion in a clinical setting was challenging and interesting. It certainly made for interesting days. After 8 years I spread my wings and moved to the UK to be the Subject Co-ordinator for the public health Master’s programme at Oxford Brookes University. I taught and supervised across the breadth of public health, while also teaching the health promotion courses. Probably half the students were international students with really broad experience in the world of public health. I think they taught me as much as I taught them.

I moved back to an academic position at the University of Otago almost five years ago. It is a joy to be home.

How would you describe your current role, and have you seen an increased interest in health promotion from young people since you started?

Dr Morgaine:
My current role is as an academic (teaching and research) in Te Tari Hauora Tūmatanui or the Preventive and Social Medicine Dept (an old name for Public Health). Although it was a generic position, I am lucky enough to be teaching almost exclusively in my specialty of health promotion for the first time. I teach the undergraduate introduction to health promotion. In the time I have been back the class size has increased from about 70 to about 90 on average each year. The Bachelor of Oral Health students make up a good portion of the class. The numbers have increased since Otago has offered a Bachelor of Health Sciences majoring in either Public Health, Māori Health, Global and Pacific Health, or Community Health. It is exciting to work with young people who are also interested in social justice and equity. I also teach postgraduate papers – one focused on the broader determinants of health, and one focused on the practicality of planning and evaluating health promotion projects/programmes. Our class sizes have grown in this area too. Young people in both the undergrad and postgrad courses are strongly driven by what they can contribute to addressing social justice. I particularly enjoy the reciprocity in these classes.

My research is focused on evaluation of programmes and projects, how best to improve what we do. I do this work with people employed in Public Health Services as well as people who work in their communities. I like to work alongside people, and I like to be useful to them. This is what drives my approach to research.

You have said that you are really interested in best practice in health promotion and bringing evaluation into everyday practice. Can you please elaborate on this?

Dr Morgaine:
I love my profession. I want us all to be the best we can be. I think knowing about the ‘how’ and ‘why’ of what we do is really important. It means we can serve our communities and contribute to wellbeing in a way that is both helpful to them and justifiable to those who fund programmes. Without even realising it, we all undertake planning and evaluation every day. We make plans for our families, our friends, our selves, to address our own needs; and we evaluate them too, to decide if it was worth doing, worth doing again, or something we are going to steer clear of. Planning and evaluation in health promotion is taking those everyday things and getting formal about it. In my teaching, I try to make the various theories and approaches to planning and evaluation as practical as possible, so the skills can be used in real-life practice.

As you know HPF is working on the development of an accreditation framework for health promoters and providers in New Zealand with the goal to establish a national accreditation organisation (NAO), under the global accreditation framework of the International Union for Health Promotion and Education (IUHPE). How do you see this benefitting health promoters and health promotion in Aotearoa?

Dr Morgaine:
Health promotion is still a fledgling profession, even though the Ottawa Charter is 35 years old. Many people across all sorts of health professions say they do health promotion. And of course, they do to some extent. However, to be a Health Promotion practitioner you need to understand the depths and strengths of health promotion; its underlying principles and values; and the skills that are needed to practice well.

Having a formal process for recognition of experience, training, skills and knowledge, allows us as a profession to have a place to stand, and stand tall. It is an important part of being acknowledged as having speciality skills and values. It signals to the other health professions as well as to the community that we value ourselves and our communities. The NAO within Aotearoa New Zealand will specifically recognise our communities and approaches, as well as ensuring we meet international standards.

Having an internationally recognised accreditation signals our professionalism to other countries and makes it easier for our practitioners to travel to other countries to work if they want (once we are allowed to travel)

Do you plan to stay in the academic world and if so why?

Dr Morgaine:
Well, I am an old lady now. Changing jobs when you are my age is difficult. And I truly love my job – I love teaching especially, working with young people, seeing them make their way in the world – where else would I be?

Unless someone offers me some random other spectacular job that allows me to do all the things I love, this is where you will find me.

What would your advice be for up-and-coming health promoters?

Dr Morgaine:
Get some training under your belt so you have frameworks to help you approach new and different topics, projects, and so forth. Grab as much continuing professional development as you can. This will help you in your personal practice AND help you justify your plans and practices to those in the hierarchy.

  • Be open to working across different areas, so you gain as much experience as you can.
  • Find a way to challenge the status quo (in a way that means you can keep your job, if possible)
  • Find yourself a peer group who you can talk through the challenges and celebrate the good things with.
  • Find yourself a more experienced health promoter who can be a mentor.
  • And finally, in the words of my mentor many years ago, if you are not in trouble you are not doing your job properly. If our plan is to achieve social justice, we are bound to upset those who have power. Don’t be surprised if you find yourself in trouble, but be safe as well (hence the peer group, good training, etc)

Community, Experts, News
Dr Grace Wong has been an avid health promoter for many years and is a leading advocate for tobacco control in Aotearoa.

A part-time senior lecturer in Nursing, Associate of the Centre for Migrant and Refugee Research at AUT, Dr Wong is the founder and co-director of Smokefree Nurses Aotearoa.

The protection of the health of Asian New Zealanders plays a key role in her research. Haoura recently caught up with Dr Wong to discuss what it was like growing up as ‘fourth-generation Aotearoa-born Chinese’ in Christchurch, which at the time had a population of just 400 Chinese, her love for health promotion and what motivated her to get involved in the fight against smoking.

Dr Wong also shares about her work with migrant, refugee and asylum-seeker communities, as well as her involvement with an art-based initiative that aims to reduce racism, which was intensified around the globe and in NZ by Covid-19, against Chinese people.

HAUORA: Can you tell us a bit about what it was like growing up as a ‘fourth-generation Aotearoa-born Chinese’ and what it’s like to belong to a large extended family?

When I was little there were only 400 Chinese people living in Christchurch and not one was an extended family member. My Mum’s family came from Wellington, so we visited every Christmas. I remember roller skating up and down my Popo’s big old hallway. My Uncle Ray converted those skates into skateboards for me and my sister.  And then we whizzed down the drive and turned sharply on to the footpath, so we didn’t get hit by a car. My Popo made the best yum char long before there were lots of Chinese restaurants.

HAUORA:  What were your early career aspirations?

Being in a long line of oldest daughters I guess I was always bossy.
And I wanted to help people. I also wanted to know what to do if someone keeled over in front of  me. So, I became a nurse (and I try not to be bossy!).

HAUORA: You’ve been associated with HPF since the 1990s and we were delighted to welcome you to the HPF Board recently. What drew you to HPF and health promotion?

I love health promotion because it is the most optimistic of health professions. It draws out the best in individuals, families, communities and populations.
It  celebrates diversity. Everybody is welcome here.
That’s what drew me to health promotion and the HPF.

HAUORA: You have been dedicated to tobacco control over the years and have done a lot of research on smoking. What motivated you to enter this field?

DR WONG: In my culture, like others, we never forget a good turn. I will always be grateful to  Emeritus Professor Ruth Bonita, Dr Marewa Glover and Trish Fraser who set me on the tobacco control path. I love our country and its people. Tobacco control is about   equity. Everyone deserves a fair go.

HAUORA: Protecting the health of Asian New Zealanders has played a major part in your research. How big a problem is smoking among Asians here and is the smoke-free message getting through to them?  

DR WONG: I really appreciate this question because the illusion that Asian smoking rates are low   falls away as soon as the data is disaggregated by gender. Asian men smoke at nearly the same rate as the general population. Women’s rates are low. In Auckland we are  lucky to have Smokefree Asian Communities to help Asian smokers quit.

HAUORA: You were also the founder and co-director of Smokefree Nurses Aotearoa and use research to promote nurse action to achieve the Government’s Better Help for Smokers to Quit health target and the Smokefree 2025 goal. Do you see NZ as being on target to be smoke-free by 2025 and is enough being done to hit that target? How can we as health promoters help to achieve this goal?

DR WONG: Aotearoa is at risk of missing the Smokefree 2025 goal. I believe that we can serve people best by listening to them rather than buying into intense debates about what is right and what is wrong. Quitting smoking is incredibly hard. Our role is to advocate for and offer evidence-based options, practical support, and encouragement appropriate to peoples’ culture, circumstances and preferences.

HAUORA: Can you tell us about your work with migrant, refugee and asylum-seeker communities in this country and what sort of initiatives are in place to ensure their health and wellbeing, especially during Covid-19?

DR WONG: I was relieved to hear about the government meeting with leaders of ethnic communities recently. Many migrant, former refugee and asylum-seeker communities are fearful of Covid-19. They rely on sources they trust for information     and direction. Direct service delivery organisations like the Asian Network Incorporated, Asian Family Services and Shanthi Niwas Charitable Trust, listen to their communities, advocate for services for them, and support them mentally,  physically, socially and culturally.

Unfortunately, Covid-19 has exacerbated racism against Chinese people around the world. You are currently a project team member on the Aotearoa Poster Competition, an art-based initiative which aims to reduce racism against Chinese people, which has also been heightened in Aotearoa, by Covid. When did this initiative start, how does it plan to achieve its goal and how is it is progressing?

 The Aotearoa Poster Competition 2000 is a positive pushback against an ugly    reaction to a frightening pandemic. It is a response to a marked increase in racism against Chinese people. The campaign aims to redirect hearts and minds away from blame and anger, and to encourage everyone to stand up to racism safely. The Museum of New Zealand, Te Papa, just added the four winning posters to their collection. They are expressive, meaningful and beautiful.  

Banner photo: Photo by Stephanie Krist on Unsplash