Matariki: Te Tau Hou Māori is one of our favourite times of the year and a chance for whanau and friends to reflect on the past, celebrate the present and plan for the future.
HPF’s Maori Health Promotion Strategist Mereana Te Pere said it was great to see how Matariki, which is being celebrated nationwide until July 11, had gained recognition over the past few years.
“More people now recognise the mana and significance of the Māori calendar and how we can better harmonise our lives with the rhythm of nature.
“Increasingly we’re learning that Matariki not only acts as a time marker, but also as an icon for Māori pūrakau, atua, and a tool that connects our physical bodies with the spiritual realm and the changing of seasons and elements,” said Mereana.
Mereana said it was thanks to Māori leaders such as Sir Mason Durie and Prof Rangi Mātāmua, that the move to living a life guided by Māori models and the maramataka had grown traction and were now recognised in many fields as beneficial for health and education in Aotearoa.
Sir Mason introduced Matariki as a guide for health promotion at the World Conference on Health Promotion in Rotorua in 2019. (PICTURED)
“Matariki provides a health promotion agenda for Māori and Indigenous peoples that endorse Indigenous rights, keep our skies clean and fresh, protect our lands, preserve our native forests, enable whānau and families to flourish, support community initiatives, safeguard our rivers and ocean, and restore nature’s balance,” he said.
“The indigenisation of our thinking and systems is shifting and widening the scope of how we can live and tackle challenges,” said Mereana.
HPF has welcomed Government’s plans to revamp and strengthen the healthcare system to provide more equitable and better health care for all New Zealanders.
NZ’s Health Minister Andrew Little who unveiled the major changes yesterday (May 21) said ensuring fairer access for all New Zealanders and putting a greater emphasis on primary healthcare were two of the main drivers of the reforms.
“The reforms will mean that for the first time, we will have a truly national health system, and the kind of treatment people get will no longer be determined by where they live.
“By making these changes we can start giving true effect to Tiro Rangatiranga and our obligations under the Treaty of Waitangi,” said Mr Little.
The main changes include the setting up of a new and truly independent Māori Health Authority, aimed at overcoming the huge health disparities for Māori as a whole, and the replacement of the 20 DHBs by one new body Health NZ. A new Public Health agency will also be created within the Ministry of Health.
HPF’s Executive Director Sione Tu’itahi said HPF was pleased to see the creation of a Māori Health Authority (MHA) which would help not only to address the inequities, but also to acknowledging the rights of Tangata Whenua as the other partner in Te Tiriti o Waitangi, the founding document of our nation, and one of the two founding documents of health promotion in our country.
Mr Tu’itahi said however that by not including environmental determinants in the reframing was a missed opportunity.
“Let’s hope that the new Public Health Agency, and the MHA will pick this up. The health sector and all other sectors should seriously note that the planet is broken, as mentioned by the UN Secretary-General recently. We cannot achieve human health without a healthy planet.
“Overall, the reform is a move in the right direction, but let’s wait for the details, especially the distribution of power and the allocation of resources.”
Associate Health Minister (Māori Health) Peeni Henare said while New Zealand’s health system performs well overall against most international comparisons, it has significant issues delivering for Māori who continue to lag behind in key health status indicators.
“Māori health has suffered under the current system for too long,” Mr Henare said.
“We will legislate for a new independent voice – the Māori Health Authority – to drive hauora Māori and lead the system to make real change.
“It will have joint decision-making rights to agree national strategies, policies and plans that affect Māori at all levels of the system and it will work in partnership with Health New Zealand to ensure that service plans and the commissioning of health services drives improvement,” Mr Henare added.
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.”
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
Now more than ever we are able to put a spotlight on tough topics and hold people accountable so we can create a fairer society for everyone, writes HPF’s new Māori Health Promotion Strategist Mereana Te Pere
When I drive through the streets of Manurewa on the way home, I often hear the helicopter hovering above, usually as I am nodding my head to music. When I drive along Great South Road I see the effects of what happens when someone (or in this case a whole community) does not have adequate access to the right health avenues they need or are entitled to. In Manurewa it is not unusual to see queues of people a the local Work and Income office. There are three (soon to be four) prisons all within a 4km radius, homeless families sleeping rough outside the church and takeaway shops, and Pātaka Kai emptied out. On a positive note, the window-washers are always polite, even if I don’t have any spare change. Despite these things, Manurewa is my home away from home, and a place that has also given me wonderful memories and caring friendships. Times seem to be always be tough in ‘Rewa’, but make no mistake, some of the most talented and generous people I have had the privilege to know and work with, have been born in ‘the south side’.
I love my place here in Tamaki with the wonderful people I consider my city whānau. But sadly the situation here reflects my hometowns of Te Puke and Tauranga. There I see awa that are becoming too polluted from local orchards and factories for our kids to swim in. But we need jobs right? I see too many tangi as a result of suicide. I see whānau being sent home from the GP or hospital with a bill of health, only to end up in the urupā. And I see people resort to drug dealing because its the only realistic option for generating a steady income. In this profession there are no conviction or reference checks, no experience necessary and there is always high demand. This way of life can make perfect sense for the generations of families forced beneath the poverty line.
But surely it’s not all doom and gloom? I reiterate that I love my home. I miss my whenua all the time, and when I am able to return I feel re-nourished. My happiest memories come from a upbringing full of tree-hut building, endless days swimming at the river, adventures through the bush, and playing with all the cousins at the pā, because that was our safe place and the centre of the universe. Twenty years ago this was the norm, but times have definitely changed, and now so must we.
Thirty years ago it was normal to tease someone for being gay, obey your elders with blind loyalty and see parents smoking around the tamariki inside the family home. Fortunately in today’s world, people are more connected, more socially aware and more liberal than ever. Social justice movements like Mauna Kea, Black Lives Matter and #MeToo means we no longer have to ask for permission to be treated with fairness, dignity and respect, because it is our right. Now more than ever we are able to put a spotlight on tough topics and hold people accountable so we can create a fairer society for everyone.
And this is why I put my hat in to the ‘health promotion’ ring. I have always pursued avenues for the most vulnerable members of my whānau, and all Māori, to thrive and have the best opportunities for quality and fulfilling lives. But as simple as that might sound, history shows that progress is slow and arduous. So when I think of the challenges ahead, it is the love for my whānau back home and here in Tāmakimakaurau who have been short-changed, that pushes me to give 100% for everyone and never quit. I feel very fortunate to be in a role where I can tackle those tough issues and serve these communities. Being a Māori Health Promotion Strategist is more than a job and pay packet (although in these uncertain times I am extremely grateful for my job), but it’s also part of a life mission to contribute meaningfully alongside the many other champions around the motu, to the health and wellbeing of all Māori whānau.
Ehara taku toa i te toa takitahi, engari he toa takitini (My success is not my own, but from that of many)
The significant contribution that Trevor Simpson has made over the past decade to HPF, Maori health promotion and the world was reflected on at a farewell morning tea on Friday, October 9.
Mr Simpson who is Co-Executive Deputy Director and Senior Māori Health Promotion Strategist at HPF will take up the inaugural role of Chief Advisor, Māori, at PHARMAC at the end of this month.
HPF’s Board Chairman Mark Simiona thanked Mr Simpson on behalf of himself and the Board for his service and wished him well in his new role.
HPF’s Executive Director Sione Tu’itahi said he had really enjoyed working with Mr Simpson and thanked him for his wisdom, fantastic leadership, humility and fearless resolve and adherence to the values of the Forum.
“You built valuable relationships over the years with leaders and networks and generously shared your knowledge with everyone.”
Mr Tu’itahi said he was confident Mr Simpson would be more than capable of taking on the challenge of his new role at PHARMAC. “We are glad that Trevor’s new role is testimony to our HPF culture of building capacity to deliver outcomes, and enhancing service-leadership.”
Mr Simpson looked back on the many people he had worked with at HPF and some of the highlights of his time with the organisation.
“Over the years I have had the deep satisfaction of being part of an organisation that both demonstrates and entrenches its constitutional values and overarching principles in all that it does,” he said. “I leave here a different person.”
Mr Simpson (Tuhoe, Ngāti Awa) also acknowledged his ‘tipuna’, adding that the legacy they had left was a “blueprint of leadership’.
“Our elders back home are big on humility and humble servitude. If you don’t have that, then you can’t be a good leader.” Meanwhile in a press release PHARMAC said: “Trevor, as our Chief Advisor Māori, will ensure we receive robust Māori advice at a senior leadership level to inform and shape how we give effect to our commitment to Te Tiriti o Waitangi, including equity for Māori, into all of our work.”
“Ko taku reo tāku ohooho, ko taku reo tāku māpihi mauria.” Koinei tētahi o ngā whakataukī ka pēnei mai te Māori. E ai ki ngā korero, ki nga whakaaro hoki, he tino taonga kē tō tātou reo rangatira. He tāhuhu ki te wharepuni, he toka ki te moana, he pounamu mai rānō . I tuku iho te kōrerorero nei mai ngā mātua , mai ngā tīpuna kia kore ai tō tātou reo, e rite ki te moa, ka ngaro.
There are profound reasons as to why we should uphold and maintain Te Reo Māori, the first and indigenous language of our beloved country.
During Te Wiki o Te Reo Māori/Māori Language Week HPF encourages you to reflect on just how essential language is to one’s culture and its pivotal role in the sustenance of one’s identity and wellbeing/hauora – culturally, spiritually, mentally, and physically.
The theme for Te Wiki o Te Reo Māori which launched yesterday to mark the day in 1972 when the petition for te reo Māori was presented to parliament remains: ‘Kia Kaha te Reo Māori!’. Go to https://www.tewikiotereomaori.co.nz/ for more information.
In 1972, 30,000 signatures were delivered to the NZ Parliament calling for te reo Māori to be taught in schools. It was a defining moment in the journey to revitalise the language. The aim is to grow one million speakers by 2040.
Of 7000-plus languages in the world today, at least 2000 are being threatened by extinction. The loss of a language is a loss to all of our human family. In our new reality of one global community, cultural diversity is as important as biodiversity.
One simple way HPF suggests we can do to sustain all languages is to adopt an auxiliary language, in addition to each culture’s native language. Everyone can learn that same auxiliary language, alongside their mother tongue.
Knowledge and communications can be facilitated effectively across cultural boundaries, while each culture retains and advances its distinct identity, wellbeing and contributions to its own wellbeing and our collective wellbeing.
A new action plan that will help to achieve better health outcomes for Māori has been welcomed by HPF.
Whakamaua: Māori Health Action Plan 2020-2025 is the implementation plan for He Korowai Oranga, New Zealand’s Māori Health Strategy and will set the Government’s direction for Māori health advancement over the next five years.
Whakamaua is underpinned by the Ministry’s new Te Tiriti o Waitangi Framework. The plan presents new opportunities for the Ministry, the health and disability system, and the wider government to make considerable progress in achieving Māori health equity — a direction supported by the final report of the Health and Disability System Review.
HPF’s Deputy Executive Director and Senior Strategist in Maori Health Promotion Trevor Simpson says a pleasing aspect of Whakamaua is that it reasserts the relevance and value of He Korowai Oranga which was promulgated in 2002.
“Importantly, this operationalises He Korowai Oranga and provides a plan of action for work that will improve Maori health outcomes over time,” says Mr Simpson.
“One aspect that will need to be part and parcel of Whakamaua is the development of an effective and efficient, well-trained workforce. In this regard, health promotion and the health promotion workforce must be supported to fulfil this role.”
In his foreword to the plan Associate Minister for Health Peeni Henare says Pae ora is the overarching aim of He Korowai Oranga and is underpinned by the three key elements of whānau ora, mauri ora, and wai ora.
Mr Henare says ensuring the voices of Māori are captured in the plan has been an integral part of its development.
“The priorities and actions outlined are born out of the myriad conversations the Ministry and wider government had with key stakeholders including whānau, hapū, and iwi,” he said. “I am excited and hopeful for the opportunity this action plan presents.”
The Ministry’s Director General of Health Ashley Bloomfield says in his foreword that the Ministry will progressively update Whakamaua to respond to the outcomes of the Health and Disability System Review, and ensure we are well positioned for recovery from the COVID-19 pandemic.
“Our commitment to the Ministry’s obligations under Te Tiriti o Waitangi has fully informed the development of Whakamaua and will continue to inform its implementation over the coming years.”
Whakamaua outlines a suite of actions that will help to achieve four high-level outcomes. These are:
– Iwi, hapū, whānau and Māori communities exercising their authority to improve their health and wellbeing.
– Ensuring the health and disability system is fair and sustainable and delivers more equitable outcomes for Māori.
– Addressing racism and discrimination in all its forms.
– Protecting mātauranga Māori throughout the health and disability system.
The launch by the Environmental Protection Authority (EPA) of its Mātauranga Framework is a positive step towards recognising the role of indigenous knowledge in promoting planetary health, says HPF’s Deputy Executive Director Trevor Simpson.
The Mātauranga Framework aims to help the EPA, which is the Government agency responsible for regulating activities that affect New Zealand’s environment, incorporate Māori perspectives and mātauranga evidence into its decision-making.
Mr Simpson who is HPFs Senior Strategist in Maori Health Promotion welcomed the initiative and said “the acknowledgement of Maori world views in relation to Te Taiao, the natural environment and its connection to human wellbeing is a positive step.
“It is recognition that indigenous knowledge can inform our approach to nature, the ecosystem and our kaitiakitanga relationship to life and the planet.”
The Principal Advisor in Kaupapa Kura Taiao, the EPA’s Maori Advisory team, Erica Gregory, said there was no one definition for mātauranga, but it could be described as a unique knowledge and understanding of Te Taiao – the natural environment.
“It has its own unique characteristics that are as valid as, but different from, other knowledge systems including science. A simple example of mātauranga would be the Māori consideration that when a pōhutukawa tree is in blossom it is also a good time to harvest kina.”
EPA’s Chief Executive Dr Allan Freeth said the Mātauranga Framework was the first of its kind to be developed for a New Zealand regulator.
The EPA plans to implement mātauranga into its decision-making, policies, and processes by June 2021.
The primary goals of the mātauranga programme are to:
Enable well-informed decision-making.
Ensure the EPA understands the issues and implications of mātauranga for its decision-making processes.
Increase the understanding of mātauranga across the EPA.
When HPF’s Executive Director, Trevor Simpson and his wife Vanessa decided to make a radical change to their career-based lifestyle, sell up and take to the road for a new adventure little did they realise they would soon find themselves in ‘lockdown’ up North. Stuck in a beautiful and relatively empty holiday park has given them plenty of time for reflection, writes Trevor.
By Trevor Simpson
In the weeks preceding the Covid19 level 4 “lockdown” (I do loathe the use of this word) my wife Vanessa and I had made the decision to completely change the career-based lifestyles we were living. Our plan was to sell our small apartment in Auckland, buy a nice caravan and traverse this beautiful country unencumbered and free to delight in the natural environment. The first two parts to the plan went remarkably well – within three days of listing, our apartment had sold and a week later we had acquired the caravan. Vanessa had resigned from her role as a registered nurse and I was fortunate enough to negotiate a reduced role with HPF that would allow me to continue to contribute in a small way to the important work that HPF does, while roaming the countryside.
Barely a week into our excursion, which comprised small stays in Orewa and then Kororareka, Russell, we found ourselves in Matakohe in the northern Kaipara. Here sits a beautiful holiday park set on a rise overlooking the harbor and the mangrove estuaries that spread out across the expansive water catchment that is the Kaipara. On the day we arrived the Covid19 alert level moved from 3 to 4, our travel plans came to an abrupt halt and here we were to be held for the duration of a 4-week lockdown.
A strange but fortunate outcome was the relative emptiness of the park (left). The off-season had just begun and other than the owner and her family there were only three other groups in the park. We later found out that two of these groups were visitors from the United States and Rarotonga, Cook Islands waiting out the mandatory stand-down period and hoping to receive clearance to return home. Unlike ours, theirs is a tenuous and stressful situation. They remain, like us, in isolation in Matakohe, although with enviable social distancing (50 metres or so) and the comfort of perfectly arranged bubbles. Amongst the groups, the general mood of conversation is one of hope, a sense of gratitude and good fortune, and I sense, a level of fortitude and belief that the crisis will soon end.
In the days since arriving I have found an unexpected sense of calm and contemplation. The restrictions imposed by Covid-19 have provided an unanticipated opportunity to take in those things that I might ordinarily have overlooked on any busy working day. This is a quiet and peaceful place but when you sit and listen, it resonates with the sound of the wind, the rustling of leaves, of birdsong and the melodic trills of insects. We witness Papatuanuku clothed in vibrant autumn hues. Here you see the sun rise and set every day. You watch the tides come and go. There is a pulse and rhythm to nature that I had forgotten somehow.
In April of 2019, the International Union for Health Promotion and Education (IUHPE) together with HPF held the 23rd World Conference on Health Promotion in Rotorua. At this conference we saw the drafting and ratification of the Waiora – An Indigenous People’s Statement for Planetary Health and Sustainable Development. For the first time we witnessed the inclusion of indigenous knowledge, world views and indigenous health promotion in a high-level legacy document. In doing so, the health promotion global community agrees that Indigenous knowledge should be part and parcel of the work we do in addressing the global challenges that confront humanity.
The Waiora Statement explains:
Core features of indigenous worldviews are the interactive relationship between spiritual and material realms, that our planet has its own life force, the special nature of our relationships with ancestral lands and the interconnectedness and interdependence between all that exists, which locates humanity as part of the planet’s ecosystems.
In reflecting on the Waiora Statement, this Matakohe experience has reminded me of two important aspects in terms of my role as an indigenous health promoter. The first is that in expressing my indigeneity I am asserting my intimate connection to the natural world, to nature, to Papatuanuku. I am not separate from, I am not above, but part of nature. My role and responsibility then, is to protect and sustain her for future generations – an overriding obligation to be embraced.
The second point and probably the most important, is that the glue holding all of this together is spiritual. It is Wairua.
Matakohe has uplifted me in unexpected ways. It has helped to me to “re-see” and reconnect. It has helped me to understand again what is important and what I’m called to. Covid-19 in all its global devastation and frightening impact will soon end but my indigenous spirit and the way I see the world as a health promoter will remain for the rest of my life.
An inaugural anti-racism, Te Tiriti o Waitangi and decolonisation online and offline open-access event to be held this month was inspired by a tweet from Kiwi singer, songwriter and documentary-maker Moana Maniapoto, says Dr Heather Came-Friar.
Dr Came-Friar who is one of the coordinators of Te Tiriti based Futures: Anti-racism 2020 (TBF2020) from March 21 – 30 said the tweet was about the need for more decolonisation training.
“The event is about building anti-racism capacity, deepening understanding about Te Tiriti, decolonisation, mobilising people, inspiring people, building awareness, knowledge and hopefully some action,” she said.
Dr Came-Friar who is a founding member and co-chair of STIR: Stop Institutional Racism said the response to the event was phenomenal with over 4500 registrations to date, 49 partners and “’lashings’ of watch-parties and associated face-to-face events.”
HPF’s Executive Director Trevor Simpson who is on the STIR team said the response to the event after months of ‘mahi’ was encouraging.
Webinar topics include institutional racism and anti-racism, decolonisation, building Tiriti-based futures and transforming our constitution. Overseas presenters will also discuss lessons for Aotearoa from their experiences with these issues.
The open-access webinars will be posted online, where they will become permanent resources for anti-racist activism and Tiriti education.
TBF2020 also includes face-to-face events in multiple locations, these will include Tiriti workshops, train-the-Tiriti-trainer hui, public talks, webinar viewing and discussions and community pot luck dinners. New anti-racism and Tiriti resources, both printed and online, will gradually be added to the site.
TBF2020 will start with a one-day hui on March 21, Race Relations Day, hosted by Te Rūnanga o Ngāti Whātua in Tāmaki Makaurau.
Check out the diverse programme at https://our.actionstation.org.nz/calendars/tiriti-based-futures-2020-events#
Waitangi Day on Thursday, February 6 marks 180 years since the signing of Te Tiriti O Waitangi (Treaty of Waitangi) and is a time to reflect on our nationhood and national identity.
is also an opportunity to reflect on the relationship between the Treaty and hauora,
health and wellbeing.
is widely understood that in part, Te Tiriti o Waitangi was drafted based on a concern
for the declining health of Maori at the time,” says HPF’s Deputy Director
in the context of health and wellbeing, the link to Te Tiriti o Waitangi remains
as relevant as ever. It is in matters of social justice, health equity and the need
to address the wider determinants of health. It draws on the importance of Tino
Rangatiratanga, Maori self-determination and mana motuhake.”
Executive Director Sione Tu’itahui said because it is about the wellbeing of
all peoples, and their environment, “Te Tiriti inspired us to organise the
world conference on health promotion last April. Additionally it influenced our
drafting of the conference’s two legacy statements. Further it has driven us to
consolidate Indigenous knowledge, especially health promotion, and planetary
health, at the international level, working with our partner, the International
Union for Health Promotion and Education (IUHPE).
Tu’itahi said viewed from that global vantage point, it is undoubtedly clear
that the wellbeing of one is the wellbeing of all, whether it is at the local,
national or global level.
increase in natural and human-made challenges, such as the coronavirus, fires
and cyclones, within the context of climate and other earth systems’ crises, Te
Tiriti provides a pathway to collaborative effort for the benefit of all.”
you can’t make it to the official celebrations in
Waitangi, there are numerous events to mark the day around the
HPF’s Executive Director Trevor Simpson discusses
the importance oforganisation-wide
of an organisation often rests on the skills, knowledge and competency of the
staff that it employs. When contemplating the importance of this we see that the
human resource element and the ability of an organisation to achieve its goals
are intimately entwined. The people we have in our workforce are critical to
success and without the right employees in place, we sometimes see less than
desirable results. The capability, capacity and retention of our workforce in
any organisation should be of paramount concern if we are to meet our long-term
health and other parts of the health sector, recruiting to an organisation
often means we are faced with limited choices in terms of bringing in competent
people. On the face of it, it depicts a fluid, dynamic and often transient
workforce that by nature reduces our choices. Additionally, we are sometimes
looking for specialist personnel, perhaps suitably qualified Maori, Pasifika or
Asian. In health promotion this is particularly evident where inducted staff
are selected to cover a role, and then are trained further to build competency.
forward that has seen measurable and positive results is the platform of organisation-wide
training in formal education. This approach provides for an organisation to
develop its staff through formal learning in the communities (and sometimes buildings)
in which they are working. The advantages of doing training in this way are
numerous and wide reaching.
probably not the most important (except to your accountant!) are the cost
benefits. The training and the trainers come to you in your community. Staff
are not required to travel to another location, meaning savings on commuting,
accommodation and per diem allowances. For some this means that issues around
childcare and making arrangements for whanau while they are away are also negated.
They simply go home at the end of the day. Additionally, with the practice of
paying a set fee, the organisation gets to make savings through having larger
numbers of their staff trained at the same time. The more staff on the course the
higher the saving.
benefits aside, the outcomes for the organisation and the communities which it serves
shouldn’t be underestimated. In health promotion we know that sometimes health promoters
are isolated in their role, have limited capacity to deliver the desired
outcomes because of this and are often required to explain the comprehensive approach
of health promotion to other staff. Organisational training not only diminishes
this problem but strengthens the organisation and makes it much more effective.
If everyone in the team understands health promotion, regardless of their own specific
roles, they become supportive of their colleagues and the notion of health
promotion itself. It is therefore a strengths approach to building a strong
organisation and by virtue of this, and over time, a strong community.
to do this kind of community development is to do cross-organisational
community training. This is where two or more organisations pool their funds to
have training delivered in their general location. A mix of staff from each
organisation attends the training. This approach can have an enduring impact on
communities. A critical mass of health promoters can influence beyond the
health care system to make inroads into the wider determinants of health at a
local level. Perhaps think along the lines of Local authorities, schools, early
childcare centres, workplaces, marae, housing and all kinds of community groups
– health promoters can work in and across any of these areas. In short, the
potential for improving and maintaining the health of communities is endless.
The HPF level
4 Certificate of Achievement in Introducing Health Promotion is one such course
that delivers in this way. This course is delivered in collaboration with the
Manukau Institute of Technology as the accredited institution, meaning that the
students who complete the course will gain a recognised qualification together
with 10 credit points. Although a formal framework the course can be delivered
off campus in the regions or in city and urban settings. Importantly it introduces
health training to returning or new students – an entry level course which can
lead onto higher education and professional development in the health field.
If anyone is interested in this type of training please feel free to contact firstname.lastname@example.org
A report into hazardous drinking
in New Zealand reveals that Māori who drink alcohol and live in deprived
circumstances are less likely to have a harmful relationship with alcohol if
they speak te reo Māori.
Figures on hazardous drinking among Māori which
were crunched by the Health Promotion Agency, using three years of data from
the New Zealand Health Survey showed the
lower the socio-economic area a non-reo-speaking Māori person lived in,
the more likely they were to drink dangerously.
HPF’s Deputy Executive Director and Maori Strategist Trevor says
these findings are important as they give efficacy to the assertion that the Maori
language is an important protective factor for the health of Maori.
“Once learned, Te Reo Maori effectively opens the learner to traditional
notions of health and wellbeing- deeper understandings embedded in the language
itself. In other words, Te Reo Maori can be viewed as a determinant of health
Hāpai Te Hauora GM Māori Public Health, Janell Dymus-Kurei
says the report adds to the evidence that te reo Māori me ōna tikanga (Māori
language, knowledge and traditions) are vehicles for wellbeing for Māori.
“Hopefully these findings will precipitate a new
approach to health promotion which positions matauranga Māori at the centre.
This is how we work in Māori public health and it’s time that the rest of the
system caught up.”
Key findings from the report also show: Māori with higher levels of education are less likely to be hazardous drinkers and inequities among Māori and non-Māori persist across all age groups.
HPF commends a new initiative by Ngā Pae o te Māramatanga (NPM)
New Zealand’s Māori Centre of Research Excellence to celebrate and recognise
the careers of three Māori leaders and visionaries, who have a long history of
bringing about major social change and impact in Aotearoa New Zealand.
Professor Rawinia Higgins, NPM board member, says the new Ruānuku positions formally acknowledge the generous
ongoing roles these exceptional Māori leaders have agreed to provide to NPM.
inaugural distinguished Ruānuku are: One of New Zealand’s most respected academics, Emeritus Professor
Sir Mason Durie, who was a plenary speaker at last April’s 23rd
IUHPE World Health Promotion conference co-hosted by HPF in Rotorua; Sir Tīpene
O’Regan highly regarded Ngāi Tahu kaumatua and academic and award-winning Emeritus
Professor Ngahuia Te Awekotuku who has been at the forefront of the women’s liberation movement
in New Zealand.
“Our first three NPM Ruānuku … are esteemed scholars, visionaries
in their fields, leaders in the life of our nation, and have brought about
considerable social change in the lives of many Māori,” says Prof Higgins.
HPF’s Deputy Executive Director and Maori Strategist Trevor Simpson says the initiative pays homage to three outstanding individuals who have made significant contributions in their respective fields.
“Nga Pae o te Māramatanga continue to lead the way in terms of Maori advancement in research excellence. Building on this, the Ruānuku acknowledgements are a timely and appropriate way to recognise individual achievements at the highest level, over many years of effort. In all three recipients, we have wonderful examples of leadership, persistence and servitude not only to Maori but to wider society,” he says.
Professor Rawinia Higgins, NPM board member says the trio are “esteemed scholars, visionaries in their fields, leaders in the life of our nation, and have brought about considerable social change in the lives of many Māori”.
NPM recognised these inaugural appointments yesterday (Oct 22) as Māori
and researchers from across the country gathered in Dunedin for the annual
national Royal Society Te Apārangi Research Honours Aotearoa awards. At Te Tumu
School of Māori, Pacific & Indigenous Studies, Māori senior students spoke
about how these Ruānuku have influenced their studies and inspired their career
Twenty years after introducing “Te Pae Mahutonga” as a framework for health promotion in New Zealand at an HPF conference in 1999, Sir Mason Durie introduced another star-based framework to guide health promotion for Maori and other Indigenous peoples.
Sir Mason introduced “Matariki” at the 23rd World Conference on Health Promotion in Rotorua, last April.
“Matariki is the Māori name for the cluster of stars also known as the Pleiades (or Subaru in Japan). It rises in mid-winter and for many Māori, it heralds the start of a new year, a time for remembering the dead, celebrating new life and planting new crops,” he said. “The focus on stars reminds us that we are part of an unbounded universe.”
Based on the eight main stars in the cluster, he named eight Matariki dimensions of health: Mana Tangata -Human dignity, Whānau Ora – Families, Hapori – Communities, Ranginui – The sky, Papatuanuku- The land, Nga Wai – Rivers and oceans, Ngahere – The forests, and Te Ao Tuturu – Rhythms of nature.
“Matariki provides a health promotion agenda for Māori and Indigenous peoples that endorse Indigenous rights, keep our skies clean and fresh, protect our lands, preserve our native forests, enable whānau and families to flourish, support community initiatives, safeguard our rivers and ocean, and restore nature’s balance, ” Sir Mason asserts.
He also pointing out that when combined, the six stars of Te Pae Mahutonga and the eight stars of Matariki can continue to guide health promotion for Indigenous peoples into the future.
HPF’s Deputy Executive Director Trevor Simpson, one of the principal architects of the Waiora Indigenous Statement reflects on its significance
The Waiora Indigenous Statement adopted at this year’s IUHPE World Conference in Rotorua provided a watershed moment for indigenous health promotion at the global level. It is a call to action which leverages on the assertion that indigenous people’s perspectives, worldviews and human experience informs a “new” way to think about health promotion and by virtue of this, a different perspective on planetary health and human wellbeing.
Of course, health promotion in its current format, largely based on western world views associates human health with the health of the planet. The Ottawa Charter identifies eight prerequisites, the fundamental conditions for health amongst which a stable eco-system and sustainable resources are but two. As broad fields of study these two areas remain vitally important, but it seems odd that planetary health and wellbeing is not specifically addressed within the existing health promotion framework. From observation it is more implied than defined. Further, it is difficult to discern where health promotion makes a clear and concerted effort to think past the Anthropocene, the current focus on an individual, human centred approach to health.
The Waiora Indigenous Statement provides some interesting
componentry to help us understand at a fundamental level where indigenous
thinking positions itself in the planetary and human wellbeing discussion. As the
document rightfully points out, indigenous people and worldviews are diverse. However,
when we overlay these aspects of diversity, we can then identify the
commonalities which draw indigenous peoples together.
This provides a powerful construct, particularly when we
centre on the core features; the interactive relationship between the spiritual
and material realms, intergenerational and collective alignments and that the
Mother Earth is a living being. It posits that Planet Earth and human beings
have a special relationship to each other, one founded on interconnectedness
and interdependence. We are therefore in the indigenous perspective, part of
nature and not above it.
In a pre-conference discussion with Tamati Kruger, one of
the highly acclaimed plenary speakers at this year’s event, he touched on a key
principle of the Tuhoe Iwi’s Waitangi claim settlement outcome, principally the
section in the Te Urewera Act 2014 in which the Crown (Government of Aotearoa
New Zealand) and the Tuhoe people agreed that the Urewera (previously the
Urewera National Park) was a “living person”. He suggests that this aspect was
an imperative in the settlement negotiations. Without it, it would have been
very difficult to reach an agreement.
As a significant precedent in law it is also nevertheless an
assertion of world views.
It comes with a necessary proviso of course, duties on both
parties: a living person should be cared for and nurtured. Care and nurture
have in turn strong elements of responsibility and obligation. Indigenous Tuhoe
people, therefore, have no choice but to provide for and nurture their piece of
nature and in return have their place and wellbeing secured. As Tamati said in
his plenary speech in Rotorua, “the Tuhoe people do not own the Urewera. The
Urewera owns itself”.
This indigenous viewpoint leaves much to ponder. It
questions our current thinking. It touches on the need for a paradigm shift in
the way human beings see themselves in their relationship with this living
planet. And it is now urgent.
As a living document we encourage all to endorse, use and
critically analyse the Waiora Indigenous Statement. It is an offering for
health promoters, policy makers and leaders. An intergenerational gift that
seeks to define what health promotion means from an indigenous worldview. It is
also a very useful resource to inform the development of health promotion
itself- to be part of the actual framework rather than sitting outside it. To
be part of a new design for people and planet.
The Waiora Indigenous Statement is a statement for all. It
asks that we make space for and privilege indigenous peoples voices and
indigenous knowledge in promoting planetary health and wellbeing. It offers a
new way of thinking, resetting the course for health promotion and sustainable
development. It suggests that if we listen carefully, we just might hear
something beautiful and profound. Something to learn, something to embrace. Something
for you, me and the generations to come.
By Trevor Simpson
In April next year Aotearoa New Zealand will welcome the global health promotion workforce to Rotorua City for what is arguably the most important event on the health promotion calendar. The 23rd IUHPE (International Union for Health Promotion and Education) World Conference 2019 on health promotion will bring together experts, practitioners and interest groups who will converge to discuss health promotion across a range of political, economic and social contexts.
At the earliest stages the notion of the importance of indigenous health promotion and the opportunity to leverage indigenous aspirations for wellbeing were at the fore. Elevating this discussion to the highest level became a driver – not only for the inclusion of indigenous elements in the conference programme but rather to underpin and permeate every aspect of the meeting.
There is an unprecedented opportunity for indigenous health promotion leaders to use this platform to share our ideas, strengthen our resolve and promote wellbeing from a specific indigenous perspective.
Milestones for Indigeneity – a conference with a difference
From the initial discussions around the feasibility of bringing the conference to Aotearoa New Zealand through to the eventual bid in Curitiba, Brazil, the team at the Health Promotion Forum (HPF) were deliberate in ensuring the place of indigeneity. Indeed, the bid made to the IUHPE Global Executive Board in May 2016, included an indigenous Maori approach that ensured cultural imperatives were attended to from the outset; thoughtfully laying a platform upon which the entire event will be projected. In doing so this conference will provide the basis for unity in diversity for global health promotion, aligning western, eastern and indigenous perspectives across the theme of sustainable development and planetary wellbeing.
There is an unprecedented opportunity for indigenous health promotion leaders to use this platform to share our ideas, strengthen our resolve and promote wellbeing from a specific indigenous perspective.
The overarching theme of the conference for the first time includes the indigenous term “Waiora” loosely meaning “life-giving water”. Similar to “Vaiola” in Pacific vernacular the word relates to the sacred nature of water as a life-giving element. Appropriately, delegates will be situated in the south of the Pacific Ocean, the largest body of water on Earth, the historical home to many indigenous people, all of whom maintain a deep appreciation and affection for the ocean and the islands upon which they depend.
Te Reo Maori a world-first
For the first time Te Reo Maori as an indigenous language will be one of the four official languages of the conference. It will not only be used and encouraged throughout but also built into the official programme. Delegates will be able to experience this from the opening powhiri (Maori welcome ceremony), the inaugural speech in the Maori language by a plenary speaker, Tamati Kruger through to the poroporoaki (closing ceremony) where in each case the language will take precedence. Broadly, indigenous Maori themes, language, storytelling, arts and performance will provide a wonderful array of cultural features to enhance what is shaping up to be a wonderful scientific programme.
Significantly, along with Tamati Kruger four of the other 11 plenary speakers are from indigenous backgrounds. Stanley Vollant, Sir Mason Durie, Tony Capon and Colin Tukuitonga will bolster what is already a strong format for indigeneity at the plenary level. In terms of leadership this group provides a global perspective that will influence indigenous health promotion practice well into the future.
The programme also includes an Indigenous sub-plenary and opportunities to observe and participate in oral presentations, workshops and poster walks where indigenous health promoters and those working in indigenous communities can share their ideas.
Committed to the cause
Some wonderful work is also going on in the background. For the first time a team of guest editors will pull together an Indigenous Supplement to the IUHPE Global Health Promotion Journal to be released in time for the conference. The propensity for a supplement such as this to reach across the globe is not underestimated and the leadership of the IUHPE team working on the journal, the editors and guest editors to engage in such a project is a fine example of commitment to an important cause.
Additionally, a small team is working on drafting a Rotorua Indigenous Statement (yet untitled) to be considered for ratification in Rotorua. Not underestimating the magnitude of this project, the team is looking to include a wide range of perspectives, draw on expert knowledge and finally put out a call for support. At this stage the proposal is to release draft one version early in the New Year for members to consider, followed by a second draft in early March. The third and final draft will be presented at the conference itself and with the support of the delegates, formally endorsed.
In mentioning Rotorua, it should be noted that Te Arawa, the tribal hosts and supporters of the conference are renowned not only for their hospitality but also for their cultural strengths in history, language and arts. These are significant factors which have contributed to tribal, social and economic development not only in the city but across the lake’s region. It is impossible to escape indigeneity in this part of the world. It is an indelible asset that speaks to a world of possibilities, not only for Aotearoa New Zealand but for everyone and every place.
Trevor Simpson is HPF’s Deputy Executive Director / Senior Health Promotion Strategist (with Portfolio in Māori development).
I tēnei tau ka tū tētehi o ngā mahi whakapakari o HPF ki Tāmaki Makaurau, arā , ko tō mātou Certificate of Achievement in Introducing Health Promotion. Ia tau, ia tau ka tuku a HPF i ētahi karahipi kia taea te tangata ki te whakauru ēnei mahi akoranga. Ko ēnei karahipi e tuwhera ana ki ngā tāngata katoa o Aotearoa. Ko te utu mō ēnei karahipi he rīpoata.
Nā runga i te whakahauhau a HPF ka āhei ngā tauira ki te kōrero , ki te tuhi hoki i roto i te reo Māori. Ko te kōrero tuhi e whai ake nei nō tētahi o ngā tauira, i roto i tōna reo mai Te Tai Rāwhiti . Ko te kaupapa o tōna kōrero a tuhi ko ōna mahara me ōna whaiwhakaaro i runga tēnei wānanga. Kia ora Tomairangi, e mihi ake tatou ki a koe.
Kei aku nui, aku rahi, aku whakatamarahi ki te rangi,
E tuhi ana au i tēnei reta kia koutou ngā pītau whakarei kua whai whākaaro mōku me tōna ngākaunui ki ngā mahi i horahia ki mua ia mātou i roto i ngā marama kua hipa. I roto i ngā wānanga e rua i haere ai au ki Tamaki Makaurau te ako mai i te rangatira me te kaiārahi rongonui ā Trevor Simpson. Ko ngā akoranga i ākona e au i roto i āua wiki e rua ki tōna taha kua kīkī katoa tōku hinengaro i te mātauranga me ngā tikanga e āhei ana ki te ao hauora me ōna painga katoa.
I mua i tōku tīmata i tēnei wānanga kaore au i tino mōhio ki te ia o te Helth promotion, nā tōku hanatū ki ēnei wānanga me te rawe hoki o te āhua whakaako ā Matua Trevor i kaingākaunui au ki tēnei mahi me tōku hiahia te whai i tēnei huarahi o te Health promotion hei tikitki ano mo tōkū mahunga. Ko tā ngā kupu ā tōku pāpā ā Apirana Turupa Ngata ki āu i roto i tōna whakatauākī, “E tipu e rea, mo ngā rā o tōu ao”.
I roto i ngā akoranga nei kua huakina ōku whatu ki te ao e noho nei me ngā uauatanga e pēhī nei i tōku hapu me tōku iwi Māori. Ko ēnei akoranga kua tuhia ki tōku rae hei taonga tuku iho mo tōku whānau, meinga kore mo tēnei kaupapa ka aha mātou te iwi Māori ā te ao hurihuri. Ko tētahi o ōku wawata nui he whai i ngā tapuwae o tōku māmā, he nēhi ā rohe mo Ngati Porou. Nā tōku whai i tēnei huarahi kua whai kē tōku māmā i mua mai i āu kua harikoa tōku ngākau.
Nō reira me mihi ka tika au ki te rōpu nei ā te Health Promotion Forum of New Zealand me tō koutou tautoko i āu me tōku whānau ki te whakatutuki i tēnei tohu hei tikitiki ano mo tōku whānau, tōku hapu me tōku iwi Māori. Ka hoki ōku mahara ki ngā wānanga me tēra whakataukī “ko te ātaahua o te noho tahi ā ngā teina me ngā tuakana i raro i te whakaaro kotahi” . Mēna kore mo te karihipi i whiwhia e au e kore au e taea te whakatūtūki i tētahi o ōku tino moemoeā, hei whakahoki atu ki tōku iwi nō reira he mihi manahau tēnei ki ngā kaiwāwāo me ngā kaiwhiriwhiri i whakahōnore i āu ki tēnei whiwhinga āu, e kore ngā mihi e taea e te kupu.
All New Zealanders are being encouraged to take part in Māori Language Week which launched on September 10.
Nau mai ki Te Wiki o Te Reo Māori – Welcome to Māori Language Week
Ngā mihi mahana ki a koutou i runga i tēnei kaupapa whakahirahira kua tau ki runga i a tātou katoa
“The Māori language is one of the best ways to say ‘We are New Zealanders’. Everyone can help to celebrate and revitalise our country’s first language,” says Māori Development Minister Nanaia Mahuta.
Te Wiki o te reo Māori runs from September 10 – 16 with the theme ‘kia kaha te reo Māori’ or ‘let the Māori language live’.
Mahuta says people can show their support for the language in many ways.
“Mums, dads and grandparents can show active interest and support for their kids as they learn Māori at school. If the school is not providing any Māori language, families can ask them to start.
“The business world and community groups can display bilingual signs to show te reo Māori is welcome in public and private spaces.
“And everyone can try a simple ‘kia ora’ (hello) or ‘mā te wā’ (bye) as they go about their daily business. Each time you use Māori correctly it is a valuable gesture to restore it as an everyday language. It all adds up”.
Prime Minister Jacinda Ardern who visited Wellington High School on Monday to mark the start of the week told students one of her biggest regrets was not learning how to converse in te reo Māori.
In response to a student who asked how te reo and tikanga would be a part in her daughter Neve Te Aroha’s life she said: “Clark and I have only had very early discussions – we’re only 12 weeks in – but we’ve certainly got the books to be able to ensure that she’s learning te reo even through her early storytime,” Ms Ardern said.
Ms Ardern congratulated Wellington High School for making it compulsory for all Year nine students to learn te reo.
“Te Reo Māori me ona tikanga underpins Māori World views, values and beliefs. Custom, culture and language are inextricably linked,” says Trevor Simpson, Deputy Executive Director, HPF.
“Learning Te Reo Māori is a fantastic way to build an understanding of Māori views on health and wellbeing. By saying “kia ora” to another person what we are actually saying is that we wish for the other person to be enveloped in wellbeing and this is articulated at the very first interface between two people.”
Sione Tu’itahi, the Executive Director of the HPF says while HPF supports Māori language week our support will continue until next year when for the first time te reo Māori will be an official language at a global conference.
Celebration of te reo Maori will be a highlight at the 23rd IUHPE World Conference on Health Promotion: WAIORA: Promoting Planetary Health and Sustainable Development for All in Rotorua from April 7-11 next year.
“Our aim to sustain te reo Maori is always long-term. Given that we are co-hosting this world conference, it is only right that we honour te reo Maori this way …”
As Emma Frost walked out of Te Papa where she had just shared about her tupuna Meri Te Tai Mangakahia she felt cleansed and reinvigorated.
“Moving out of Te marae I gratefully ran my fingers along the kohatu with the cleansing waters running over it,” says Emma who is HPF’s Activities Coordinator and Office Manager.
“For our talks had so moved us all there felt the need to wash away the tears, revitalise ourselves and move forward to new challenges.”
Emma was a panellist at a gathering of Māori historians, curators, archivists, and mokopuna who got together at Te Papa in Wellington on Sunday (August 12) to share an afternoon of kōrero and waiata in celebration of the diverse history of mana wahine.
In May 1893, Meri Te Tai Mangakahia (Te Rarawa, Ngāti Te Reinga, Ngāti Manawa, and Te Kaitutae) was the first woman to speak in any New Zealand parliament, presenting the motion that women should be able to vote and to be ‘accepted as members of the parliament’.
Her reasons included whanau who had no male issue or tane to look after their land. Or, their men were koretake in managing their whanau affairs.
“It never occurred to me that wahine Māori were involved in this world history action that not only helped shape our nation but that of nations around the world,” Emma told her audience.
“I was immediately impacted by this new knowledge because …. what I am familiar with in terms of great icons of women leadership in the history of Aotearoa are Jean Batten and Kate Shepherd.
“But this wahine: whose photo sits on the walls of our marae, who was the daughter of our great Chief Re Te Tai and the grand-aunt of my mother, Irene Frost became someone I could personally relate to, not just because of our toto but because we are both antagonists of women’s reform, kaitiaki of our burgeoning young women, keepers of the values important to us – whanau, hapu, iwi relationships, te Ao Maori and a future that inspires justice and peace… that is why I am moved to try and preserve and tell her story.Emma explained how Meri was also behind Ngā Komiti Wāhine, national forums for Māori women to debate land, cultural, and political issues.
“I currently sit on the Women’s Centre Waitakere, I’m tuned into campaigns advocating the rights for women – gender equality and increasing the presence of women on governance boards. As a member of the MWWL Wahine Māori Toko I te ora I am proud to continue her legacy of supporting and presenting on women’s issues.”
Emma said the memorable event was well received and there was a lively Q & A afterwards.
“Questions centred around what Mana Wahine meant to us? What do we think about funding for Captain Cook commemorations and how have the women who moved us inspired us professionally or in other ways? Some were moved to ears and we’re still asking ourselves ‘what happened’
Kiwi musician Ria Hall’s video of her open letter to the Prime Minister earlier in the day generated much discussion while her strong vocal range during her live performance at Te Papa was also one of the highlights of the afternoon.
Aroha Harris who was also a panellist summed up the event: “If you weren’t there, you missed out. Something powerful happened. I loved it – loved being a part of it; loved hearing you all and getting to know the women you chose.”
Others who payed tribute to the diverse history of mana wahine
Matariki Williams (Tuhoe, Te Atiawa, Ngati Whakaue, Ngati Hauiti) talked about the lady in the portrait by Wilhelm Dittmer titled Maori girl, whose identity is unknown.
Helen Brown (Ngai Tahu) focused on one of the “ordinary, yet extraordinary” women who populate our histories — Mere Harper (1842-1924) who was of mixed descent (Tahu mother and Pequot father). Over six feet tall she was famous for her work as a porter.
Aroha Harris (Te Rarawa, Ngapuhi) not only want to talk about Akenehi Hei as the first registered Māori nurse, and a pioneer in that sense, but also as a woman working steadfastly (and in historiographical terms, invisibly) at the frontline of Māori health.
Melissa Matutina Williams (Te Rarawa, Ngati Maru) centred her talk on Mira Szaszy as a complex woman who was both of and before her time in terms of gender politics and defining what a ‘modern Māori woman’ could look like, do and achieve in the mid-to-late 20th century.
Leonie Hayden(Ngati Whatua o Kaipara, Ngati Rango) chaired the talk capably and with foresight and understanding of the issues our ‘inspired women’ were facing.
REMEMBERING: Our very own Emma Frost pays tribute to her tupuna Meri Te Tai Mangakahia at an afternoon of kōrero and waiata in celebration of the diverse history of mana wahine Te Papa, Wellington.
SHARING: HPF’s Emma Frost, third from left, joins other panellists in celebration of the diverse history of mana wahine at Te Papa, Wellington.
Banner pic: A commemoration plaque to Meri Te Tai Mangakahia at her marae in Waihou.
Photo by Juliet Lagan
Health Promotion Forum is privileged to have had a brief catch-up with Adrian Te Patu.
Adrian is a past board member of our organisation and is currently co-vice president of the Public Health Association of New Zealand. Last year he became a member of the World Federation of Public Health Associations and has just begun leading the Federation’s indigenous working group. Here are a few words from Adrian.
We know you’ve had a few roles over the years. Could you tell us about some of those?
I really enjoyed representing my communities as an elected member of our Community Board on the Christchurch City Council. Local government is having an ever-increasing role in our lives and it was an advantage for me coming from public health where thorny divisive issues like fluoridation are the norm. I was elected before the earthquakes and the response, recovery and community engagement principles were paramount. I particularly enjoyed having the confidence of Ngai Tahu in my role.
What are some highlights from your work over the years?
What I particularly enjoyed in the early 2000’s was being a member of the Think Tank of the Te Waipounamu Health Promotion Coalition. This South Island group was an active part of the Health Promotion Forum that organised hui, symposia, discussion platforms and networked across the island. Some significant leaders in health today were part of this and we were supported wonderfully by our coordinator Helen Rance.
Tell us about current projects you are working on
It’s a privilege to lead the newly established “Indigenous Working Group” of the governing council of the World Federation of Public Health Associations. This is a fantastic opportunity to promote the plight of some of the 370 million recognised indigenous peoples of the planet. This association is a recognised civil society by the World Health Organisation alongside significant organisations such as; International Red Cross, The Order of St John, Doctors Without Borders and others. Our working group is in the forming stage at present.
What do you see as the emerging ideas, issues and foci for/of health promotion and public health?
The importance and continuity of the HPF and the PHA. This requires us to be relevant and to adapt to the environment no matter what the political sway or appetite is. No government or coalition should determine the right of these organisations to exist. So we make it so….
Any other comments?
The awarding of the 23rd IUHPE World Conference on Health Promotion to the Health Promotion Forum of New Zealand in Rotorua 2019 is an amazing accomplishment and is part of a well planned and executed series of events. This is due to years of dedication under the stewardship of Sione Tu’itahi.
A new paper, published in UK publication Ethnicity and Health in June, indicates we have a way to go to address ongoing inequities for Māori and other indigenous groups. It points out that, in the Aotearoa context, Te Tiriti o Waitangi “is a legislative, policy and professional imperative for the public health community.”
HPF Deputy Executive Director, Trevor Simpson has co-authored the paper, which finds that there is variable application of Te Tiriti o Waitangi and there is room for further development in many areas of the New Zealand public health service. It points to Treaty Understanding of Hauora in Aotearoa-New Zealand (TUHA-NZ) as “landmark document” and an essential tool to operationalise the policies outlined in Te Tiriti.
The paper Realising the rhetoric: Refreshing public health providers’ efforts to honour Te Tiriti o Waitangi in Aotearoa, New Zealand investigates the ways public health units and non-governmental organisations meet their Te Tiriti o Waitangi obligations in terms of service delivery to Māori. Drawing on data from a nationwide survey of public health providers the article argues New Zealand public health providers can strengthen efforts to advance tino rangatiratanga (Māori control over things Māori) in every day practice.
Trevor worked alongside Heather Came (Senior Lecture, Auckland University of Technology), Tim McCreanor (Associate Professor Massey University) and Claire Doole, (Senior Lecturer, Auckland University of Technology), to bring this important paper to fruition.
The work was supported with a grant from the Faculty of Health and Environmental Sciences, Auckland University of Technology.
Te Kōpae Piripono is a successful whānau intervention based in Taranaki. Te Pou Tiringa and the National Centre for Lifecourse Research, University of Otago have formed a research partnership to carry out a robust evaluation of the initiative. Research team members are Dr Mihi Ratima, Aroaro Tamati, Hinerangi Korewha, Erana Hond-Flavell, Dr Will Edwards, Dr Moana Theodore, and Professor Richie Poulton. The research programme is ‘Te Kura Mai i Tawhiti’.
About Te Kōpae Piripono
Te Kōpae Piripono was established in Taranaki in 1994 in the form of an early childhood education centre, and its governance body is Te Pou Tiringa. It was recognised in 2008 by the Government as a ‘Centre of Innovation’, with the potential to be implemented in other settings.
The initiative was premised on the accepted wisdom that early connection to culture, practice and language have a long-term effect on indigenous health and well-being. The emphasis on whānau ora has been integral to Te Kōpae since its establishment, with its underlying objective to respond to the social and cultural impact of historical grievance (massive land confiscations and Taranaki wars) and the continued trauma experienced by Taranaki Māori communities trying to restore their cultural and social strength and health and wellbeing.
Te Kōpae Piripono has been able to advance its vision in a way that is consistent with the Government’s Te Whāriki early childhood curriculum framework. The core aspiration of Te Whariki is for children to grow up as competent and confident learners and communicators, healthy in mind, body, and spirit, secure in their sense of belonging. The programme’s early-childhood centre setting allowed for greater self-management and provided a more reliable source of funding that reflected the wide range of activity the initiative hoped to achieve and sustain.
Te Kōpae Piripono aims to revitalise Taranaki Māori language use and cultural practices.
It actively promotes the use of Taranaki mita (regional language variation), tikanga (cultural practice) and taonga (oral and cultural resources).
There is critical awareness among leaders of the importance of whānau participation beyond the walls of the centre in the revival of language.
The initiative maintains a firm stance on active language use and acquisition and has a rigorous whānau selection and induction process.
The programme has also developed its own model for positive resolution of issues, called ‘Te Ara Poutama’, which may be used for both children and whānau members. Children learn to advocate for their needs, and to negotiate and find solutions themselves. The process helps isolate the issue from the person, enables constructive dialogue, and fosters trust and confidence to positively resolve issues.
Longitudinal research shows that influences in early life matter greatly in terms of how a person fares later in life across a wide range of domains. It has been demonstrated that high quality early life interventions represent one of the best ‘investments’ a society can make to ensure an optimal start to life – one which will net significant returns over time via long-term benefits for individuals, whānau and society. There is huge potential for intervention in the early years to lead to substantial health gains later in life across a broad range of health issues that disproportionately impact Māori. These include health outcomes related to non-communicable diseases such as diabetes, coronary heart disease, stroke and also mental health issues and disability. While there is clear evidence around early years interventions leading to improved outcomes, what is largely missing are proven interventions that address ethnic inequalities, are effective for Māori and achieve sustainable positive health outcomes across the life-course. The aim of the Te Kura Mai i Tawhiti research is to contribute to generating an evidence base around what constitutes effective early life kaupapa Māori programming for tamariki and whānau that will lead to improved health outcomes later in life for tamariki.
Te Kura Mai i Tawhiti – research programme
Figure 1: Te Kura Mai i Tawhiti Research Programme
A feasibility or Proof of Principle study is under way in 2016 to firstly demonstrate the ability of the team’s research methods to determine change over time in tamariki and whānau on key constructs of interest (e.g. tuakiri, whānauranga, self-control). The Proof of Principle study will focus on whether, over the course of a year, an individual changes over time, taking into account developmental changes.
Findings from the Proof of Principle study will be used to design two future studies. Firstly, a 10-year prospective project to compare same age cohort tamariki in Te Kōpae Piripono, with at least two comparison early years programmes selected from Taranaki or similar regions. This involves conducting a longitudinal study to compare groups across key child behavioural and whānau development measures (i.e. the measures used in the Proof of Principle study). In addition to the prospective study, a retrospective (historic) study will be undertaken (Figure 1 – as a part of Tangi ana te Kawekaweā). This will focus on previous graduates and whānau of Te Kōpae Piripono from the past 20 years (n>150 whanau) with an emphasis on graduate outcomes in health, education, Te Ao Māori and other determinants areas that may have been influenced by the kaupapa Māori child and whānau programming.
If the research generates robust evidence of the success of the Te Kōpae Piripono model, there is potential for the overall approach and/or key elements of the intervention to be scaled up for implementation in other settings (e.g. other ECE and Māori medium) to complement broader approaches to addressing determinants of health and education and in other domains. The research is currently supported by the Health Research Council of New Zealand, the Ministry of Education, the New Zealand Council for Educational Research and the University of Otago.
According to the New Zealand Medical Workforce survey released in late January 2016, Māori are under-represented in the medical workforce, when compared to the proportion of Māori in the general population.
An article in www.stuff.co.nz examines Nelson Marlborough District Health Board’s Māori workforce, where Māori make up 3% of the staff, compared to Māori residents representing 12% of the local population. The article explores the measures being taken by the DHB to redress the issue.
According to the DHB’s Māori Health and Whanau Ora general manager Harold Wereta a long-term aim of the board is to strengthen the diversity of its workforce. The board is exploring ways to improve the recruitment and retention of its Māori employers, he says in the article.
In the meantime the health board is working to improve the cultural awareness of all health board staff. “Māori health and health inequalities are the responsibility of all health professionals,” says Wereta
In October 2015 HPF’s Deputy Executive Director Trevor Simpson and Senior Health Strategist, Dr Viliami Puloka together presented to a multi-sectoral group in Kaitaia. “Towards Health Equity – putting the tools in the kete” discussed health and social inequities and suggested ways in which the group – from health and social services providers, WINZ and local authority representatives, police and education professionals – could work together to improve outcomes in their local community.
A working group formed from the meeting with the group continuing discussions and working more cohesively to improve equity in the wider northern region.
Zoe Aroha Martin-Hawke is National Manager – Te Ara Ha Ora: Māori Tobacco Control Leadership service at Hapai Te Hauora. Jo Lawrence-King finds out about her work and how it exemplifies the principles of health promotion.
Tupeka kore (tobacco free)
Hapai te Hauora has initiated a number of successful health promotion programmes, not least of which focusses on reclaiming a tupeka kore (tobacco free) Māori identify.
According to Zoe the organisation “strongly promotes a working model that focuses on empowering Māori communities to have a voice on tobacco harm, and to create environments that prevent future harm from a product that leaves our communities ill and dying. “
Hapai te Hauora promotes and provides practical examples on how to provide a platform for Māori communities locally, regionally and nationally to take action. The team also works alongside other local, regional and national organisations who are also showing leadership in these areas.
“We are dedicated to ensuring Māori are strongly represented in local, regional and national policy development opportunities,” explains Zoe. “Iwi prior to European contact were tupeka kore. Māori leading and participating in the development of healthy and culturally affirming public policy, which contributes to reclaiming this identity, is one of our key health promotion strategies.“
By having iwi, hapū and whānau leading change, the Hapai Te Hauora team believe it will see more of a positive impact on intergeneration health outcomes. This, they feel, will contribute more effectively to a sustainably equitable, healthy future for all.
All activities of the initiative have involved a process of evaluating outcomes based on empowering whānau and Māori communities to control their own wellbeing and to influence New Zealand society to ensure that their determinants of health are addressed. More recently Hapai have supported the development of a Rangatahi Māori Tupeka Kore Consumer action group. The group consists of young Māori wahine who currently smoke, but are on a mission to prevent other young Māori from taking the habit up. Their work is focused on changing how the product is sold in their local area. The wahine are informing their local community about rules and regulations regarding the sale of cigarettes and are encouraging communities to monitor local dairies to ensure they are not selling single cigarettes or to people who are under age. They are also to working with merchants; encouraging them to take a stand by becoming smokefree retailers.
Within this work Hapai also provides support for personal health by linking action group members to smoking cessation treatment services; providing them with the expertise they need to successfully stop smoking. Hapai/Te Ara Hā Ora often works to find ways to seamlessly link people with services, whilst also promoting the message that none of us is independent of our physical environment and that change needs to happen at all levels.
Hapai measures both short and long-term olicies, increased numbers of Tupeka Kore hapū, iwi and whānau and reduced rates of smoking initiation. The growing engagement of Māori in tupeka kore work is also an indicator of the success of this initiative.
The quality of the engagement is also measured, including such things as: transparency of the process; relevant, timely, fitting delivery of information and the degree to which the engagement is inclusive and culturally appropriate.
About Zoe Aroa Martin-Hawke
Zoe is a member of HPF’s board. Her broad background includes
Māori medium early childhood education,
Business and community partnership roles,
Managing strategic community engagement and bottom-up leadership movements for health issues such as problem gambling, nutrition and physical activity, tobacco control; alcohol and other drugs.
Zoe has also been heavily involved in workforce development opportunities and NZQA training programmes. Her focus has been on increasing knowledge and delivery of best practice health promotion initiatives; with an emphasis on engaging Māori in policy development at a local, regional and national level.
About Hapai te Hauora
Hāpai Te Hauora invests in community and whanau wellbeing locally, regionally and nationally. Since 1996 the organisation has supported communities to have a voice on issues that affect them and their whanau so that whole communities can be well. It also provides infrastructural support to the hauora sector to strengthen public health action.
Hapai does this through innovative research, workforce development, public health planning, information technology solutions and policy development. Along with its subcontractors or whanau whanui, the team also delivers on public health issues including tobacco control, problem gambling, alcohol and other drug harm minimisation, wellchild, nutrition and physical activity.
Health Promotion: Enlightenment, engagement and empowerment
View the powerpoint presentations from a workshop with Professor Sir Mason Durie on 17 September 2009.-
Power point presentations
Part 1 discusses the progress to date and looks to the future for Māori health
Part 2 focusses on the key role of whānau in Māori health.
A feature article on an Australian TV website has highlighted the issue of the indigenous health gap; an issue that echoes the situation of Māori here in Aotearoa New Zealand.
The article, by Bianca Nogrady, highlights the fact that indigenous Australians have a life expectancy ten years lower than non-indigenous Australians. She identifies social determinants of health such as income, access to affordable housing, stress and race as key factors in this gap.
Crowded housing and ear infections
Nogrady cites an example, by Professor Dennis McDermott from Adelaide’s Flinders University, of housing and ear infections. Where a large number of people live at close quarters – as is more common among poorer indigenous people – children are more likely to suffer repeat ear infections as they are passed around the household.
“What happens is that non-Indigenous kids get it maybe once, they have a brush with it, and then it’s gone,” says Prof McDermott. “But with Indigenous kids in an overcrowded situation, it goes around and comes back, goes around and comes back, such that it’s a huge impact on hearing loss.”
This hearing loss has life-long effects. Children can’t hear in school, adults can’t hear on the job, it can impact on mental health, anger management, and wellbeing, McDermott says.
The impact is doubled with racism
According to Prof. McDermott racism has a clear and proven impact on people, as does connection to country – or the land from which people come.
“That psycho-spiritual connection to country, and doing these ceremonies, observing, burning the country when necessary…, is actually a positive contributor to health.”
In Australia there is hard evidence to support that those people living ‘on country’ and experiencing at least some elements of a traditional lifestyle are healthier. They tend to be more physically active, have a better diet, lower body-mass index, lower blood pressure, lower blood glucose levels, lower prevalence of diabetes and a lower risk of cardiovascular disease.
Despite the issue seeming insurmountable Prof. McDermott is optimistic. He compares the health gap to climate change, explaining that there is no vested interest in listening to the evidence and making a change. However, he says; “I think if we can only get that message through and build a critical mass of discourse in the community, then the politicians will fall in line.”
The original article appeard on www.abec.net.au. Read it here.
Five key elements, outlined in a 2010 paper by Dr Mihi Ratima remain imperative to the success of Māori health promotion today. Commissioned and published by HPF, Dr Ratima’s paper Māori health promotion – a comprehensive definition and strategic considerations looked at what was, at the time, a relatively new field of health promotion. Five years on, HPF Deputy Executive Director Trevor Simpson revisits these key elements as a timely reminder that there is much yet to be done to solidify and affirm Māori health promotion as a discipline and practice.
1. Consistent with Māori World Views
A key facet of the Māori world view is the belief that all things in the universe: animate and inanimate; seen and unseen; are interdependent and interconnected. All things connect to – and are impacted on by – the individual. The individual is not separate from – or “above” – the natural environment.
The Māori storytelling tradition not only provides a foundation for beliefs of origin: it also constructs for the individual a model for behaviour, of collective aspirations and exemplars for human potential (see teara.co.nz website). Clearly there is a correlation here with ecological health promotion. However more is needed to articulate the idea that an understanding, acceptance and incorporation of Māori world views into health promotion approaches can affect Māori health in a positive way.
2. Māori holistic view of hauora- health and wellbeing
If we accept that the Māori view of health and wellbeing is holistic then there is an argument for health promotion to work in a holistic way too. There is a need to investigate how we are designing health promotion interventions. The most problematic thing is the current narrow focus on issues such as tobacco, physical activity and nutrition. Issues-based and results-based accountability contracting present significant challenges to holistic health promotion. Positive health outcomes are often quite difficult to claim when health promoters are working across the wider social determinants of health. A new form of strategic and longer term thinking is required.
There are some parallels between the western model of health and indigenous Māori concepts of hauora – health and wellbeing. Both share the concepts of physical and mental health. But there are two other components of the Māori model of health that need further examination.
Professor Sir Mason Durie’s now widely acclaimed Te Whare Tapa Whā model identifies the two other key facets – whānau (family) and wairua (spirituality). Together with physical and mental health, they make up the four cornerstones of Māori health.
The importance of whānau (immediate and extended whānau) as an indicator for health is now fairly well accepted in the health sector. The Whānau Ora programme was first rolled-out in 2010. As interventions are evaluated, there will be an increasing body of evidence to inform future practice in relation to this aspect of Māori health promotion.
There is also growing acceptance that wairua is critical to Māori health status. Establishing the link between wairua and health outcomes can be difficult to validate, quantify and/or qualify, however and, while there is some research under way more investigation will be needed; particularly from an indigenous Māori perspective.
3. Increased control by Māori (individuals and whānau)
A key tenet of health promotion is empowerment; both of individuals and communities. It is an aspect that comes to the fore when contemplating health promotion work in Māori communities. Gone are the days of doing things “to” Māori communities. Regardless of what the intervention is, if Māori feel that they are not in control of, or party to the process, then the likelihood of success is diminished. Working “with” these communities rather than “on” them will ensure authentic relationships are maintained and nurtured, and increase the likelihood of good outcomes.
4. Foster Māori identity
A strong identity for Māori is critical in all facets of life. Access to te ao Māori (the Māori world), a sense of belonging, marae, knowledge of whakapapa, tikanga and te reo are all part of this. It loosely relates to the notion of tino rangatiratanga, or self-determination, encouraging Māori participation and ownership. Māori health promotion interventions must take this into account. Any interventions must incorporate a clear demonstration that Māori identity is valued and promoted thus increasing feelings of cultural acceptance and support rather than “othering”. Including things such as karakia, powhiri, mihimihi and manaakitanga into a Māori community health promotion programme would assist in assuring success.
5. Interventions are culturally competent
The key issue in developing culturally competent health promotion interventions is that a culturally competent person must be involved throughout the process; ensuring the Māori content of the proposed health promotion project is appropriate. Any human resource component will require a demonstrable level of cultural competence that goes beyond cultural “safety” practices and possibly means more than simply learning and knowing “about” Māori culture. From the point of view of the capacity of the Māori workforce, though; this person may not always be Māori.
By celebrating and realising indigenous Māori elements of te Tiriti health promotion, HPF and its members are striving to be at the cutting edge of health promotion both locally and regionally.
Trevor Simpson looks back at how HPF has led the way in developing the relationship between Te Tiriti o Waitangi and health promotion in Aotearoa New Zealand over the past 18 years.
1997: the challenge is laid down
In 1997, during the HPF conference “Challenging the Future” an inspiring remit was put to the Health Promotion Forum of NZ and its members: to examine the place of The Treaty of Waitangi and the Ottawa Charter in health promotion practice. An epic journey began, in which the vast talents and of a wide group of individuals combined to create a significant and forward-thinking document. Launched in 2002 the Treaty Understanding of Hauora in Aotearoa NZ (TŪ-HANZ) provides a strong basis and strategic framework for health promoters to embed Treaty-based practice into their everyday work. TŪ-HANZ provides the solution to the apparent conundrum of connecting the Treaty to the health sector itself and all who work in it; and health promoters seemingly have been very generous in abating the confusion.
That health promoters themselves called for such a document suggests this is a workforce that recognises not only the importance of the Treaty itself but its direct link to health as a human right; the notion of health equity and the imperative of social justice. There is recognition that failure to act on any one of these would diminish the key values and principles of health promotion itself. This flows from the belief that a true (or truthful) Treaty partnership is equitable rather than based on trust, and is premised on rights and obligations contained in the articles themselves. The matter of Māori health was a key premise for the drafting of the Treaty in the first place. Busby’s pre-Treaty correspondence with Lord Normanby is testimony to this. Hauora – health and wellbeing – therefore cannot be positioned away from the Treaty discussion – quite the contrary – it is the place start.
2008: HPF constitution amended to reflect values of te Tiriti o Waitangi
In 2008 HPF reviewed and amended its constitution to reflect its values and purposes within a new and contemporary context, and to further the development of health promotion from a unique Aotearoa New Zealand perspective. One key amendment included entrenching the key values of respect for – and commitment to – Te Tiriti o Waitangi; utilising the Māori text rather than the English. This signalled a subtle but important shift away from “Treaty” as part and parcel of its constitutional framework to align instead to te Tiriti; the Māori context. They say change is constant: sometimes, as in the development of Treaty based health promotion, it happens slowly and one step at a time. A natural evolution through changeable political landscapes and a growing awareness of who we are and where we have come from.
The new constitution also brought in Māori concepts such as manaakitanga (hospitality and kindness), tinana (physical health), wairua (spiritual health), hinengaro (psychological health), rangatiratanga (self-determination) and whanau ora (family health) into its values. In addition the HPF Board composition now requires that half of the members must be Māori – reflecting, in a human resource capacity, a visible Tiriti relationship. By elevating Māori world views to a constitutional level the idea of Tiriti based health promotion is energised or at least given a lift; and it provides a basis to progress to the next step.
Progress continues today
As health promoters in Aotearoa New Zealand we are moving ourselves closer to the place where we need to be. Of course we are not there yet but in this space HPF will continue to play an important and ongoing role. For instance we will be exploring the synergies between Whanau Ora and Tiriti based health promotion. We will also look into Māori health promotion and Te Pae Mahutonga as unique but complimentary frameworks to the Ottawa Charter and will take time to review TU-HANZ. At this point we can reflect on where we have come from in the journey and we can nurture the idea of Tiriti based health promotion and – perhaps finally – Tiriti nationhood.
Trevor Simpson is Deputy Executive Director and Senior Health Promotion Strategist at Health Promotion Forum, where he holds the portfolio for Māori health promotion. He is regarded as a world authority in indigenous health promotion.
Written by Trevor Simpson
Edited by Jo Lawrence-King
This guide helps communities have a voice in the submission process. Produced by Regional Public Health, it gives advice and tips for health promoters on understanding the submission process, the health promoter’s role and how to engage with communities.
This literature review, commissioned by the former Health Funding Authority in December 2000, examined the most relevant literature on strategies that improve Māori and Pacific peoples’ access to primary health care services. It may help inform PHOs when planning services to improve access.
Outgoing co-leader of the Maori Party, the Honourable Tariana Turia, signalled her support for public health and health promotion this week. In a heartfelt speech, delivered on her behalf to the Public Health Association Maori Caucus Hui, Mrs Turia emphasised the holistic definition of health. She proposed the use of the phrase mauri ora (life force) to better describe it and expressed her desire to see a relentless effort to achieve equity of health outcomes for all.
Minister Turia’s speech ended with encouragement to continue our work: “keep asking the curly questions; demand answers that are sourced in our own solutions. We must leave no stone unturned until we can change the circumstances for the health of all our whanau, and enable all our families to flourish.”
“Health is not merely the absence of illness or disease; a medical condition, a pinpoint on a chart,” read Mrs Turia’s speech. “It must be found in the sense that one’s life is rich and vibrant; the capacity to take action; to purposely make life better.” Mrs Turia referred to the World Health Organisation’s assertion that health is a ‘positive concept emphasising personal and social resources, as well as physical, mental and spiritual capacities’. “We must organise to do whatever it takes to improve, promote and protect the health of the whole population. We must mobilise on many fronts – participating in public policy processes; sharing information; building our workforce.”
“It was hugely encouraging to receive the endorsement of such a respected member of our community,” said HPF deputy executive director Trevor Simpson. “Minister Turia’s words closely match our mahi (work) and will spur us on to continue contributing to public policy, building the health promotion workforce and offering support and leadership to health promoters across New Zealand and the world.”
Mrs Turia went on to propose a new definition for health – mauri ora – which, she says, “is about whanau flourishing – about vitality, integrity and energy. We find mauri ora through positive relationships in the wider environment…”
And she expressed a wish to see an organisation created – dubbed the Relentless Institute – that ensured every person on the planet has equity of access and opportunity to health outcomes.
Mrs Turia planned to attend the hui, despite it being just ten days out from her valedictory speech in parliament. Unfortunately fog kept her plane on the ground in Wellington, so her speech was delivered on her behalf by Adrian Te Patu, Public Health Consultant and facilitator for the hui.
15 July 2014
Written by: Jo Lawrence-King
In a recent Health and Social Needs report prepared by Litmus Ltd for the Ministry of Health the Chatham Island community was described as having a strong sense of whānau connection, resilience and nurturing (Smith et al, 2013). Our Deputy Executive Director, Trevor Simpson recently had the opportunity to witness these strengths for himself, when he visited Chatham Island in late March to present a series of workshops.
Some great work being done by the Ha o Te Ora o Wharekauri Trust- Māori Community Services (MCS) on Chatham Island is a great example of a “wrap-around” health promotion service in action within a small community. It was encouraging to see the important role played by health promotion in an integrated approach to health and wellbeing on the Island.
Established to improve the health status of Māori, MCS’ three areas of focus are:
Whānau Ora- Māori Community Health Service
Whānau Ora Mobile Service
Community Health Promotion
The Whānau Ora – Māori Community Health Service is underpinned by the notion of Hauora Wananga (health and wellbeing development from a Māori perspective and world view). It works within and across a range of activities, including:
education and promotion
liaison and coordination.
The service draws on the four mainstay philosophical aspects of Te Whare Tapa Whā and utilises whānau health plans and face to face sessions to both identify whānau needs and to develop effective strategies for them.
The scope of the Whānau Ora Mobile Service is vast. Two full time kaiawhina; one a community health worker, the other an enrolled nurse; work to improve prevention and self-care by empowering whānau to both manage their own health and develop health literacy.
Delivered across multiple settings including schools, kohanga reo, marae and provider clinics, the service provides:
children under 5 checks
smokefree cessation and other smokefree activities
health and social service referrals
a transport service
family violence, alcohol, drugs and problem gambling services.
The Community Health Promotion work form the basis of cross generational knowledge sharing and interaction where kaumātua and rangatahi work together, sharing energy, resources and time. The main focus is on increasing physical activity and healthy eating.
A 24/7 fully equipped gym, together with a qualified personal trainer, are available to all members of the community for a nominal $50 annual membership fee. Classes offered at the gym include yoga, circuit training and line dancing.
Healthy eating is encouraged through:
Encouraging personal management of diet and nutrition
a fruit tree planting programme
education on preserving kai
a traditional kai gathering programme
a Rongoa project
smoking cessation services
an after school programme.
The Service also offers a programme of social activities aimed at reducing the burden of isolation and increasing connectedness within the community.
Underpinning all these services is a free GP clinic and pharmacy based at the hospital and 24/7 for emergency service.
The approach to wide cross-community involvement is evident in all areas of work. The service’s flexibility also makes it possible to include other social and health projects as they emerge.
Barby Joyce, manager of the Māori Community Centre says that, despite the vast array of existing services in place, the service will continue to “branch out” and take on board some of the innovative ideas of the local young people who she says “have much to offer to the community and to the development of the service.”
Although infectiously positive, Barby was honest in her appraisal of outstanding issues that need to be addressed. Housing standards, mental health, alcohol and drugs and family violence were still a concern: “The service is working hard to find effective solutions to these issues,” she said.
Judging by the great work being done in this small community, there is a good chance solutions will be found: this service has shown itself to possess patience and perseverance; focusing on creating a strong, adaptive and healthy community.
Established in 2003, Ha o Te Ora o Wharekauri Trust- Māori Community Services are contracted to and funded by the Hawke’s Bay DHB and also Te Puni Kokiri to deliver services to all the residents of the Chatham Islands.
Although available to the wider community, the service has been tasked with targeting and making inroads into the Māori and Moriori populations. In the 2006 census 64.2% of the total population of the Island identified themselves as belonging to the Māori ethnic group. However the all-encompassing approach to the work means that all community members are valued and seen as important. On observation this has created a positive and warm environment and increasingly a place for many in the community to gravitate to.
With an underpinning philosophical approach of nurturance and a deep affection for the people and the land, Te Ha o Te Ora will remain a vital support mechanism for the Chatham Islands and all who live there.
Trevor’s workshops were held at Te Ha o Te Ora o Wharekauri Trust Centre in the small western settlement of Waitangi. Supported by staff of the Māori Community Service, these workshops provided a first time opportunity for a member of HPF to contribute in a small way to the workforce development needs of this isolated South Pacific Island. Along with MCS staff, a number of participants from various service providers together with individual community members attended.
Smith, L., Duckworth, S (2013) Wharekauri, Rekohu, Chatham Islands Health and Social Needs Report. Ministry of Health and Litmus Ltd 2013.
By Trevor Simpson
Edited by Jo Lawrence-King
Every year Waitangi Day provides a useful basis to reflect on our nationhood and the common historical grounds that brought us all together. At the same time it reminds us about the relationship between Te Tiriti o Waitangi, hauora, health and wellbeing. For HPF, Waitangi Day emphasises the importance of good human and societal relationships between all people. HPF’s Deputy Executive Director explains the close relationship between hauora, Te Tiriti o Waitangi and the Health Promotion Forum.
HPF has a constitutional arrangement premised on two important factors; firstly an adherence to Te Tiriti o Waitangi and secondly the notion of health and wellbeing as an indomitable human right.
When we dissect the story we find information that supports the view that Te Tiriti o Waitangi was in part motivated by the declining health status of Māori. In 1832 James Busby, in communication with Lord Normandy decried the “miserable condition of the natives” much of which was a result of the pre-Treaty effects of unmanaged colonisation. Indeed when we look into the body of the language within Te Tiriti itself we see a direct correlation to health and wellbeing and the legal obligation to protect rights that ensure this. To begin with the preamble declares Queen Victoria’s desire to protect the authority of the chiefs to the own authority and infers a commitment to a peaceful future.
The 3 Articles and health
Article the First touches on the rights of sovereignty and the notion of governance. Good governance in any circumstance would require that those in power provide the resources and infrastructure that supports health and wellbeing for all citizens. Health promoters recognise that this reinforces the need to increase health equity and to accord the appropriate resources to ensure this happens.
Article the Second confers and affirms Māori rights to Tino Rangatiratanga or absolute sovereignty. This includes domain over everything held precious and their lands. Under this article, Māori would consider health to be a taonga. In the wider sense this article speaks about having authority and control over the determinants of health and wellbeing.
Article the Third relates to the idea of equal citizenship. In the field of health this, as with Article the Third, communicates the idea of health equity. That is, all people have the right to hauora. This of course resonates with the health promotion principles of social justice and fairness.
For HPF, Waitangi Day emphasises the importance of good human and societal relationships between all people. It connects with “hauora- everyone’s right” the vision of HPF and builds on the notion of Te Tiriti o Waitangi as a crucial component in moving Aotearoa New Zealand towards a just and equitable society.
Read more about Māori concepts of hauora.
6 February 2014
A speech to parliament on Wednesday 28 January 2014 by Minister Tariana Turia has highlighted the groundswell of support for Whanau Ora as a model for health and wellbeing applicable to all New Zealanders. Health Promotion Forum (HPF) Executive Director Sione Tu’itahi believes that the model goes even further; with relevance to people around the world.
“Whanau Ora [……] has been openly embraced by New Zealanders of all cultures and creeds,” said Ms Turia in her speech “[It is] about empowering and enabling families to set their own priorities, to focus on outcomes.” According to Ms Turia 160 providers are now using the Whanau Ora tool, with approximately 33,000 New Zealanders benefitting from the approach. Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme.
Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf
Ms Turia is not alone in seeing the value of community health promotion, with Minister of Health Hon Tony Ryall reportedly considering funding for such a programme. – See more at: http://www.hauora.co.nz/whanau-ora-a-model-for-people-around-the-world.html#sthash.eWk0Ul5D.dpuf
Tu’itahi welcomed Ms Turia’s speech and Mr Ryall’s interest in community health programmes. “We are rapidly moving from a model of hauora (health and wellbeing) by and for Māori to one that is widely recognised as being of value to all peoples of Aotearoa New Zealand,” he said. “I predict that it won’t stop there: this will become a model followed by peoples across the globe.”
Aotearoa New Zealand – and HPF – are highly regarded internationally. In particular our approaches to indigenous health promotion were well-received at last year’s International Union of Health Promotion and Education (IUHPE) conference. Key elements of these approaches include a focus on the holistic view of health and wellbeing, increased control by communities over interventions and incorporating indigenous world views into health promotion planning. All of these aspects are reflected in the Whanau Ora approach.
Whanau Ora is founded on the principle of self-determination. Unlike the conventional models of health care, the Whanau Ora approach empowers whanau and communities to have control over their own wellbeing. Instead of focussing on illness and its treatment, Whanau Ora helps participants identify those elements that determine hauora and to prioritise strategies to improve outcomes.
“This is not an exclusively indigenous issue,” says Tu’itahi. “There is a broad movement towards self-determination – in health and many other issues. People around the world are taking an increasing interest in being well, rather than treating illness; on looking at the big picture of what affects our ability to fulfil our potential and doing something to address those determinants of our health.” He believes that the Whanau Ora model will be one that is taken up and adapted for people around the world. “Once again New Zealand will be a pioneer,” he said. “Perhaps what we do need to recognise is that we owe Māori a debt of gratitude for a model that has the potential to revolutionise the hauora of people around the world.”
Visit the Government’s web-page about Whanau Ora.
HPF – and New Zealand – is making a significant contribution to world health agendas. Its most recent input was to the scientific programme of the 16thWorld Congress on Tobacco or Health. As a member of the board of the International Union for Health Promotion and Education (IUHPE), HPF’s Executive Director Sione Tu’itahi ensured the needs of indigenous peoples and ethnic minorities were included in the recommendations invited from the global organisation.
“This is a big step for New Zealand, the HPF and for Maori and all other indigenous peoples,” says Sione. Smaller countries and ethnic minorities are often overlooked and vulnerable to the driving force of large companies and countries. “Having a voice at this level is a wonderful opportunity to advocate for the rights of these less-represented peoples.”
Recommendations about the conference from the IUHPE included:
Discussions about the post-2015 development agenda to ensure health, including non-communicable diseases and social determinants are given the appropriate attention.Discussion around support for politicians in the battle with tobacco industry on initiatives such as plain packaging.Seeing outputs and outcomes of the WHO Europe NCD ministerial event focussing primarily on tobacco.
Focussing on ‘how to do’ as much as ‘what to do’
Including the health needs of indigenous peoples and ethnic minorities in all strategies.
Sione is the first indigenous person from the Pacific region to hold an official post with the IUHPE. He is a member of the global board in his role as Vice-President of IUHPE, South West Pacific Region, which covers New Zealand, Australia, all small Pacific island nations and some countries in Asia.
IUHPE is a global umbrella organisation for health promotion professionals and organisations of the world. Its headquarters are in Paris. For the next three years (2013-2016) its South West Pacific Region office will be co-hosted by the Health Promotion Forum and the Health Promotion and Research and Evaluation Unit (HePPRU) of Otago University’s School of Public Health. HePPRU’s Director, Associate Professor Louise Signal, is also the Director of IUHPE for the South West Pacific Region.
Sione recently attended a meeting of the IUHPE’s Global Executive Board in Paris. Read moreabout the trip here.
TheHPFis a national umbrella organisation for health promotion organisations and teams in New Zealand.
“Assertive, if not aggressive approach” called for by the Right Hon Sir Edmund Thomas
Retired Court Appeal Judge the Right Hon Sir Edmund Thomas (pictured right – from 3 News) called for an “assertive, if not aggressive approach” by communities and community groups; to reverse the extreme inequality that currently exists in Aotearoa New Zealand. He was speaking to a packed Maidment Theatre in Auckland, late October.
HPF Health Strategist Dr Ieti Lima was in the audience and reports on some of Sir Edmund’s key points to support his argument.
Call for “sufficient force”
In his powerful, engaging and, at times, challenging lecture, Sir Edmund proposed a focussed campaign to promote substantive human rights. He further called for “sufficient force” to ensure people claim the minimal social, economic and cultural standards to which they have a right. Sir Edmund asserted that, if the governing bodies or the courts cannot generate the required assertive approach to support people’s rights, the community must initiate the action needed. “Discussion and debate will not suffice,” he said. “This legacy is now too entrenched to be so readily reversed.”
Neo-liberalism at the heart of the problem
Sir Edmund was unequivocal in linking the “extreme – even obscene – inequality” that exists in Aotearoa New Zealand to the “traumatic neo-liberal transformation” that has been pursued here.
According to the retired judge, the top ten per cent of New Zealand’s population today owns half of the country’s wealth, while the bottom 50 per cent owns just five per cent of the wealth.
He pointed to Maori health statistics as appalling, and declared that he finds “the neglect of a people socially and culturally offensive.”
So how has this gross inequality been tolerated in a country that once prided itself on its egalitarian culture and sense of social justice? Sir Edmund’s explanation was blunt; it has been fostered and sustained by the rich and powerful, to perpetuate their own wealth and privilege. Sir Edmund argued that the term ‘equality’ is today more often than not defined in terms of equality of opportunity. By suggesting that all people have the same opportunity, the term obscures the true extent of inequality within the community. If this definition remains, it simply provides the opportunity for those in an advantaged position to further advance their superiority and privilege.
“This perspective of equality in turn impairs social mobility,” he said. “The disadvantaged are stuck with being disadvantaged. … It becomes a vicious circle”.
Neo-liberalism – according to Sir Edmund – is a theory that insists human well-being can best be advanced by ensuring strong property rights, free enterprise, free market and free trade. He identified eight features of the neo-liberal legacy:
Values directed by economic order
Assertive action by community groups
Sir Edmund challenged his audience to consider who will speak for “losers” in a capitalistic society? How can they be guaranteed their basic economic, social and cultural human rights? He proposed that a first step in any campaign to achieve a more equal and just society is to identify and challenge the damaging features of neoliberalism. Ultimately the aim is to arrest and reverse them.
In the absence of legal options to redress the inequalities, Sir Edmund called on a focussed campaign by community groups. “They [must] possess sufficient force for people to claim that the minimum social, economic and cultural standards they reflect are theirs as of right”.
Sir Edmund was the speaker at the annual Bruce Jesson 2013 at the Maidment Theatre, University of Auckland. He is a retired Court of Appeal Judge and former acting judge of the Supreme Court. His lecture was made to a mainly academic audience.
Author: Dr Ieti Lima
Editor: Jo Lawrence-King
Māori mental health patients are twice as likely as non-Māori to be put into seclusion. Workforce development has been identified as one of the ways to address this disparity.
Seclusion means being placed in a locked, bare room alone. The person is monitored through a window and family members are kept away. It is widely accepted that seclusion is not a legitimate form of treatment for escalating behaviour and can be highly distressing for the patient. The Ministry of Health reportedly has a plan to eliminate seclusion of Māori patients over five years.
In an interview on Radio New Zealand with Marion Blake, Chief Executive of The Platform Trust, said there are a number of possible reasons for the disparity, but there is no evidence to suggest Māori are any more violent than other people with mental illness. She suggested one of the ways to tackle this disparity is workforce development – particularly in tikanga Māori.
Anne Brebner at health research organisation Te Pou says cultural issues aren’t on the top of everyone’s list of priorities when people seek treatment for mental health problems.
Health Promotion Forum offers workshops and courses to provide understanding Māori culture and health models.
The Platform Trust is a national mental health network of community organisations.
Find out about HPF’s training programmes:
A Treaty Understanding of Hauora in Aotearoa New Zealand (TUHANZ). This is a practical, hands-on course, which explains how the articles of the Treaty can be applied to health promotion planning.
Working with the whanau ora tool . A practical guide to developing health programmes where Whanau, Hapu, Iwi and Māori communities play a leading role in achieving Whanau Ora.
Māori indigneity, whanau ora and the determinants of health. Explores the link between Māori indigenous notions of health and wellbeing, the wider determinants of health and elements of whānau ora. As well as informing workplace practice this interactive workshop will provide an open platform for learning, sharing and personal development.
Māori concepts of health promotion. Introduces participants to shared understandings of traditional Māori concepts, ideologies and practices in relation to health and wellbeing.
Story published 12 November 2013
Photograph courtesy of Ophelia Cherry
Three key project areas were agreed at a recent hui taumata (summit) of Māori Public Health Leaders at Te Ohāki Marae in Huntly.
The three agreed areas of focus are to:
1. provide support infrastructure like communications, a clearing house, agenda setting and a mobilisation plan (dubbed He Mahi Kaitiaki).
2.promote action around institutional racism
3.foster wider social and political change.
All three of the projects will be interconnected: aiming to increase participation in Public Health dialogue, increase a sense of collective responsibility to make change and challenge the current political arrangements in health to do better.
The project ideas will seek further support and mandate at the national annual hui being held at Turangawaewae Marae this 14-15th November.
The hui drew on the knowledge of Māori public health Leadership programme graduates to develop a plan of action for Māori public health. Led by Tania Hodges of Digital Indigenous.com Ltd and Grant Berghan, Public Health Consultant hui asked the question “If there was just one thing we could do as leaders…?”
The agreed focus areas were arrived-at following two days of intense and challenging discussion, with debate focussed on improving health for Māori communities and whānau.
There are nearly 500 graduate members of the programme, with membership of the alumni covering the length and breadth of the Aotearoa New Zealand and involves people from a wide gamut of Public Health. There was much discussion around the importance of mobilising this expertise to improve Māori health outcomes.
Te Ohāki Marae itself was a significant venue for the summit, with historical references to Te Kirihaehae Te Puea Herangi who famously placed a stake in the ground where the marae and wharenui was to be situated. For the attendees at the hui the stake was seen to symbolise the point from which stronger Māori public health action would be advanced.
The Health Promotion Forum offers training in several areas specific to Māori health. Click here to find out more about our workshops and other training opportunities.
Read about Māori health models here.
Click here to find out about the Maori Public Health Leadership course.
Wordle created by Papatuanuku Nahi
Article created: 15 October 2013
Health promotion programmes in Aotearoa New Zealand were held up as models of best practice in August at the annual conference of the world’s most highly respected health promotion organisation. Senior Health Promotion Strategists from the Health Promotion Forum (HPF) are participating at the conference of the International Union of Health Promotion and Education (IUHPE) in Pattaya, Thailand, August 25-29 2013.
Trevor Simpson – Deputy Executive Director at the HPF – presented a plenary session to showcase a health promotion module developed by Maori and in close collaboration with the Maori service users for whom it was being designed. “This is a point of difference from many other health promotion approaches to indigenous peoples,” says Trevor. Very often health promotion resources and practices are developed centrally, with little or no involvement of – or representation from – the people for whom they are being developed. “We have found our approach to be highly successful in inspiring and empowering people to make beneficial changes to their health.”
The HPF’s Senior Health Promotion Strategist Karen Hicks presented her abstract “A Contribution to the Global Dialogue”. In her presentation she will discuss how health promotion competencies, the advent of a professional society and a code of ethics together give health promotion professionals the tools they need to make effective improvements in health.
New Zealand is strongly represented in health promotion globally. The HPF’s Executive Director, Sione Tu’itahi, is Vice-President of the South West Pacific Region of IUHPE, while Associate Professor Louise Signal, Director of the Health Promotion and Policy Research unit (HePPRU) and Health, Wellbeing & Equity Impact Assessment Research Unit (HIA), Department of Public Health, Otago University is its Regional Director. Together the HPF and HePPRU co-host the IUHPE’s South West Pacific Regional Office.
He Mara Kai (the food garden) is an initiative focusing on good nutrition and physical activity by supporting Kohanga Reo (Māori speaking early childhood centres) to grow vegetables. It was originally created as part of the Labour Government’s Healthy Eating, Healthy Action (HEHA) initiative 2004-2010.
Theresa Wharekura, then Manager Te Kupenga Hauora, paints a picture of the initiative, its origins and its plans for the future.
Another model of Māori health is based on Te Wheke, the octopus and the eight tentacles that collectively contribute to waiora or total wellbeing.
View Te Wheke (PDF, 1 MB)
This essential document, produced by HPF in 2002, provides understanding of the application of te Tiriti o Waitangi in health promotion practice in Aotearoa New Zealand.
HPF also provides a two day practical, hands on course to explain how the articles of Te Tirit can be applied to health promotion practice.
The purpose of this paper is to provide a definition of Māori health promotion and to discuss Māori health promotion strategic issues to inform practice.
Māori health promotion is the process of enabling Māori to increase control over the determinants of health and strengthen their identity as Māori, and thereby improve their health and position in society (Ratima 2001). While this brief definition gives an indication of what Māori health promotion is about, by itself it does not convey completely the meaning and uniqueness of Māori health promotion. To more fully understand Māori health promotion, it is useful to refer to two models for Māori health promotion – Te Pae Mahutonga (Durie 2000) and Kia Uruuru Mai a Hauora (Ratima 2001). Together, these models describe both the breadth of Māori health promotion and its defining characteristics. The characteristics include the underlying concept of health, purpose, values, principles, pre-requisites, processes, strategies, key tasks, and markers.
A full definition of Māori health promotion is necessary to guide practice and enable common understandings as a basis for clear communication and advocacy for Māori health promotion. – See more at: http://www.hauora.co.nz/m%C4%81ori-health-promotion-comprehensive-deiniiton-and-strategic-considerations.html#sthash.LEDe55tb.dpuf