Community, Maori

Chatham Islands provide excellent health promotion model

April 2, 2014

  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:

1. Whānau Ora- Māori Community Health Service
2. Whānau Ora Mobile Service
3. 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:

• general health
• education and promotion
• advisory services
• 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:

• health education,
• health assessments,
• children under 5 checks
• smokefree cessation and other smokefree activities
• health and social service referrals
• a transport service
• breastfeeding advice
• 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
• community gardening
• 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.   Reference: Smith, L., Duckworth, S (2013) Wharekauri, Rekohu, Chatham Islands Health and Social Needs Report. Ministry of Health and Litmus Ltd 2013.   April 2014 By Trevor Simpson Edited by Jo Lawrence-King