By Tariana Turia
Health and wellbeing has been a major political issue for Maori over many generations. There was a dark time in our history, when tangata whenua came very close to extinction. We had lost our lands, much of our language and cultural knowledge, and the Maori population was shrinking to critical levels, reaching an all-time low in 1896 of around 42,000 people.
Looking back to that time, it is easy to see how powerful ideologies can be in shaping policy and service delivery. In the mid 1800s the beliefs held by politicians were very different from today. Racism was there, it was in your face, and was accepted as normal. Politicians did not care to improve health outcomes for Maori, instead the focus was on assimilation, or eradicating the ‘problem’. As Dr Isaac Featherston, politician and physician infamously announced in parliament in 1856, their role was to “smooth down the pillow of a dying race.”
A simple idea shaped many racist, heartless and killer policies that led to the demise of Maori health over many decades. This is the power of ideology.
Our growing population today can be directly attributed to the courage and leadership of our rangatira, our politicians and our whanau of that time. That history should be universally known. We should automatically associate the names of Sir Maui Pomare, Te Rangihiroa, Tutere Wi Repa and Pohau Ellison with the Māori Medical Practitioners Association established in the early 20th century. We should know the name of Akenehi Hei, who was the first Maori nurse to qualify in 1908. We were fighters, survivors, and we worked together to improve the health of our people, and grow our whanau, hapu and iwi.
The efforts to improve our health, did not focus on clinical solutions alone. In fact we looked to revive our cultural heritage, our identity, our connections to the land, and our health and wellbeing at the same time, using integrated solutions that fit within our concepts of the world.
While we came back from the brink of extinction, we have not quite achieved the same health status as non-Maori in this country. Every couple of years a new report comes out which highlights our plight, and that of our tamariki – the most recent one to be produced out of Auckland University again showed the poorer health outcomes of our children who are 30% more likely to die from treatable illnesses.
I believe this is down to institutional racism; its roots sit within a system that has been shaped around an ideology that does not accept nor fit our Maori views of wellbeing. The health system has been constructed by people who have no understanding of racism and the damage that it can cause to a person’s health, to the wellbeing of a whanau, or to our socio-economic status.
There have been numerous reports that have showed the insidious nature of racism in the health system. Puao Te Atatu which came out in 1986; Peter Davis’s report published in UK magazine The Lancet, 6 years ago; and many more since.
It is about the power of a thought, the power of ideology. This is what sits at the heart of our health status as tangata whenua. The problem is that key people responsible for change do not accept that racism exists, instead they work to preserve a system which is faulty, and does not produce the outcomes we seek for Maori health.
As innovative people, we have sought to develop systems around this problem – avoiding a system that does not work for us. We established alternative solutions and responses, and we have started to put flesh on the bones of what works for us. We must continue to foster our own best practice models in health, but we must also challenge the system as it exists currently to ensure that we see change for the better for our next generation.
I have had enough of the lip service given to Maori, and the poorer levels of treatment passed to our whanau. It is time to make a change, and it is time to speak up on what we are seeing and work towards implementing solutions that fit with our views on health and wellbeing. It is only then, when we are actively challenging this system that we will see the change that we seek.
Tariana Turia is Associate Health Minister and co-leader of the Maori Party