President Joe Biden addresses the American people after Trump's victory and widespread calls to drop the Treaty Principles Bill.
Opinion by Mihi Blair
THREE KEY FACTS
Barriers for Māori accessing hospital services include poor communication, hostile healthcare environment, primary care barriers and racism.
Pacific Peoples have high rates of dying early from long-term health conditions such as heart disease, diabetes, kidney failure, stroke and lung disease.
Lack of education, poverty, and substandard living conditions due to lack of income are all well-established causes of poor health.
Mihi Blair is kaiwhakahaere Hauora Māori, mana taurite (general manager, Māori health and equity) at ProCare. Her career is dedicated to driving positive change for Māori and Pasifika communities. Blair is on the board of Emerge Aotearoa Housing Trust and co-chairs Ngā Matapihi o Te Wairua – GPNZ Māori PHO Leaders Roopu.
OPINION
For many, having a simple kōrero about your health might not seem like it’s achieving a lot.
But if you’ve never been part of the health system, and you have a high mistrust of it – talking with someone you know and trust, in a place that’s comfortable to you, with people who understand you, your perspective and your hesitations, a kōrero can be the beginning of a much more productive health journey.
ProCare's Mihi Blair.
I remember my first time mistrusting the health system. It was 26 years ago when my mother started feeling ill and would go to the doctor for treatment. Unfortunately, the constant reassurance that it was a stomach bug, and lack of urgency in referring on for tests resulted in us rushing her into the hospital emergency department with severe stomach pain. We were told “it’s not like she will die”, three weeks later, my mum aged 45 years passed away from cancer. When I share my horrific experience, many tell me of theirs. So perspective is everything, as is building a system of trust.
As the kaiwhakahaere Hauora Māori, mana taurite (general manager, Māori health and equity)at healthcare provider ProCare, with general practices that serve the largest Pacific and Māori populations in Tāmaki Makaurau, my focus is to ensure we look at ways to remove system barriers that have created massive inequities throughout primary health care, for Māori, Pacific, and all those in need. It’s also about ensuring we build a system where Māori and Pacific people can trust the system, thrive and be leaders of their own health.
Māori and Pasifika are still uncertain of immunisation.
By determining our own health, we need to address the systemic barriers experienced by whānau – poor communication, hostile healthcare environment, access to primary care, and unconscious bias/racism to name a few. We’ve always known that a big part of achieving that vision is about getting out in the community, but since the pandemic others are starting to see the benefits of this too.
Putting whānau at the centre, not individuals, when first building trust and knowledge is a priority of advocating for change in primary care. By focusing on the whānau needs and following through on things like health checks, blood pressure checks or immunisations, it all starts to build trust.
Additionally, by attending community events like Pasifika and Te Matatini as well as creating our own health and wellbeing events at places like marae and setting up outreach clinics, we create a safe space for whānau to have mana-enhancing conversations about their health.
Procare's Mihi Blair, Eruera Keepa, and Bindi Norwell.
A lot of kōrero is happening in changing the hospital system, but we need to focus on primary care and prevention measures so that our whānau are not going to hospital in the first place. Additionally, it’s about providing education and preventative care for conditions that have serious consequences for our people, such as gout, or addressing cervical screening needs, or running programmes like Ready Steady Quit for smoking cessation.
This will have a future benefit of reduced hospital costs and dependency on secondary care. However, more investment and changes in the model of care in primary care is needed, especially for immunisations. We have an opportunity to support Health Minister Shane Reti’s goal for immunisation whereby 95% of 2-year-olds are fully immunised with the age-appropriate vaccines.
We can achieve greater outcomes for Māori and Pacific by working collaboratively, so we partner with specialist providers like Turuki Health, Etu Pasifika, The Fono, alongside other Māori health providers and marae to help communities with that support or advice from people they trust.
The voices of our whānau are valuable and we are hearing there are multiple approaches to engaging with whānau, although with well-meaning approaches, there is duplication of multiple providers contacting whānau for immunisations or even worse not at all.
The need of working together is more apparent now than ever, so that the communities we serve, their cultural needs, access of choice, training and policies are aligned to whānau needs.
It’s a significant undertaking, but we’re seeing some good results.
For some populations, particularly Māori and Pacific, childhood vaccination rates in some communities, sit as low as 34%. For the 143 general practices that we look after across Tāmaki Makaurau, we’ve managed to lift our vaccination rates for 2-year-olds to 87%, and to 88% for 8-month immunisations – ahead of the national average, mahi that we should be incredibly proud of. We’ve vaccinated more than 18,000 tamariki over the past 12 months, despite caring for some of our most vulnerable communities.
When did my trust build back with health? When I had my first pepī and my midwife and GP enabled me to kōrero for my whānau as a whole and not an individual. This gave me the confidence to make my choice for immunisations and future health decisions for them with my GP. While it’s great to see positive outcomes, there’s always more to be done. It’s all about pushing through the barriers, building trust and using as many levers as we can to reach people where they are, particularly for those who need it the most. So that’s exactly what we’re doing, and what we’ll continue doing in the future.
