Teaching this week is around Maori in recognition of Waitangi Day on 6th February - commemorating the signing of the Treaty of Waitangi in 1840 between Maori and the representatives of the British Crown.
Maori make up about 15% of the population we see in MMH ED and are over represented in statistics or poorer health outcomes when compared to non- Maori - even when social factors & co-morbidities are accounted for. It seems therefore that either overt or subconscious bias is occurring in our interactions as health professionals and / or we are failing to engage with Maori patients in a way that is more likely to achieve a good health outcome.
We will be covering Maori & NZ history & impacts of colonisation, health inequities, Maori culture & language, and engagement with Maori patients. We will also focus on end of life issues as regards Maori.
A massive Thank You to Kate Anson for her preparation, commitment & running of this session
Resources to Listen / Watch & Read through:
Best health outcomes for Maori: Practice implications
A resource booklet prepared for the Medical Council of New Zealand by Mäuri Ora Associates Best health outcomes for Maori: Practice implications. This isn't about being PC. This is also your obligation as a doctor as defined by the Medical Council of NZ. After all - if you are not culturally competent - can you be clinically competent? May seem a bit dry but has some of the info about health inequities but also history & tikanga and what your responsibilities are, surprisingly readable.
Aureretanga Parihaka
Te Ahi Kaa this week features a dramatised documentary recreating the political manoeuvrings behind the invasion of Parihaka in Taranaki on 5 November 1881.
PARIHAKA
Why wasn’t I told? If you haven't heard of Parihaka, you should follow these links. A shameful episode in NZ European history met by by one of the earliest examples of peaceful non-violent resistance (preceding Gandhi and Martin Luther King). You can listen to this dramatised documentary and / or read the NZ geographic article.
Waitangi Special - The Waitangi Tribunal
After almost 40 years since it was established, the Waitangi Tribunal continues to have an integral role in righting the wrongs of the past. In this one hour...This is about how Māori & non-Māori New Zealanders can move forward - our equivalent of a Truth & Reconciliation process such as took place in post apartheid South Africa. Its all in te reo Māori with subtitles.
OPERATION 8
This is just the trailer to the documentary Operation 8 - find it if you can, its worth a watch. How the government & police went completely over the top with anti-terrorism raids on Tūhoe territory in 2007. Operation 8 - On October 15 2007, citing evidence of guerilla camps involving firearms training, police raided 60 houses across NZ, many of them in Ruatoki.
Mana: The power in knowing who you are | Tame Iti
Tame explores how the old saying of "Te ka nohi ki te ka nohi" (Dealing with it eye to eye) creates a far more productive space for open dialogue around any issue ...Tame Iti being eloquent.
There is so much more. Cultural competence is a lifelong journey & we are all at different stages of the journey (not necessary related to your age) but the better you get at it, the better the rapport & engagement you will have with your patients, the more likely you are to make a correct diagnosis and be able to work together with the patients & families to achieve the best health outcomes - you will become a better doctor and have more job satisfaction.
Ēnei ōku whakaaro. (These are my thoughts - this is my opinion: KATE ANSON)
Some other tips:
Try saying "kia ora" as a greeting or farewell, also works as a thank you
Try to learn how to pronounce names, if not sure, ask
Spend time with introductions - to all people present
Try to find out some personal info & don't be afraid to share a little of yourself - maybe ask the social history first
Don't make assumptions about people
Be aware of your own subconscious biases
You may be a fab doctor but if they think you don't care, it won't matter
Some more resources that you may find helpful are listed below:
mauriora.co.nz - cultural competency foundation plus treaty timeline videos & text
maoridictionary.co.nz - good for helping your pronunciation as has option to hear the word spoken
acem.org.au - indigenous health & cultural competency modules
treatytalk.org.nz - ordinary people talk about what the Treaty means to them & NZ
teara.govt.nz - Te Ara Encyclopedia of NZ
nzhistory.govt.nz - treaty timeline - good account of history of colonisation & its impacts
implicit.harvard.edu - take an implicit bias test - learn more about your own biases
itstopswithme.humanrights.gov.au - stand up, speak out - thoughts on how to combat racism and other forms of discrimination
countiesmanukau.health.nz - population profile - helps you understand more about the population MMH serves
