7 April 2001 Hon Tariana Turia Speech Notes

Speech to Te Ohu Rata o Aotearoa (Maori General Practitioners Annual Conference), Rotoiti, Rotorua
'What are the indicators of Maori health and therefore the qualities of Maori health workers'

Tena koutou nga uri o Te Arawa. Koutou e tautoko nei i enei kai mahi kei te mahi iwaenganui i a ngai tatau.

Tena koe Rees, nahau i tono kia haere mai au ki tenei po whakahirahira a koutou. Kei te tu whakaiti tenei uri o te awa o Whanganui i mua i a koutou i tenei po.

Huri noa i tenei hui, tena tatau katoa.

I want to congratulate you all for the efforts and the sacrifices you have made as you sought out to reach your goals.

To those, fortunate enough to be award winners I offer you my congratulations.

I also want to acknowledge your whanau, particularly your partners and children who have supported you in your work.

Tena koutou katoa.

You give substance to that whakatauaki of ours which says:

Ehara taku toa I te toa taki tahi, engari he toa taki tini.

I remember being told a story by one of Paratene Ngata¡¦s whanaunga that he, Paratene, felt he was the wrong person to go to when one wanted to discuss health. Paratene said to this cousin of his and I quote:

¡§Boy, don¡¦t come to me if you want to talk about health. I deal in sickness. People don¡¦t come to me when they are healthy they come to me when they are sick¡¨

It is that little story which moved me (and I was told to choose my own theme for my korero tonight, so this is not a jack up) to share with you my thoughts on what qualities I consider a healthy member of a whanau, hapu or iwi could be like.

A definition of health that I will use is that of the World Health Organisation who in 1947 stated that health was influenced by social and cultural factors. Health they said:

¡§Is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity¡¨

That definition, very clearly says to me that health has family/community, physical and psychological dimensions.

To the above definition I would add the spiritual dimension.

It also says to me that health is not to be seen as the sole preserve of health professionals.

Very clearly, I see that there are a number of people and professions who have and do contribute to and clearly influence the state of health of Maori people.

They include politicians like myself, a member of the Labour/Alliance coalition.

They include officials from the Public sector but especially those from the Treasury who argue at Budget time as to whether we politicians have ¡§got it right¡¨.

They are always right!

They include the Business interests who will make decisions as to whether they will continue manufacturing on the West Coast or move to Auckland.

Interests who may make a decision to close their New Zealand operation and move to where labour is cheaper in Asia or the Pacific islands in order to remain ¡§competitive¡¨.

They also include a group of people who are gatekeepers, people who will come up with plausible reasons to deny Maori access to proper care and treatment resources.

How many of you here tonight believe that the ¡§clinical decisions¡¨ are in fact objective and how many of you believe they are value judgments which are not devoid of the ¡§politics of medicine¡¨.

I have digressed somewhat from the theme of my korero.

To return.

The qualities I wish to discuss in essence relate to the issue of identity, the question, which, arrives at various stages of our life, the question the answer for which we probably will never find.

While there probably is not anyone, who has all these health qualities, they are qualities which identify health and are also the qualities which are necessary for one to be an effective whanau, hapu and iwi health worker and I will include those of you who as Paratene says, 'deal in sickness'.

Indeed after I had identified these qualities I felt quite sick. (There were so many I did not have!)

I want to put the view that healthy Maori are people who believe they have a place in this world.

People, who have been encouraged, to participate positively in the society.

People who feel they are part of and have been included in this democracy of ours.

People who feel their views will be respected even though they may be a minority.

What then might some of those qualities be?

They include:

„h Knowing the reo, being bi-lingual.
How many of us feel uncomfortable in that we can neither speak nor understand the reo.

How many of us do not feel good about that? How many of us feel, as our children say, "stink"?

If I was fluent in te reo I would certainly feel a lot better - I would feel and be more healthy.

„h Knowing ones whanau.
I have met too many people who have, through a variety of circumstances, not known their whanau.

George and I have fostered these young people and as dedicated as we were to loving them we could never ever replace the loss of their whanau.

We were unable to tell them those little stories, which make up the rich tapestry of whanau life.

We could not say "your tipuna was like this" or "your aunty achieved that" We were unable to remove the loss of their whanau from their eyes, from their hearts and from their minds.

Anyone here who has been lost will appreciate in some small way what these young and not so young, people feel.

„h Knowing one¡¦s ancestral house and burial ground.
These as we all know can be seen as the genealogical library. Both contain
the history of the people. Both are physical reminders of our origins and our
destination.

Some people say that the degree of alienation of a person in life can be
gauged by the destination of the hearse in death.

There are too many of our people who in life lived amongst strangers and
in death are buried alongside different strangers.

„h Respecting whanau.
There are rights and obligations, which go with belonging to a whanau.

As children we have a right to be cared for, nurtured, loved and kept free from harm.
As we grow older we have a responsibility and are obligated to care for our children and our parents in the same way that they cared for us.

George and I did not raise our kids to then go off and care for other people leaving their father and I to care for ourselves in our old age - no way.

Their responsibility to us was to have grandchildren, to keep us young and later to care for us as we matured in our twilight years.

Selfish individualism must not negate responsibilities and obligations to the whanau.

„h Recognising that the support system is more important than individual autonomy.
It is often said that no person is an island. Mason Durie states that the
whanau "is the prime support system for providing care and nuturance, not
only in physical terms but culturally and emotionally".

„h Knowing that to raise children to be independent is to encourage weakness and illness, but to raise children to be inter-dependant is to encourage strength and good health.

Durie says with respect to this indicator "That the much-lauded state of self-sufficiency or self-realization does not convey a sense a sense of health to Maori.

Quite the reverse, since an insistence on being overly independent suggests a defensive attitude, while a failure to turn to the family when the occasion demands is regarded as immaturity, not strength."

„h Respect for hapu customs and processes.
Too often ignorance of the rationale for our customs leads to ill health.

This is particularly so with the institution of the tangihanga the purpose of
that is often forgotten and misunderstand.

It offers the "kiri mate" the opportunity to be supported to grieve.

It creates an opportunity to farewell the spirit and the soul of the deceased.

It rekindles the institution of gifting and the reaffirmation of kinship ties.

It offers the opportunity to form new relationships and retell the stories of
the deceased and the whanau.

It removes the fear of expressing grief.

„h Awareness of the whanau, hapu and iwi influences that shape personal assumptions, beliefs and values.
All of us have been shaped by cultural landscapes emanating from our whanau, hapu and iwi experiences.

All of us can look to whakatauaki to identify iwi traits and characteristics.
I will recite three and you can try and work out which iwi are being referred to here:
1. "He piko, he taniwha, he piko he taniwha"
2. "Moumou kai, moumou taonga, moumou tangata ki te po"
3. "He iwi moke, he whanoke"

„h Knowing that normality is culture bound.
As a minority we often have imposed upon us and we in turn succumb and allow ourselves to be seen as not being normal.

The current political term for normality is "middle New Zealand".

As a youngster growing up in Putiki I considered myself to be normal.

„h Acknowledging the stories of the past in order to learn from and not repeat the mistakes of history. Knowing the effects of racism and colonisation.
We must be more honest about the past.

Simon Upton in his valedictory speech stated that we as a nation must not allow ourselves to succumb to historical amnesia and denial.

The knowledge of the two phenomena of racism and colonisation are bound up in the history of our nation.

We need to acknowledge the impact on Maori and refrain from victim bashing.

Only then can we consider ourselves as a Nation to be growing towards maturity and good health

„h Having addressed the personal issues that impact negatively upon one¡¦s life. Keeping well physically, intellectually, spiritually and psychologically.

We all carry the baggage of our life's journey with us.

We need to address that baggage which will weigh us down and inhibit our becoming healthy and enjoying the fruits of life. Let us not remain victims of our oppression.

Let us move to being people who thrive.

„h Believing in the goodness of Maori and humanity. Accentuating the positive and eliminating the negative.
Given all the negative press and statistics, how many of us see ourselves and our people positively?

How many of us interact with our people on the basis of tikanga mau painga.

In conclusion I would expect that to be healthy would be to pay allegiance to and stand with those who will weep over us when we die.

The question is do we know who will weep over us when we die and are we prepared to stand by them in life?

George, John and I appreciate being asked to share this evening with you.

Tena koutou katoa.

Ends

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