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Turia Speaks On Diabetes And Indigenous Peoples

Hon Tariana Turia

Opening Speech To The 5th International Conference On Diabetes And Indigenous Peoples, Christchurch Convention Centre

Tena koutou te mana whenua e awhi nei i te kaupapa o tenei huihuinga.

He mihi kau ana tenei ki a koutou katoa. Ahakoa nga piki me nga heke, e pa ana ki nga mahi hauora, ko koutou ano e kaha tonu nei ki te mahi I enei tu momo mahi.

Ki a koutou nga manuhiri tuarangi, e whai ake nei he huarahi ake ora mo a tatau whanau. Kia kaha koutou!

Ko tenei te mokopuna o Ngati Apa, Nga Rauru, Whanganui me Tuwharetoa, e mihi atu nei ki a koutou.

I am pleased to be speaking to you today and to be opening the 5th International conference on Diabetes and Indigenous Peoples. To our visitors, who have travelled from across the seas, welcome to Aotearoa. I hope that you enjoy your visit to our country and you build many strong relationships that will last longer than the duration of this conference.

While this conference is specifically about diabetes, I believe that the strategies and solutions we adopt to reverse the ever-increasing numbers of indigenous people that suffer from diabetes, are inter-woven in our ongoing indigenous development.

The late Dr Erihapeti Rehu-Murchie who was of Ngai Tahu descent wrote in Hauora: Maori standards of health III, 1995 that "Maori health is to a great extent a result of socio-economic and socio-cultural factors which have their roots in colonialism and the struggle to adapt to rapid change arising from post World War Two urbanisation. Until the grievances arising from failure to honour the Treaty of Waitangi are resolved Maori ill-health will remain a problem."

Indigenous strategies often seek not to focus on the sickness, but on a model of wellness that takes into account the interconnectedness of all things, sometimes referred to in the health sector as te whare tapawha (the four cornerstones of health). Te whare tapawha encompasses wairua (spiritual), hinengaro (mental), tinana (physical) and whanau (family).

In the rohe where I come from, we have a saying:
E rere kau mai te awa nui
Mai te kahui maunga ki Tangaroa
Ko au te awa, ko te awa ko au

(The river flows from the mountain to the sea,
I am the river, the river is me)

It can be said that our identity, our whakapapa (genealogy), is inextricably tied to our rivers, our mountains, our lands, our lakes, our forests and our seas. And so too, is our health and wellbeing.

The epidemic of diabetes is as a result of lifestyle changes that have been forced upon our people. It is a disease that has had a devastating effect on our whanau, hapu and iwi because it affects all the major organs of the body.

In Aotearoa, Maori have one of the highest death rates for diabetes in the world and are twice as likely to have been diagnosed with diabetes than non-Mäori. (Ministry of Health, 1998). Such statistics have major and long-term health and development implications for our whanau, hapu and iwi. They are, however, like all preventable diseases, reversible, through the adoption of policies and practices that draw on indigenous knowledge and experience.

Treatment of diabetes to date, has not been as successful as it could, because the focus for treatment has been on the individual in isolation and not the whanau. It is impossible for a whanau to cope with diabetes if they are not all informed about the disease, it's treatment, and the role that they can play.

I know my cousin who has diabetes did not cope until the whole whanau became engaged in a whanau exercise programme, and they all changed their lifestyle and eating patterns. They realised that they were all living with diabetes, and all had a responsibility to help in whatever way that they could.

You, who are attending this conference, will be far more expert than I am, about the treatment of diabetes and the best ways to educate whanau.

Our whanau, hapu and iwi are determined to play their role in their own development in relation to health. This coalition Government has also committed itself to whanau, hapu and iwi development. It is this combined willingness that will allow dynamic, innovative and positive developments within the health sector.

For many years our people have been patiently telling successive Governments what the strategy must be for a more inclusive society in this country. To date there has been a failure to take heed. Now we have so much to do, the will to do and insufficient resources to do it with.

However, in the current climate of co-operation both between communities and government, and between government agencies themselves, there is a strong will to work alongside each other with that limited resource with the hope that the much improved level of co-operation may provide the catalyst for progress.

The approach this Government is taking to addressing the social wellbeing of our whanau is a different approach than that taken in the past. The Government has committed itself to work with whanau, hapu and iwi to reverse the high incidence of diseases such as diabetes.

As a Government, we have taken the next step to look at development pathways that ensure whanau have capacity to address health issues that may arise for them in the future.

The Government’s policy for Maori development aims to address disparities and drive Mäori development through a new partnership approach between 'whanau, hapu and iwi' and the state sector, business, local government and the wider community.

At the heart of what this Government and I are working for, is the development of our whanau. At the heart of whanau development is the need to attain and maintain their health and wellbeing. The ability of whanau to carry out their economic and social development plans relies on their ability to 'be' and 'stay' healthy.

Our whanau members are often best at coaxing us into living healthier lifestyles. Our mokopuna (our grandchildren) are the best at getting their nannies and koroheke to take them walking, to play with them outside, to walk them to and from school. How can one refuse the vitality of their grandchild? It is often for our mokopuna that we will prepare a wholesome meal, which we may not have bothered to prepare for ourselves.

A vital ingredient to ensuring the level of self-reliance is the ability to maintain a healthy indigenous population is developing an indigenous health workforce. Such a workforce must have the depth of understanding, the diversity, the experience and the ability to work amongst our whanau, hapu and iwi to address health issues before they arise and well before they reach the current levels of diabetes that we have.

The most dramatic change in the health sector has been the growth of Mäori health providers. While Mäori providers reflect the diversity of the Mäori population and they include; iwi providers, providers which emerged from within mainstream health providers, providers built by Mäori health professionals, and community-based Mäori social service providers. The expertise must be retained within the whanau, hapu and iwi to ensure their continued development.

It is not about the "toa taki tahi" (the singular strength), it is about the "toa taki tini" (the collective strength).

Capacity building in this context will take all the undoubted intelligence, creativity, entrepreneurial skill, passion and commitment of whanau, hapu and iwi, because it requires us to be focused on capability, and not on need and deficiencies.

Development and, therefore, capacity building, is not a nebulous process for which the results are invisible. Indeed, it is a process - the results of which can be seen on our people’s faces, and is evident in our hearts and minds.

Development, like whakapapa, is a dynamic process and is always changing and evolving. It is never static, nor are the mechanisms and processes, by which it is achieved. It will result in people taking control of their own lives and life situations.

Development for whanau, hapu and iwi is recognition and an acknowledgment of the interdependence, the nature of reciprocity and the obligation and responsibilities that whanau hapu and iwi have toward each other.

Development for us means we must affirm our cultural values, beliefs and practices that lead to respectful interaction with each other and with the environment that we occupy. Then we can determine how best we can move forward into the ever-changing world, being whatever we want to be.

Whanau, hapu and iwi must be involved at every stage of developing, implementing and evaluating solutions. I would argue that successful models must stem from whänau, hapü and iwi and Mäori organisations working in conjunction with government agencies.

The United Nations has said in their Draft declaration on the Rights of Indigenous Peoples 1993 (Article 23) that: Indigenous peoples have the right to determine and develop priorities and strategies for exercising their right to development. In particular, indigenous peoples have the right to determine and develop all health, housing and other economic and social programmes affecting them and, as far as possible, to administer such programmes through their own institutions. New Zealand needs to give consideration to how it implements its obligation with respect to this and other UN Treaties.

Diabetes has such an overwhelming influence on all our people’s health and I hope this conference provides us with a valuable forum to move forward the goal of improving diabetic outcomes for Indigenous Peoples. As I said in the beginning, it is important that we use conferences such as this to build relationships amongst ourselves. You all have valuable contributions to make to your own peoples' development and in your own countries. Share your lessons, and learn from each other. We may be separated by the sea, however, I am sure we share similar aspirations for our future generations.

I declare this conference officially open and I wish you all the very best. I'm sure it will be valuable in terms of building and strengthening long-standing relationships and sharing indigenous knowledge.

Na reira ki a koutou katoa, tena koutou, tena koutou, tena koutou katoa.

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