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Tariana Turia: Culture, health and safety

Hon Tariana Turia
5 March 2004 Speech Notes

Culture, health and safety

Speech to open Maori Indigenous Health Institute, Christchurch School of Medicine, 3.00pm

E nga mana, e nga reo, Ngai Tahu – tena koutou katoa.

E nga iwi e huihui nei i tenei ra, tena hoki koutou.

As is customary when tangata whenua get together, our thoughts return to our tupuna, those who established the spiritual and cultural frameworks of our world, and who mapped out our peoples' course through life.

Their example, of strength and courage, of wisdom and understanding, of love and caring, and faith, is what inspires us to follow the guidelines they laid down for us.

Some days, that challenge seems greater than at other times. That is true of any journey through life.

As our tupuna said: 'Kaua ma te waewae tutuki e hokia, engari ma te upoko pakaru'. We will not let a stubbed toe turn us back – only a fractured skull.

In recent weeks our souls have been fractured, however our tupuna survived worse, and we intend to carry on.

Actually, that reminds me of a story that one of our iwi leaders tells about a long campaign of litigation over Treaty issues. It went on for years and years.

At various points their lawyer, quite properly I am assured, asked if the best option might be to abandon the court case. The iwi negotiators kept encouraging their team to continue the battle against overwhelming odds, quoting proverbs like 'Kia mate ururoa, kei mate wheke'. To which the lawyer was heard to mutter to herself – 'but I'm tired of dying like a hammerhead shark!'

Incidentally, that team went on to secure many gains for our people, and the nation, including the Maori television channel which opens at the end of this month. I am looking forward to seeing positive views of our peoples reflected in the media a bit better.

Today we are here to open the Maori Indigenous Health Institute –MIHI – and I would like to mihi to those who spearheaded this initiative.

I would firstly like to thank, Elizabeth Cunningham for inviting me to be here today, and for your work on this take. Kia ora Elizabeth.

I would also like to acknowledge the representatives of the Christchurch School of Medicine here today, who have contributed to the vision of establishing this institute.

To the Dean, Dr Ian Town: I am told you have championed the Institute and, from the outset, proactively sought support from all avenues that has made it a reality. No reira tena koe Dr Town.

I would like to acknowledge Mark Solomon, te Kaiwhakahaere o Ngai Tahu. The support and guidance that you and the hapu and iwi of the Ngai Tahu collective bring to such a venture will help ensure that Mäori health initiatives effectively address our peoples' needs.

I understand the underlying objective of the Mäori Indigenous Health Institute is to become a clinical teaching and research unit that focuses on Mäori health within a culturally appropriate teaching environment. And, that the ultimate goal of the institute is to devise a medical science curriculum that builds a strong Mäori workforce around clinical teaching and research.

I believe the institute itself aims to become an incubator of success in training first class Mäori health researchers.

If the Maori Indigenous Health Institute, as a distinct institution focused on the needs of tangata whenua can achieve these objectives, then I say that our people and the nation will all be better off. I believe this approach will attract and retain our people better than existing institutions have in the past. Let us judge the programme on its results.

The Maori Indigenous Health Institute is dedicated to the memory of the late Dr Irihapeti Ramsden. I see her whänau are here today and I take this opportunity to pay a special tribute to them, and to their mother, sister, and cousin, who was an outstanding leader.

Irihapeti had an astute mind, a vibrant personality, and a warm and gentle style. She was an outstanding communicator. She saw huge potential in our people, and she was passionate about releasing it. In her lifetime, Irihapeti achieved so much and I am sure she wanted to achieve much, much more.

The death of Irihapeti was a great loss for our people, and for this country. Irihapeti worked very hard, and very effectively, to build a nation based on inclusion.

As an anthropologist, a nurse, a publisher and an educator, she strove to help people understand how their own culture impacted on others.

Irihapeti was an outstanding thinker on cultural issues and Treaty relationships. Te Kawa Whakaruruhau, the cultural safety programme she helped to establish as part of the Nursing Council's programme of training, is an expression of her vision.

Irihapeti showed tremendous strength in promoting and defending the programme, and in completing her PhD thesis on Cultural Safety and Nursing Practice in Aotearoa and Te Waipounamu, even while she was in the final stages of living amongst us all.

In her PhD thesis, Irihapeti described how difficult it can be to bring about social change through education – and I quote:

In the neo-colonial environment this requires a profound understanding of the history and social function of racism and the colonial process. It also requires a critical analysis of existing social, political, and cultural structures and the physical, mental, spiritual and social outcomes for people who are different. It is a given that this type of knowledge is not taught in a general educational pedagogy which is normally about maintaining the status quo which underpins a conservative economic system based on individual success. This usually means that most people have little understanding of Treaty of Waitangi issues and New Zealand history. It is consequently very difficult to move the issues of cultural safety in relation to Maori health forward since the basis of this work lies in establishing an understanding of national and local issues and their impact on health. (Cultural Safety Kawa Whakaruruhau, Irihapeti Ramsden, Chapter 11, Conclusion)

Te Kawa Whakaruruhau became a lightning rod for huge public controversy over Treaty issues and cultural awareness in 1995. I recently looked at the report of an independent inquiry into cultural safety and nursing education. I also saw some newspaper reports of the time.

I was amazed how similar that debate was, to the current debate on treaty issues and so-called special privileges for our people.

Te Kawa Whakaruruhau taught nursing students to recognise that many of the things they took for granted about their attitudes and practice are determined by culture. Awareness of their own culture empowers nurses to care better for patients from different cultures.

Usually it was the culture of tangata whenua that was offered as an example of what was different. For this reason, te Kawa Whakaruruhau was attacked as indoctrination with the Maori activist view of history, political correctness, brainwashing and extremism.

The inquiry, however, found there was almost unanimous support among nursing students and tutors for Te Kawa Whakaruruhau, but there was some concern about the way it was taught in some polytechs.

It is obvious that a few examples were blown out of proportion in the media. Once that happened, members of the public who knew almost nothing about the programme saw a chance to air their prejudices, with little regard for facts or reasoned argument.

Irihapeti herself described it this way:

Making public appearances before the Select Committee on Education and Science, dealing with aggressive and usually uninformed television, radio and press people as well as supporting others embroiled in the stresses and tensions of the Cultural Safety story, has required significant emotional and intellectual resources.

The seamier side of New Zealand society revealed itself in the form of hate mail and death threats as well as a level of vituperative and uninformed opinion on the talkback radio networks. (Cultural Safety Kawa Whakaruruhau, Irihapeti Ramsden, Chapter 11, Conclusion.)

I see parallels with our current debate.

There are very good reasons for the health, education, and social service programmes that successive governments have introduced to overcome disadvantage suffered by our people, among other communities, and to promote self-sufficiency and independence.

I accept that not everyone agrees, and there is room for debate. What really concerns me is the quality of that debate.

When people make generalised criticisms of 'Maori people', we take it personally. It feels like each one of us is being attacked. We feel that the huge efforts and sacrifices we make, to deliver top quality services to our people in the way we know best, are a waste of time and effort. We don't count.

It is even worse when untruths and half truths are bandied around to justify the insults. Our lack of input to the public debate underlines our marginal status.

The tone of the current debate is shredding the fabric of our society. Families, friends and neighbours are being torn apart. It is going past simple disagreements over policy. It is causing a seething anger, especially among our young people, who have never experienced anything quite like this before.

In times of social stress, it is just so important that people listen carefully to each other. Tangata whenua generally feel their voices are not heard in the media. I believe the general public is not aware of the level of frustration and anger in our communities.

Reading the 1995 news reports about Te Kawa Whakaruruhau, I wondered if we might benefit from a cultural safety component in journalism training.

Well, we no longer have Irihapeti Ramsden to champion such a cause, unfortunately. I wonder if there is someone like her, ready to step forward. Someone who doesn't mind dying like a hammerhead shark in defence of common sense, justice and mutual understanding.

We may not have Irihapeti, but what we do have is her whanau, and this Mäori Indigenous Health Institute as a wonderful tribute to her memory.

Irihapeti, while an outstanding individual, was a product of her whakapapa, her whanau, her hapu, her iwi. They are the living memorials of a woman who will live on in the hearts and minds of those who loved her, and the people of Aotearoa who today, reap the benefits of her wisdom and courage.

I am sure the present and future staff and students will be inspired by her legacy. Like Irihapeti, you will not be turned back by a stubbed toe, but will follow her example of strength and wisdom and love and courage, to ensure the success, growth, and continuation of this institute.

Kia ora tatou katoa.


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