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Tariana Turia: Community Health Workers Hui

Community Health Workers Hui,

Maraeroa Marae, Porirua

Thursday 24 July 2008; 11am

Hon Tariana Turia, Health Spokesperson

My mokopuna has a favourite game.

Pick a number, any number.

Well I’ve got a number for this hui.


150,000 households in Aotearoa which Roy Morgan tells us are are extreme risk of missing mortgage payments and potentially losing their homes.

150,000 children whom the Child Poverty Action Group tells us still remain under the relative poverty line, living in sever and significant hardship.

150,000 people – most of whom are Maori and Pasifika, refugees, and low income families who have high health needs – and constitute the people who come through your doors.

Sometimes as one community worker, you may feel overwhelmed by the enormity of the task before you.

Days like today are the opportunity to regroup, restore and revive – in order to then go out again, and face the 150,000 who deserve quality primary health care, who deserve to be well, who deserve a voice.

It’s time to remind us all that you’re not alone – but part of a much bigger movement of change, a movement for hope.

I was really delighted to hear that Healthcare Aotearoa had taken up your call, for community health workers to have a hui of your own.

The demands upon community health workers are relentless; the expectations always exceed reality.

For the job title ‘community health worker’ is really just another way of saying ‘miracle worker’; ‘magician’; superman – or more to the point wonder-woman.

You are expected to be multi-skilled; able to intervene in complex situations without ever giving the impression of it being a crisis.

You are required to feel as comfortable in someone’s bedroom as you are in negotiating for specialist referral follow-up care.

Lorna Dyall summed it all up in the following statement:

“Community health-workers are seen as having clearly defined skills and expertise, their role is to be in front, to provide health messages, to gain community support on different health issues, and with health professionals working together to provide clinical support.

Community health workers were seen as unique people working at the grass roots and flax roots level and are leaders….”.

Maybe we should be suggesting a new job title – community leaders – to better describe the work that you do.

Leadership in whanau ora, in tamariki ora, in oral health, in smoking cessation.

Leadership in early intervention, in anger management, in assisting your community to ensure better self-management.

It is this aspect of self-management which I believe is the most critical of all.

Assisting whanau to be focused on healthy lifestyles takes a lot of work.

It is work which is made even harder by the conditions I referred to earlier.

I was really sad to read the comments in your newsletter from the National Maori PHO Coalition, which stated that the economic downturn and the rising cost of food and petrol is having a negative impact on Maori health.

Simon Royal suggested that not only are Maori under-utilising primary health care services and presenting at hospital more acutely than the general population, but that in the current times, when times are tough, the check-up is the first to go.

This is a huge issue for Healthcare Aotearoa, for the National Maori PHO Coalition, for Te Whiringa – the national Maori community health-workers association – and the Maori Party as well. These are huge barriers – the economic instability which is being felt at significant levels across our community.

But there are other barriers too that we need to come to terms with.

It was at this very marae in 1990, that my dear friend, the late Irihapeti Ramsden, was profoundly moved by a story told to her.

A Maori mother of three children decided that she would take her baby to the local medical centre and enquire about immunisation. Dressed casually, she approached the nurse at reception, hoping for an appointment.

At first the nurse ignored her, then turned to her with a look of sheer impatience and distraction.

The young Mum told Irihapeti that she felt so uncomfortable that she shrank away and left. Irihapeti summed it up,

“There was no exchange of words yet the interaction had been so powerful that it completely blocked access to health services.

The young woman said that she felt shy and ambivalent, did not feel able to assert herself in the Centre and in the presence of the nurse who was exhibiting behaviour which the mother felt was an unspoken commentary on her care of her baby, her casual appearance, her social class and her being Maori”.

I wanted to tell this story – which Irihapeti later wrote up in her PhD on cultural safety – because it summed up for me, how powerful the influence of attitude can be.

It reminds me how critical we, who work in health, are in opening doors or shutting them.

As community health workers, you have the opportunity to be a power holder – to create an opportunity which enables people to feel safe, to demonstrate an open and positive approach, to convey a message of welcome.

It is a vital job – and it is a valued job – but I do acknowledge that there was perhaps one lucky number that I have so far missed out.

That’s the small matter of say, $150,000.

I would love to say I had the means here today, to make it possible for the incredible leadership role of the community health workers to be recognised by the appropriate salary package.

I don’t have a magic cheque book up my sleeve – but I do wish you much luck with the very important campaign you have been leading with Te Rau Kokiri employment contract negotiations.

The eleven thousand signatures that you presented to Parliament at the end of May will be very influential in laying the foundation for supporting pay parity for Maori, iwi and not-for-profit organisations.

I want to congratulate you all on the success you have had so far, in achieving an audience with the Minister, and for the strength of the collaboration between the employers and the NZNO.

I hope these two days are an opportunity to find common ground, to debrief and de-stress; to dream, to scheme and to create the strategies that will truly make the difference across your communities.

The Maori Party is driven by our quest to Be the Change.

To be the change that will make it happen.

To be the change that will improve the health and wellbeing of whanau.

To be the change that our communities deserve – to live longer, to be healthier, to be strong, to be happy, to be secure.

I know we can do it.


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