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.