Maori Health Story Board

Maori Health Story Board

Storyboard Text

  • Kia Ora, my name is Miss X and I'll be teaching you about Maori Health in Aotearoa
  • Let me ask you. What ethnic group has the poorest health disparities in Aotearoa? Can you guess?A. PakehaB. ChineseC. MaoriD. IndianRead on to see
  • If you guessed B. Maori then you are correct. Heres why...
  • Maori are the indigenous people of Aotearoa, who in 1840, accepted a political offer ofalliance with the British by signing Te Tiriti O Waitangi. In the early 1900’s Maori had lost almost all of their land and like many indigenous people, they had become the colonized minority. The loss of land in the early 1900’s still affects Maori today and are facing the same issues of poverty, marginalization,racism, discrimination and poor health outcomes (Walker, 2004).According to Statistics New Zealand, in June 2020 the Maori population made up 16.7 percent of Aotearoa’s population making Maori one of the largest ethnic groups in Aotearoa (Statistics NZ, 2020). Despite medical research reflecting on Maori health disparities Maori are still the leading ethnic group that faces poorer health outcomes, higher morbidities, increasing mortality, over-represented in all disease categories and have the life expectancy to die seven to eight years younger than non-Maori (Barton, 2018). 
  • Wow its so dark! Imagine you found some treasure and a group of pirates said "partner with us and we'll protect you from other treasure seeking pirates, so you agree and on your journey home, they betray you and steal your treasure. How would you feel?
  • Q: What are the determining factors that lead to Maori having the poorest health disparities?
  • A: Institutional racism, unsafe cultural practices and socio-economic factors
  • Institutional racism: Came et al. (2019)claims that institutional racism is the culprit in the manifestation of healthdisparities between Maori and non-Maori here in Aotearoa. In short, institutional racism became prevalent back when the British abused Te Tiriti in the early1900’s. The British became the more dominant culture and therefore Maori becamethe minority. Maori patient’s reported that their spiritual and cultural practices were devalued inthe westernized health system and felt that the doctors only wanted to treat the physical symptoms rather than their overall wellbeing (Penny et al., 2011).Participation of the minority meant pushing ones’ own beliefs and values aside to fit into the dominant culture. Subsequently meaning that Maori were receiving care that was culturally unsafe and discriminative, two contributing factors leading to poorMaori health outcomes. Graham &Masters-Awatere (2020) reported in a study that this is still occurring today,Maori patients have reported feeling racially discriminated against, poor patient-clinician relationships and negative in-hospital experiences.
  • Unsafe cultural practices:Curtis et al. (2019) emphasized that it is not enough to be culturally competent because now, racism stems ofprivilege, marginalization and social injustice. In agreement with Curits et al. (2019), Talamaivao et al. (2020) states that healthcare professionals must be aware of their own prejudicial behaviours in order to provide adequate healthcare to Maori patients however, Maori health has continued to worsen because thecurrent cultural safety measures are not sufficient in changing the behaviours and attitudes within the westernized healthcare system. Real change is reliant on a commitment from health practitioners to decolonise thinking and encourageand empower the unique identity and well-being of Maori (Ramsden, 1993).
  • Socio-economic factors:The annual health survey from 2016/2017 found that cost was a barrier for Maori accessing healthcare (Ministry of Health, 2017), Maori are less likely to finish secondary education,poor health literacy, more likely to become unemployed, less likely to visit a doctor and pick up prescribed medications. Why? Because Maori were not being referred to specialists, less investigations into their care, less interventions and were being prescribed less effective medications meaning their health was being made worse without the appropriate and necessary care (Hunter & Cook,2020).
  • Ahh thats better, hope that journey wasn't too dark for some of you. Racism can be quite confronting. But unfortunately, it happens, here in Aotearoa.
  • Can you guess how Maori might rate their in-hospital experiences?A. GreatB. GoodC. NeutralD. Not goodE. Horrible
  • Patient-clinician relationship:- poor communication between non-Maori healthcare professional- patients feeling neglected, not listened too- facial expressions and gestures showed hostility
  • Maori patient Maori clinician relationship- Patients report better treatment when recieving care from Maori nurses. Nurses also report they are able to support Maori patients better due to relatbility (Hunter & Cook, 2020).
  • Unsafe cultural practices:- Maori feel like their cultural and spiritual needs needed to be pushed aside in exchange for the treatment they needed (Wilson & Barton, 2012).
  • Heres how Maori have rated their in-hospital experiences whilst in-hospital or receiving care from a healthcare professional
  • Its unfortunate that Maori patients are still reporting negative hospital experiences. In this next section, I will go through with you some practices that you can apply into your own nursing practice to ensure Maori feel culturally safe when receiving health services from you.
  • Copy and paste this link into your browser and we'll come back to discuss how these practices can be applied into nursing practicehttps://www.youtube.com/watch?v=aat_TEq8O9k
  • In the video 0:32-1:57 explains how she and her whanau supported her dad throughout his stay in hospital. Whanau support is important for patients who are unwell as whanau provide physical, emotional and spiritual support, part of the holistic well being of Maori (Wepa & Wilson, 2019).
  • Q: List what other tikanga practices you know, that have been applied in hospitals to ensure Maorihealth is being prioritized
  • Other tikanga practices in hospital include:- Discussing body part/tissue retention for Maori custom. E.g Keeping the placenta after birth to bury back into whenua. - Keeping the head sacred and ensuring practices reflect his. E.g different pillow cases for head vs for feet.- removal of bodily fluids/ parts where food typically sits- understanding Maori custom following death(West Coast DHB, 2019)
  • Karakia: From 1:58 to 3:23,Querida talks about Karakia being a vital practice when a patient is unwell inhospital. Karakia normally takes place before and after an intervention. Karakia is the most common spiritual act to invoke protection, healing and guidance when unwell. This is to restore all dimensions of health because Maori believe when a person is physically unwell other areas of their health are also unwell.
  • To conclude this teaching, Maori health disparities will continue to worsen if healthcare professionals do not priortize and accommodate to the needs of Maori in a culturally safe way.Thank you. Hope you have enjoyed my teaching package and learnt something new.
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