As mainstream health services struggle to keep up with demand, an initiative by Ngāi Tahu on the west coast of the South Island sees treatment offered to all comers
Could this be the way of the future for small towns with declining services?
Health care provided by Maori organizations that bring it to the people?
Everyone, that is, not just tangata whenua.
It’s an idea whose time has come, say organizers of a ‘Wellness Day’ novel in Reefton this month.
Poutini Waiora, a health and social service provider from Ngāi Tahu who has been supporting west coast whānau for 21 years, reached out to the wider community last week with an expo-style multi-clinic at the town hall.
“Come join us for a free health check,” the posters read.
And the people of Reefton – more used to losing health services than seeing them coming to their doorsteps – jumped at the chance.
“About 200 people showed up during the day, which is not bad for a town of 900 people. It shows there is a real need out there,” says organizer Tess Hunter.
Hunter and her husband Tony Manuel, both community veterans, encounter much of this need daily in Reefton.
“People have been going through a really anxious time in the last year or so since Covid. We didn’t have a GP over the winter due to shortages of locums so it was a way of saying we care and can help.
The event brought together the services of Maori and traditional providers.
“Services are there but many are 80km away in Greymouth or Westport. And rural folks may not even know they exist,” says Hunter.
At the Reefton event, blood pressure and diabetes checks, peak flow tests for asthma, child checks, advice on breast and bowel screening, green prescriptions , mental health support and Covid or flu shots were offered at the Reefton event.
Surprised locals were greeted with non-clinical offers including free hand knits and activity packs for children. Sausages, hot drinks and soup were also available.
“A man drove his 90-year-old mother from Maruia in the snow for her Covid recall. They were happy to have a cup of tea after that,” says Hunter.
Vaccinators ran out of boosters, administering 30 shots during the day, and the gut screening nurse distributed 10 test kits, a significant number for the small town.
“A young mum told me that she brought up a few things with Tamariki Ora’s nurse that she didn’t feel comfortable telling anyone, I think because she felt felt comfortable and welcome.”
The plan now is to make Reefton Wellness Day a quarterly event, Hunter says.
In the past, Poutini Waiora has held such events at Arahura marae and Hokitika to cater to the higher numbers of tangata whenua in these areas.
“Our first priority is Maori, but the well-being of the whole community is important,” says Dianna McLean, team leader for Poutini Waiora in Westport.
The organization has contracts for services ranging from community mental health to truancy and its staff are a mix of Maori and Pākehā.
“We don’t turn people away just because they’re not Maori. We have a percentage allocation for non-Maori in our budgets and mainstream services are currently in shock.”
Practicing Māori tikanga means teams start the day with karakia and put clients’ needs first, new experiences for staff previously employed in the mainstream health sector, she says.
“Our new mental health worker is from Finland. He asked me how long his appointments were supposed to last. We told him, ‘As long as it takes.’ He was blown away by it.
Poutini Waiora administrator Joan Blacktopp says the success of Reefton Wellbeing Day shows what is lacking in rural health services.
“It filled real gaps. Many people avoid going to GP clinics. It’s all formal and they have to pay, so they’re less likely to go get their blood pressure or diabetes checked.
The result, as a surgeon leaving Greymouth observed, is that many West Coasters only turn to the health system in an emergency or with advanced illness that could have been detected by routine checks. .
Greater things are calling
The success of Reefton Wellness Day is now causing some locals to wonder if some bigger things could also be better handled with a tikanga Māori approach.
“The DHB closed our nursing home and sent our elderly to die away from home – now they are coming back in wooden boxes,” says Ali Caddy, local businessman and health representative.
“Nurses want to work here – we know that – but the DHB is diverting them to Greymouth or Hokitika because there is a national shortage of nurses. We are just not their priority.
Graeme Neylon, a former member of a primary health organization and Buller adviser, said as part of health reforms the government has asked West Coast councils to take the lead in consulting communities on services of health they need and who should provide it.
“Reefton, Westport and Karamea all had a raw deal with the former Greymouth-based DHB system. But under this pilot program, we have a chance to make a fresh start, to structure things from the bottom up.
“It’s not like we’re going to find a local surgeon or anything, but if organizations like Poutini Waiora are already doing the mahi we need and doing it well, we can say they should be funded to extend their services to places like Reefton.”
Coastal councils should start working on health consultation in the near future, now that local elections are over, says Neylon.
Produced with the support of the Fund for Public Interest Journalism