Thank you for that Trish!

Kia ora Kotou, my name is Chat and following on from wonderful

insights of my fellow weavers, in my readings I really honed in on health inequities
disprortiationaly impacting Māori. Colonisation propelled some of the Wicked Problems we
see today, like the disenfranchisment of Te Ao Māori and instituionalised racism. I learned
that how we narrate these wicked problem hugely impacts the decisison making processes
Tiare spoke to. So when Māori are treated with eurocentric diagnsotic measures like Body
Mass Index (BMI), they are not only stigamtised, but the onus of their care can falls on
themselves. Imagine what would happen if instead of harakeke, you tried using branches
and twigs to weave a kete – it would snap. So how then, can we trust health care systems to
consider the needs of our most vulnerable communities?

As some of you know, Aotearoa recently introduced Te Whatu Ora that disbanded precursor
20 DHBs to become one with the aim of increasing access and reducing inequities. What you
may not know is a similar unison Universal Health Care model exsisted from 1975 – 2000s,
which unlike Whatu Ora, ignored Hauora Māori and Māori needs where studies show
“equality of access did not mean equality of outcome”. So in order for Whatu Ora to
succeed in their goals, core processes must be co-designed and informed by Māori
perspectives as it is they who will bear the impact of the outcomes. This bottom-up
appraoch requires a high level of humility. To Māori, Whakawhenuatanga was often
faciliated with the use of humour where Holmes (2007) highlighted “self-deprecation is the
Māori way”. When we spoke to Alex and Sau, although humour in and of itself was not a
strong theme that emerged, they did demonstrate humility by co-designing processes for
their mahi. Especially, when they first embarked on their leadership journeys, they both
said they were the first to freely admit that they didn’t know anything. Both Alex and Sau
who resonated in their preference to build Hau at an individual level rather than a
consensus, invested time to “walk alongside their staff” which helps them be attuned to
their unique strengths and ways of working. To Sau, my Team Lead, this was also an
opportunity for her to address discomforts in areas needing improvement or additional
training. To me this really anchors my trust in knowing I am heard and supported. Alex who
describes himself as “stubbornly compasisonate” exercised humility in his mahi regularly,
leaving his ego behind. I believe this humility is the first step to compassion, much like the
removal of Muka in prepearing of the Harakeke for To Iho.
As we already mentioned, our leaders were passionate empowering mentors that I think
serves as wonderful mirror in to their own compassion. Both Alex and Sau created
opportunites for their team to grow their skills and be confident. Alex did say though that it
can at times come with effort as he described how he had to push to include voices of his
staffs’ valuable expertise to a Pākeha board who “preffered to speak to someone that looks
like them”. This advocacy and reciprocacy was extended in times of tension too where Sau
made every effort “never to assume anything” when resolving conflict.

So if we incorperated all these elements; compassion, humility, hau and advoacy, is this
enough to to ensure equitable health outcomes? Almost everything we know is learned, so
it comes as no surprise that we must train future Health Care leaders throughout their
education to appreciate and consider both Tikanaga and Hauroa Maori in their praxis. Now I
know this comes as no surprise to anybody, but training is particularly paramount to ensure
the sustainability of equitable Kauapa. As Neil too would touch on, permeating the voices of
Māori is critical in the way forward, to de-colonise hegemonic westernised narratives.
Research shows that because the exsisting governance in health care is a very heriachical
approach, it can take a great deal of time to be shifted. Ensuring early exposure through
education can therefore mean the difference between a leader equipped to consider
challenges faced by Māori to a leader who knowingly or unknowingly goes on to perpuates
inequities. Thus failing to do so, would be like me trying to weave a kete right now with no
practice – it simply takes learning.

Thank you so much for listening, please allow me to pass on to Neil

References

Brown, H., & Bryder, L. (2022). Universal healthcare for all? māori health inequalities in
aotearoa new zealand (1975)-2000. Social Science & Medicine (1982), , 115315.
doi:10.1016/j.socscimed.2022.115315

Came, H., & Griffith, D. (2018). Tackling racism as a “wicked” public health problem:
Enabling allies in anti-racism praxis. Social Science & Medicine (1982), 199, 181-188.
doi:10.1016/j.socscimed.2017.03.028

Frawley, J., Russell, G., & Sherwood, J. (2020). Future directions: Cultural competence and
the higher education sector Springer Singapore. doi:10.1007/978-981-15-5362-2_19

Grint, K. (2005). Problems, problems, problems: The social construction of ‘leadership’.

Human Relations (New York), 58(11), 1467-1494. doi:10.1177/0018726705061314
Holmes, J. (2007). Humour and the construction of maori leadership at work. Leadership
(London, England), 3(1), 5-27. doi:10.1177/1742715007073061

Mayer, D. M., Bardes, M., & Piccolo, R. F. (2008). Do servant-leaders help satisfy follower
needs? an organizational justice perspective. European Journal of Work and Organizational
Psychology, 17(2), 180-197. doi:10.1080/13594320701743558

Panesar, D., Rahiri, J., & Koea, J. (2021). Indigenous health leadership: A kaupapa
MāoriPerspective from aotearoa – new zealand. BMJ Leader, 5(2), 83-86.
doi:10.1136/leader-2021-000445

Whakamaua māori health action plan, 2020-2025 (2020). . Wellington, New Zealand:
Ministry of Health. Retrieved from https://natlib-primo.hosted.exlibrisgroup.com/primo-
explore/search?
query=any,contains,9918991660302836&tab=catalogue&search_scop
e=NLNZ&vid=NLNZ&offset=0

Alice Snedden’s (Producer), & . (2022). Why do we still judge fat people? | Alice Snedden’s
bad news. [Video/DVD] retrieved from: https://www.youtube.com/watch?v=9FOSaEdql-k