… even talk about cultural responsiveness and appropriateness can overlook and ignore the history of colonisation experienced by many Indigenous peoples and the consequent need to challenge racism and recognise indigenous sovereignty (Cram & Mertens, 2016).
We (Māori) are continuously reminded at every decision point and movement that we work within a colonial system that perpetuates western thinking and practice, even in our small, vulnerable Māori spaces. We are continuously in a process of decolonisation and its hard work!
In my experience, what works is research and evaluative practices that allow Indigenous issues, concerns, ways of understanding and practice to be placed at the centre. In particular, research should focus on strengthening whānau health and wellbeing that is context-sensitive, promotes social justice and enhances the life circumstances of community.
I would like to see is a shift from consultation with Māori using kupu like “being responsive and appropriate,” which I see written time and time again in organisational documentation and strategic plans, towards practices and policies that are accountable to Māori –
Reciprocal and responsive relationships, where Māori are at the table at the very least 50/50.
I want to see a health system that is embedded in practices of cultural safety, and where the effectiveness and success of service provision are based on whānau experience.
We must define health and processes of engagement for ourselves – the re-claiming of health and cultural safety as a space for Māori to be ourselves, a space that is negotiated, adaptive, and shaped by people, whānau, and communities and that asserts the value of kaupapa Māori in addressing issues of self-determination.
Identifying, naming, and defining are powerful acts that can change perceptions and determine who and what has value and then drive subsequent actions, such as policy development and research. Māori and the Crown have a political, legal, and spiritual covenant of equitable partnership through Te Tiriti o Waitangi.
We need to move away from the business commercialisation and compartmentalisation of health and towards the relationships of health – whakawhanaungatanga – relational practice.
Currently, Māori over under-served, overseen, vulnerably, oppressed, impoverished and marginalised across the board in all health areas. Māori have had our systems of control and authority undermined by colonisation and its intergenerational impacts.
Māori demonstrate differential use of primary healthcare when compared to non-Māori. The difference is race! A key enabler for reducing inequalities in health outcomes is developing a capable workforce. Systemic change is necessary to overhaul our racist health system and Māori health workforce do and continue to make a significant contribution towards supporting our people but it’s not enough.
Our health system needs to commit to transformative and actionable change on the ground for our Māori health workforce. We need to close the gap between academic theory and practice and contribute towards a current kaupapa Māori movement. We need to learn about the realities of the Māori health workforce – to listen and problem solve – be innovative, collaborate, gain traction and grow a movement.
When need environments where our people can feel relief/respite from a western dominated society where we no longer have to explain the ordinary – kaupapa Māori, no longer have to justify te ao Māori, Mātauranga Māori. Where we can concentrate on being present, connecting, and sharing. We need environments where kaimahi are seen first and foremost as Māori and then their professions – not divided or siloed but complementary to who they are. By placing kaupapa Māori praxis at the centre of change we can set new standards of engagement, models of care and codes of ethics.
I recognise that everything Māori is dynamic, sustainable, beneficially for our health system, and we need shift power structures and systems back to whānau, hapū, Iwi.
We need more spaces and systems that are unapologetically Māori. Need our workforce to come together whānaungatanga, re-energise, share, connect, be inspired and to be recognised for all the mahi they do.