Maku e ki atu - He tāngata, he tāngata, he tāngata.
What is the greatest treasure in the world?
I will say to you – It is people, it is people, it is people.
Māori Cultural Competencies for health and disability advocates
These competencies recognize that the advocacy workforce is made up of people from a range of backgrounds who have shared values and approaches. The purpose of the competencies is to specify what is required for best practice to assist advocates to provide services that are appropriate and acceptable to Māori. They will be introduced as part of training on Māori Cultural Competencies and are to be integrated into advocacy practice. Central to the competencies is the intention that all people are treated with dignity and respect.
Cultural competency requires a commitment to continuous improvement through ongoing planning, education, training, review, supervision and feedback, like any other area of competence.
Professor Mason Durie describes Cultural competence as about the acquisition of skills to achieve a better understanding of members of other cultures. He notes that the goal of culturally competent care is to improve relationships and thereby achieve “better clinical results”. This means that people are best served by those who are part of or in tune with their culture. Māori culture, like other cultures is dynamic and encompasses a range of preferences and practices. The key to understanding this is to understand significant concepts as well as local or regional variations in Tikanga and cultural protocols.
Assessment options to measure competence
Standard of the competent practitioner
MĀORI CULTURAL COMPETENCIES
Knowledge, skills, behaviours, personal attributes displayed by the advocate
How you will know if the level of competence has been achieved?
What the competent practitioner does and what their practice looks like (usually after 12 months on the job)
Te Tiriti o Waitangi
Declaration of Independence
Te Reo Māori (introductory)
Māori history and colonsiation
Māori health statistics and inequalities
International Declaration on the Rights of Indigenous People
Advocates are familiar with the context of current Māori issues and feel confident about working with Māori.
Te Tiriti o Waitangi is relevant to and reflected in advocacy practice.
Māori identity, cultures and values are well understood and respected by advocates.
Māori consumers and whanau are provided with a culturally appropriate service
Māori consumers and whanau feel their culture is acknowledged and respected
KNOWLEDGE The advocate is familiar with the following areas of knowledge:
It is important to be able to reflect on one’s own cultural identity, history, attitudes and experiences to achieve an understanding of the impact of professional practice and interactions on people from different cultures
The advocate can describe and discuss:
their own cultural identity and/or whanau/hapu/iwi links
their own personal values and beliefs with regard to working with Māori
values and beliefs that are important to Māori
the importance of whakapapa to Māori
basic concepts within a Māori worldview (such as tangi, manaaki, aroha)
their personal vision for Māori
how they manage personal and professional boundaries in relation to working with Māori
They know about family systems and whanau dynamics
They know the tangata whenua within their area
They know the waka, maunga and iwi within their area
They know the linkages between whanau, hapu and iwi
They know the key relationships within the local Māori community
They are aware of key local events for Māori, such as Waitangi Day, Poukai, Hui Taurima
They can describe the way in which health and social services are being provided within their region and how these are accessed and provided to Māori
They have knowledge of the issues for Māori using mainstream health and disability services, systems and processes.
They can describe and discuss the significance of Te Tiriti o Waitangi
They can make links between service provision and the articles and principles of the Treaty
The have an understanding of inequalities and privilege
They can recognise racism and have a range of strategies to deal proactively with it.
Tikanga Māori :
It is important to have an under-standing of basic Māori customs, beliefs and concepts. Advocates need to be able to:
describe the powhiri process in formal and non-formal situations
understand the concepts of tapu/noa, mana/mauri, whakama, manaaki tangata, whanaungatanga, kanohi kitea
be familiar with at least two karakia (one for food and one general)
name the HDC and local Kaumatua and know the correct protocol for making contact with them
describe one of the Māori frameworks and models of health
Understand the concept of reciprocity in relation to Tikanga Māori (eg research participants).
SKILLS & BEHAVIOURS
The advocate is able to demonstrate the following attributes, skills and behaviours to achieve culturally safe advocacy practice when interacting with Māori.
Values and understands own culture
Has regular contact with the place they call ‘home’, as in their papakainga (where they belong) and/or maintains links with their own whanau, hapu and iwi
Demonstrates a personal commitment to things Māori and has a positive attitude towards Māori and Iwi world views
Has respect for the views and beliefs of Māori and Māori processes
Ensures correct protocol and procedures are followed
Has clear professional and personal boundaries
Takes part in powhiri (formal and non formal welcomes) with confidence
Consults others to ensure due regard for Māori process is given
Te Reo Māori:
Māori names often have connections to the past and the present so getting the pronunciation right is a mark of respect.
Is familiar with the recommended Te Reo Māori glossary and alphabet
Can pronounce Māori place names and key words accurately and with confidence
Is confident to ask how to pronounce names correctly
Knows basic greetings in Te Reo Māori
Knows at least three waiata that can be used in greeting situations
Can do a basic introduction/mihi in Te Reo Māori
Can sing three songs in Māori
Can describe a whakatauki (proverb) relevant to the region they work in
Effective communication and positive relationships:
When working with and assisting Māori, the advocate will be guided by the consumer and their whanau. It is important the advocate:
Understands the importance of introductions and time to make connections and understand each others perspectives and viewpoints.
Establishes working relationships based on Trust and respect
Takes care with language and avoids jargon and technical terms that may lead to confusion and misunderstanding.
Is responsive to the Māori preference to make requests and discuss plans in person (eg by phone) or face-to-face kanohi ki te kanohi
Achieves an effective and appropriate approach to the collection of ethnicity data for aggregate purposes. *
Provides effective facilitation and resolution skills that take into account the cultural needs of Māori.
Checks all parties have a shared understanding of any decisions, plans or conclusions reached
Provides opportunities for Māori processes and karakia where appropriate.
Ensures meetings are conducted in a manner that is respectful to all parties so all present feel safe, are able to have their say and are listened to.
Mahi a Whanau: (Working with families)
Works respectively with all levels of whanau (older people, youth, children)
Communicates effectively with the whanau and maintains rapport
Checks with whanau (where appropriate) before making assumptions about why a consumer has acted in a particular way.
Encourages Māori consumers to utilize the strengths and resources within the whanau and /or their networks.
Has the ability to establish and maintain a range of meaningful and appropriate relationships of benefit to Māori
Is able to work confidently with Iwi as well as Māori individuals, whanau and groups
Is able to assist Māori and operate effectively within Māori provider and mainstream systems and processes
Is able to critique the environment they are working within in ways that take into account Māori perspectives and views.
A range of tools and approaches can be used to assess whether the advocate is practising in a competent manner.
Assessment by peer/s, supervisor or other (internally)
Written evidence of reports, action plans and self/peer evaluations
External evaluation surveys
Written evidence of presentation plans
As part of professional development and keeping up-to-date the advocate provides evidence of attending approved sessions relevant to working with Māori.
This may include:
Formal training (internal/external)
Peer support sessions
Tikanga Māori/ Te Reo Māori immersion programme
Is able to apply the appropriate skills and behaviours in both formal and informal interactions with colleagues, consumers, groups, as well as during presentations and networking.
Achieves a high level of accuracy when assessed on knowledge and skills.
Is able to clearly demonstrate the full range of knowledge and skills required for competent practice or can identify specific steps for achieving competence in specific areas requiring attention within an acceptable timeframe.
(This can be done
Has a clear plan for engaging with and encouraging Māori to use the advocacy service.
Māori using the service provide positive feedback and reflect their confidence in the advocate and their willingness to use the service again and recommend to others.
* This includes explaining that it is important to have accurate ethnicity data to plan services, improvements and enable comparisons of outcomes between Māori and non-Māori. Existing disparities will continue if services can’t measure their effectiveness.
Accident Compensation Corporation. Summary Guideline On Cultural Competencies for Providers. Wellington: ACC, 2004. See www.acc.co.nz/providers/resources/
Accident Compensation Corporation. Guidelines On Cultural Competencies for Providers. Wellington: ACC, June 2005. See www.acc.co.nz/providers/resources/
Accident Compensation Corporation. Report to Te Roopu Manawa Mai 2004. Wellington: ACC, 2004. See www.acc.co.nz
Ajwani S, et al. Decades of Disparity: Ethnic mortality trends in New Zealand
1980-1999. Wellington: Ministry of Health and University of Otago 2003.
Baxter J. Barriers to Health Care for Māori with Known Diabetes. NZ National Working Group on Diabetes and Te Roopu Rangahau Hauora a Ngai Tahu 2002.
Ministry of Health. Reducing Inequalities in Health. Wellington: Ministry of Health, 2002. See www.moh.govt.nz
Krupat E, Bell RA, et al. When physicians and patients think alike: patient-centered beliefs and their impact on satisfaction and trust. J Fam Pract. December 2001; 50(12):1057-62
Gribben B. Ethnicity and Resource use in General Practice in West Auckland. Experience in Practice 1999; March. Vol 1, No 1. See www.enigma.co.nz/hcro/eip
Jansen P. Improving Consultations with Māori Clients. NZ Fam Phys 1998; April: 25(2)
Durie M. Cultural Competence and Medical Practice in New Zealand. Report to the Australia and New Zealand Boards and Councils Conference, 2001.
Durie MH. Māori Attitudes to Sickness, Doctors and Hospitals. NZ Med J
1997; 86: 483-485
Durie M. Māori Ora: the dynamics of Māori health. 2001. Auckland: Oxford
Nursing Council of New Zealand. Guidelines for Cultural Safety, the Treaty of Waitangi, and Māori Health in Nursing and Midwifery Education and Practice. Wellington: Nursing Council of New Zealand, 2002. See www.nursingcouncil.org.nz
NZ Society of Physiotherapists. Guidelines for cultural competence in physiotherapy education and practice in Aotearoa/New Zealand. Prepared by Taeora Tinana. May 2004
Tikanga recommended best practice policy. He Kamaka Oranga Māori Health, Auckland District Health Board.July 2003
Ngā Kaiakatanga Hauora mō Aotearoa: Health Promotion Competencies for Aoteroa-New Zealand. HPFNZ 2000
TUHA-NZ: a Treaty understanding of Hauora in Aotearoa-New Zealand. Health Promotion Forum of New Zealand (HPFNZ). 2002 http://www.hpforum.org.nz
Te Pae Tawhiti, Tuhono http://www.tuhono.net
Ministry of Health Māori Health website http://www.Māorihealth.govt.nz Māori Health Workforce Development http://www.hauora.com Māori Mental Health http://www.teiho.co.nz Te Puni Kokiri (TPK) http://www.tpk.govt.nz NZ Health Information http://www.nzhis.govt.nz Te Aka Kumera O Aotearoa
A directory of Māori organizations http://www.takoa.co.nz
ACC http://www.acc.co.nz The Māori Medical Practitioners Assoc: http://www.teora.Māori.nz
Te Ohu Rata o Aotearoa (Te ORA)
National Council of Māori Nurses http://ngangaru.co.nz/ncmn
Statistics NZ http://www.stats.govt.nz
National Health Committee (NHC) http://www.nhc.govt.nz
Te Tiriti o Waitangi
HER MAJESTY VICTORIA Queen of the United Kingdom of Great Britain and Ireland regarding with Her Royal Favour the Native Chiefs and Tribes of New Zealand and anxious to protect their just Rights and Property and to secure to them the enjoyment of Peace and Good Order has deemed it necessary in consequence of the great number of Her Majesty's Subjects who have already settled in New Zealand and the rapid extension of Emigration both from Europe and Australia which is still in progress to constitute and appoint a functionary properly authorised to treat with the Aborigines of New Zealand for the recognition of Her Majesty's Sovereign authority over the whole or any part of those islands - Her Majesty therefore being desirous to establish a settled form of Civil Government with a view to avert the evil consequences which must result from the absence of the necessary Laws and Institutions alike to the native population and to Her subjects has been graciously pleased to empower and to authorise me William Hobson a Captain in Her Majesty's Royal Navy Consul and Lieutenant-Governor of such parts of New Zealand as may be or hereafter shall be ceded to her Majesty to invite the confederated and independent Chiefs of New Zealand to concur in the following Articles and Conditions.
KO WIKITORIA te Kuini o Ingarani i tana mahara atawai ki nga Rangatira me nga Hapu o Nu Tirani i tana hiahia hoki kia tohungia ki a ratou o ratou rangatiratanga me to ratou wenua, a kia mau tonu hoki te Rongo ki a ratou me te Atanoho hoki kua wakaaro ia he mea tika kia tukua mai tetahi Rangatira - hei kai wakarite ki nga Tangata Māori o Nu Tirani - kia wakaaetia e nga Rangatira Māori te Kawanatanga o te Kuini ki nga wahikatoa o te wenua nei me nga motu - na te mea hoki he tokomaha ke nga tangata o tona Iwi Kua noho ki tenei wenua, a e haere mai nei.
Na ko te Kuini e hiahia ana kia wakaritea te Kawanatanga kia kaua ai nga kino e puta mai ki te tangata Māori ki te Pakeha e noho ture kore ana.
Na kua pai te Kuini kia tukua a hau a Wiremu Hopihona he Kapitana i te Roiara Nawi hei Kawana mo nga wahi katoa o Nu Tirani e tukua aianei amua atu ki te Kuini, e mea atu ana ia ki nga Rangatira o te wakaminenga o nga hapu o Nu Tirani me era Rangatira atu enei ture ka korerotia nei.
The preamble of the English version states the British intentions were to:
protect Māori interests from the encroaching British settlement
provide for British settlement
establish a government to maintain peace and order.
The Māori text suggests that the Queen's main promises to Māori were to:
provide a government while securing tribal rangatiratanga and Māori land ownership for as long as they wished to retain it.
Article the First
Ko te Tuatahi
The Chiefs of the Confederation of the United Tribes of New Zealand and the separate and independent Chiefs who have not become members of the Confederation cede to Her Majesty the Queen of England absolutely and without reservation all the rights and powers of Sovereignty which the said Confederation or Individual Chiefs respectively exercise or possess, or may be supposed to exercise or to possess over their respective Territories as the sole sovereigns thereof.
Ko nga Rangatira o te wakaminenga me nga Rangatira katoa hoki ki hai i uru ki taua wakaminenga ka tuku rawa atu ki te Kuini o Ingarani ake tonu atu - te Kawanatanga katoa o o ratou wenua.
In the English text of the Treaty, Māori leaders gave the Queen "all the rights and powers of sovereignty" over their land.
In the Māori text of the Treaty, Māori leaders gave the Queen "te kawanatanga katoa" – the complete government over their land.
Article the Second
Ko te Tuarua
Her Majesty the Queen of England confirms and guarantees to the Chiefs and Tribes of New Zealand and to the respective families and individuals thereof the full exclusive and undisturbed possession of their Lands and Estates Forests Fisheries and other properties which they may collectively or individually possess so long as it is their wish and desire to retain the same in their possession; but the Chiefs of the United Tribes and the individual Chiefs yield to Her Majesty the exclusive right of Preemption over such lands as the proprietors thereof may be disposed to alienate at such prices as may be agreed upon between the respective Proprietors and persons appointed by Her Majesty to treat with them in that behalf.
Ko te Kuini o Ingarani ka wakarite ka wakaae ki nga Rangitira ki nga hapu - ki nga tangata katoa o Nu Tirani te tino rangatiratanga o o ratou wenua o ratou kainga me o ratou taonga katoa. Otiia ko nga Rangatira o te wakaminenga me nga Rangatira katoa atu ka tuku ki te Kuini te hokonga o era wahi wenua e pai ai te tangata nona te Wenua - ki te ritenga o te utu e wakaritea ai e ratou ko te kai hoko e meatia nei e te Kuini hei kai hoko mona.
In the English text of the Treaty, Māori leaders and people, collectively and individually, were confirmed and guaranteed "exclusive and undisturbed possession of their lands and estates, forests, fisheries and other properties".
In the Māori text of the Treaty, Māori were guaranteed "te tino rangatiratanga" – the unqualified exercise of their chieftainship over their lands "wenua", villages "kainga", and all their property/treasures "taonga katoa".
In the English text of the Treaty, Māori yielded to the Crown an exclusive right to purchase their land.
Māori agreed to give the Crown the right to buy land from them should Māori wish to sell it.
Article the Third
Ko te Tuatoru
In consideration thereof Her Majesty the Queen of England extends to the Natives of New Zealand Her royal protection and imparts to them all the Rights and Privileges of British Subjects.
Hei wakaritenga mai hoki tenei mo te wakaaetanga ki te Kawanatanga o te Kuini - Ka tiakina e te Kuini o Ingarani nga tangata Māori katoa o Nu Tirani ka tukua ki a ratou nga tikanga katoa rite tahi ki ana mea ki nga tangata o Ingarani.
In the Māori text of the Treaty, the Crown gave an assurance that Māori would have the Queen's protection and all rights - "tikanga" - accorded to British subjects.
This is considered a fair translation of the English.
(signed) William Hobson, Lieutenant Governor.
(signed) William Hobson, Consul and Lieutenant-Governor.
Now therefore We the Chiefs of the Confederation of the United Tribes of New Zealand being assembled in Congress at Victoria in Waitangi and We the Separate and Independent Chiefs of New Zealand claiming authority over the Tribes and Territories which are specified after our respective names, having been made fully to understand the Provisions of the foregoing Treaty, accept and enter into the same in the full spirit and meaning thereof in witness of which we have attached our signatures or marks at the places and the dates respectively specified.Done at Waitangi this Sixth day of February in the year of Our Lord one thousand eight hundred and forty.
Na ko matou ko nga Rangatira o te Wakaminenga o nga hapu o Nu Tirani ka huihui nei ki Waitangi ko matou hoki ko nga Rangatira o Nu Tirani ka kite nei i te ritenga o enei kupu, ka tangohia ka wakaaetia katoatia e matou, koia ka tohungia ai o matou ingoa o matou tohu.
Aroha compassion, tenderness, sustaining love, empathy and joy
Ea satisfaction, through the completion of tasks or rituals
Hara any wrong doing is hara, and can impact on the wairua of a person. The assistance of tohunga and confession assist healing, otherwise the effects of hara can last a lifetime.
Ihi power, authority, essential force
Mana authority, power; secondary meaning: reputation, influence. Mana belongs to an individual and to the tribe. It is acquired through lineage, but more importantly through recognition of performance and service to others, wisdom and humility.
Manaakitanga respect for hosts, or kindness to guests, to entertain, to look after
Mauri hidden essential life force or a symbol of this
Noa safe from tapu, non-sacred, not taboo. All things have a balance of tapu and noa. Noa is the common or profane – the part that manages relationships and activities that are free from the restrictions of tapu.
Pono a principle that calls for integrity and to be truthful in ones actions
Raupatu confiscate, take by force
Rohe boundary, a territory (either geographical or spiritual) of an iwi or hapū
Taihoa to delay, to wait, to hold off to allow maturation of plans
Taonga treasured possessions or cultural items, anything precious
Tapu sacred, not to be touched, to be avoided because sacred, taboo. Personal tapu relates to the sanctity or sacredness of a person and of places. As the head is tapu, food should never come in contact with the head and items such as hairbrushes, combs, hats and scarves should never be placed on tables where food may be placed. A person should never sit on a table or pillow.
Tiaki to care for, look after, guard (kaitiaki - guardian, trustee)
Tika the principle of doing what is right and proper
Tino rangatiratanga the highest possible independent chiefly authority, paramount authority, sometimes used for sovereignty and self-determination
Tūrangawaewae a place to stand, a place to belong to, a seat or location of identity
Wairuathe spiritual force within people
Wehi to be held in awe
Whakapapa genealogy, to recite genealogy, to establish the origins of people, kinship and their connections with others
Tāngatapeople, generic term that recognizes all classes of people
Tauiwi non-Māori people living in Aotearoa
Teina/taina junior relative, younger brother of a brother, younger sister of a sister
Tohunga a generic term for expert. For example an expert in dealing with sickness that has a mental or social component available through kaumātua and Māuri clergy.
Tuahine sister of a man
Tuakana senior relative, older brother of a brother, older sister of a sister
Tungāne brother of a sister
Wahine woman, wife (wāhine women, wives)
Waka canoe, canoe group (all the iwi and hapū descended from the crew of a founding waka)
Whāngai fostered or adopted child, young person
Whānau extended (non-nuclear) family
Whanaunga kin, relatives
Whanaungatangaestablishing family/whānauconnections to maintain the warmth and cohesion of a group.
Components of place names
Ordinary geographical features such as hills, rivers, cliffs, streams, mountains, and the coast, and adjectives describing them, such as small, big, little, and long are found in many place names.
Iti small, little
Kai one of the meanings of kai is food; when it is tacked on to a place name it signifies a place where a particular food source was plentiful e.g. Kaikōura, the place where crayfish (kōura) abounded and were eaten
Moana sea, or large inland 'sea' e.g. Taupō
Nui large, big
ō or o means 'of' (so does a, ā). Many names begin with ō, meaning the place of so-and-so e.g. ōkahukura, ōkiwi, ōhau etc.
One sand, earth
Pae ridge, range
Roto lake (also means inside)
Tai coast, tide
Whanga harbour, bay
E noho rā Goodbye (from a person leaving)
E haere rā Goodbye (from a person staying)
E ngau kino nei te aroha with heartfelt sympathy
E noho rā Goodbye (from a person leaving)
Haere mai Welcome!, Come!
Haere pai atu, hoki pai mai Travel safely
Hei konā mai Goodbye for now (letter/signing off)
Hei konā rā Goodbye (less formal)
Hongi Touching of noses/foreheads and mingling of breath when greetings others
Ngā mihi o te Kirihimete me te Tau Hōu Merry Christmas and Happy New Year
Ngā mihi rāmōngā rā kei mua i tō aroaro all the best for the future
Tēnā koe formal greeting to one person
Tēnā kōrua formal greeting to two people
Tēnā koutou formal greeting to many people
Tēnā rawa atu koemany thanks
Tēnā tātou katoa formal inclusive greeting to everybody present, including oneself
Body parts glossary
Kauae, kauwae chin
Kōpū womb, uterus
Māhunga hair [when used for hair must always be used in plural, indicated by ngā (the, plural)], head
Poho chest [also called uma ]
Puku belly, stomach
Ringa hand, arm
Turi knee [also known as pona ]
Tūtae excrement, ordure
ū breast [breast-milk is wai-ū ]
Waewae foot, feet, leg, legs
Body parts, substances & tissues: Tikanga
The removal, retention, testing, return and disposal of body parts/tissue and substances are of particular concern to Māori. This includes whenua/placenta and genetic material.
This matter is likely to involve consideration with whānau, will often be associated with karakia and the expectation that all parts and tissues will be returned.
Timing may be a critical issue – for example if whānau have agreed to the testing of the whenua from a baby who has died at birth to determine the cause of death, it will be important that the whenua is returned in time to be buried with the baby.
It is expected that all body parts/tissue/substances will be stored appropriately. For example these will be kept in designated tissue areas separate from food; and the tissues and parts from the living will be kept separately from those who are deceased.
Health and wellbeing Aromatawai assessment
that describes the needs of the consumer
Hauorathe wellbeing of people, good health, being healthy Kaiatawhai
Designated Māori staff within a health or disability service who focus on the spiritual and cultural needs of consumers/patients who seek their assistance.
Kiritaki health and disability services consumer
Māuiui malaise, feeling unwell
Nga Whakataunga accountability
Where an organisation has to account for, or is liable for fulfilling an action whether or not that action is carried out by that organisation.
Nga wahine hapu pregnant women
Taeora Tinana revitalizing the body
Tangata whaiora A person seeking health and wellbeing. A person who experiences or has experienced mental illness and who uses or has used a mental health service.
Consumers/patients seeking or requiring assistance from a health professional
Tukino abuse of all kinds
Tūpāpaku the body of a deceased person
Tūroro a person who is sick Whakahapa neglect
Whakatau to restore balance through acknowledgement. All things have equal amounts of noa and tapu. When someone is sick, impaired or injured that balance is affected. The use of karakia to whakatau is one method of restoring the balance.
Death: Tikanga Māori
Rituals surrounding death and dying are amongst the most important for Māori.
The tangihanga (mourning and funeral rites) places obligations on friends, family/ whānau and hapu, such as hosting those who come to pay respects, caring for the immediate family/whānau (kirimate) during the days of mourning and making all necessary arrangements for the burial. Māori will travel vast distances to attend tangihanga because of the importance of these rituals, linking principles such as whakapapa,mana, tapu and whānaungatanga.
The main reasons for attending are to support whānau, to maintain links, express emotions, to look upon the face of the deceased and to assist the whānau to restore the balance of life to normal.
If death occurs in a health care setting or institution, it is important that whānau guide the cultural and spiritual practices that need to be followed. Karakia is performed in the room/area as soon as the Tūpāpaku is removed and the room is not physically cleaned until karakia has occurred.
Whānau must always be consulted and consent obtained before a post mortem takes place (except if required by the coroner).
Māori models of health
Tangata Whenua have a long history of maintaining the health of populations through concepts and practices such as tapu, noa, and rāhui that protect water supplies, food sources and safety
The model of Te Pae Mahutonga (Southern Cross star constellation) brings together elements of modern health promotion.
The model is presented in the shape of the Southern Cross. The four central stars represent four key tasks of health promotion; and the two pointers represent Ngā Manukura and Te Mana Whakahaere (Durie,1999).
• Te Oranga (Participation in society) • Toiora (Healthy lifestyles) • Waiora (Physical environment) • Mauriora (Cultural identity) • Te Mana Whakahaere (Autonomy) • Ngā Manukura (Community leadership) Te Whare Tapa Whā model For Māori, the concepts of health and well-being go beyond physical well-being. Good health is recognised as being dependent on a balance of factors.
Mason Durie’s Whare Tapa Whā model
of health (1994) describes four com-ponents which represent the four walls of a house and the idea that if one of these walls fails, the house will fall. Reflecting a Māori perspective of health, whare tapa whā includes consideration of:
Te taha wairua – spiritual health, including the practice of tikanga Māori in general.
Te taha tinana – the physical aspects of health.
Te taha hinengaro – the emotional and psychological well-being of the whānau and of each individual within it.
Te taha whānau – the social environment in which individuals live – the whānau of family, the communities in which whānau live and act.
In public health, there are two other perspectives which are seen as particularly important:
• Te ao turoa – the environment: the relationship between Māori and te ao turoa is one of tiakitanga (stewardship). It is the continuous flow of life source. Without the natural environment, the people cease to exist as Māori.
• Te reo rangatira expresses the values and beliefs of people and is a focus of identity. The root of all cultures is the language, and te reo is a vital expression of rangatiratanga
(Health For All People, He Oranga Mö Te Katoa, Ministry of Health, March 2002)
Tikanga is an issue of principle, values and spirituality and is relevant to all parts of living and daily activities. Tikanga has been described by Mason Drurie `as much a comment on process as it is on fixed attitudes or knowledge’.
If in doubt, it is better to ask rather than risk offence.
It is important that time be allowed for karakia and that this time is not interrupted. Karakia is an important part of the preparation for a meeting and is essential before eating. There are times when it is appropriate during the provision of health care, particularly before procedures, or before the disposal of body fluids or tissues and when there are times of heightened concern.
Whānau Support & Involvement
The support and involvement of whānau is particularly important in health and disability settings where a collective rather than individual approach may be taken on decisions following a consultative process. Whānau members may provide food and other cares and may wish to stay overnight with an ill family member in hospital to ensure they have appropriate support and comfort. The pakeha concept of `next of kin’ may be broadly interpreted by whānau members.
Sharing of information
As with most people, introductions and explanations of roles along with clear information about processes, procedures and plans are important to facilitate effective communication and the exchange of relevant information.
When visiting Māori at home or on a marae do not wear shoes inside and leave sufficient time for refreshments once introductions are complete as this signals the removal of tapu.
Use gestures with caution as these can be misunderstood. For some Māori, making direct eye contact can be a sign of disrespect especially when directed towards authority figures so don’t force eye contact. It is inappropriate to touch someone’s head without permission.
All basic practices are consistent with views of hygiene and cleanliness.
• Never pass food over the head
• Anything that comes into contact with the body or substances must be kept separate from food.
• Containers used for drinking water will be only used for this purpose
• Fridges/freezers used to store food and medication for human consump-tion must not be used for other purposes
• Microwaves used for food shall not be used for heating items that come in contact with the body (eg wheat bags)
• Tea towels are only to be used for drying dishes and will be washed separately from all other soiled linen.
• Tables, workbenches and other surfaces used for the preparation or placement of food or medication must not be sat on.
• Excrement and food will always be kept separate.
• Use different coloured pillowcases for the head and other uses
• Use different coloured flannels for the head and other parts of the body
• Washing should follow a strict order starting from the neck to the genital area with the anal area last.
The five vowels a e i o u are pronounced as in Italian or Latin. The following English equivalents are a rough guide:
a as in far
e as in desk and the first 'e' in where. It should be short and sharp.
i as in fee, me, see
o as in awe (not 'oh!')
u as in Umaga (!), put, foot
There are fewer consonants, and only a few are different from English (or Scots):
r should not be rolled
t is pronounced more like d than t, with the tip of the tongue slightly further back from the teeth
wh counts as a consonant; the standard modern pronunciation is close to the f sound; in some districts it is more like an h; in others more like a w without the h; in others again more like the old aspirated English pronunciation of wh (huence for whence)
ng counts as one consonant and is pronounced like the ng in the word 'singer'. It is not pronounced like the ng in 'finger'. i.e. Whāngārei is pronounced Far-n(g)ah-ray (not Fong-gah-ray); Tauranga is pronounced Tow- (to rhyme with sow) rah-n(g)ah (not Tow-rang-gah)!
The macron - a little line above some vowels - is used to indicate vowel length; some words which look the same have different meanings according to their vowel length; for example anā means 'here is' or 'behold': Anā te tangata! Here is the man! But ana, with no macron, means a cave. Some writers of modern Māori double the vowel instead of using macrons when indicating a long vowel, so the first example would be Anaa te tangata!