Hospital system failure for Maoris — Minister

Press, 24 April 1984, Page 18

Hospital system failure for Maoris — Minister

PA Wellington The hospital system has in many ways failed to cater appropriately for the Maori community, says the Minister of Health, Mr Malcolm. Like many other public institutions, it had been pakeha-dominated and

orientated, he said. “Hospitals are often daunting and unfamiliar even to those of us from whose culture they spring. How much more so must they be to a people who have traditionally cared for the sick in the intimate setting of the family and

marae,” he said in an address to the annual meeting of the Medical Superintendents’ Association at Palmerston North. However, more Maori staff, more flexible approaches to care, and a general increase in awareness of an interest in Maoritanga were leading to a new sensitivity to Maori health problems and, gradually, to attempts to find better ways of dealing with them. Mr Malcolm told the superintendents that the task was to accelerate that process “to ensure that we are aware of and take account of Maori beliefs and attitudes in planning and delivering health services which will be used by Maori people.” He suggested the first step towards a closer relationship with Maori community was to contact tribal elders seeking their guidance on the care they felt their people needed and to encourage them to participate in the spiritual care of Maori people in hospital. To some extent, improvements in the delivery of health care to the Maori people may mean a movement away from hospitalbased care. “It is offensive, or at least strange, to many Maori people that those who are sick should be cared for by other than their family. “I hope then, that nursing services will be restructured to provide support to MaorLhfamilies to enable them-f-* provide care within

the home or on the marae.

“If people are hesitant, for cultural reasons, to come to large-scale health care institutions, we must take health care to the people, where it is needed and on a scale which will comfort rather than intimidate.” In spite of an increasing trend towards communitybased self-help health care, hospitals would continue to have a major role in the field of Maori health. There were too many things which could only be done in hospital. “It is your responsibility, therefore, to ensure that your hospitals are places in which Maori patients and their families feel as comfortable and secure as possible.” Mr Malcolm again referred to the refusal by some hospitals to return the whenua or afterbirth to Maori patients. The afterbirth was to be treated with respect and was often buried in a sacred place where, eventually, the person would also be buried. The casual disposal of the afterbirth by the hospital without consultation with the parents represented a cultural insensitivity of the most serious kind, Mr Malcolm said. “I know of no clinical or other reason to refuse the wish of some Maori parents to have the afterbirth returned,” he said. From now on there would be no excuse for such a refusal.