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A The Maori doctor from the government’s immunization implementation advisory group, Dr. Rawiri Jansen, recently said that Maori would be a priority in launching the Covid-19 vaccine. A predictable outcry ensued, with family protests about “race-based politics” and a convenient ignorance about the other priority groups under discussion: the elderly, those with known risk factors, front-line workers.
New Zealand’s first community case of Covid-19 in months was confirmed two weeks before Waitangi Day. The new case has an awkward location in Northland, the site of the annual commemorations of the signing of the 1840 Treaty of Waitangi, an event attended by politicians, iwi leaders, whānau, lobbyists and tourists from across the country.
When news of the new case broke, Maori leaders announced that they would consider reestablishing community checkpoints. These were successfully implemented during the first wave of Covid-19, and Maori communities avoided potentially devastating clusters of infection. This potential scenario had kept many of us awake at night, aware of the vulnerability of our whānau, who suffer from many of the comorbidities associated with the worst outcomes of Covid-19 infection: respiratory illnesses, diabetes, heart disease, and plus.
This was compounded for Maori living in rural areas with inequity in the provision of urban / rural health care accumulating more risk. Community checkpoints have been a source of controversy since they were first discussed: Maori are called vigilantes for using our limited resources to protect our communities, but opponents offered few solutions on how we could effectively protect those communities. .
This is a riddle. On the one hand, people are unhappy that the government may consider acting in a way that is consistent with what was agreed under Te Tiriti or Waitangi; exchanging governance of the land in exchange for equal treatment to Maori. A treaty-compliant vaccine deployment strategy would be one that takes into account the increased health vulnerabilities that Maori experience.
On the other hand, people are not happy that Maori are using our own initiative and acting to protect us. We are not talking about violence or anarchy. We are talking about actions that protect vulnerable communities. It seems Blessings to me (a complex principle of usual Maori behavior that might include “kindness” as its most basic reading) to others it seems scary dark people on the roads armed with fluorescent vests. Interestingly, there are no complaints from these sectors when iwi uses its resources to provide disaster relief services, such as in the wake of the Christchurch and Kaikoura earthquakes and the Napier floods.
If we cannot protect ourselves and we cannot expect the government to act in a way that protects us, what are we left with? There is a spectrum of perspectives on Maori health among New Zealanders ranging from equity-based activism to benign disinterest and outright racism.
Last month, former cabinet minister and former mayor of our largest city, John Banks, responded to an interlocutor on his radio show saying that Maori were “genetically predisposed to crime, alcohol, and low educational attainment” by saying “only Wait a minute, your kids need to get used to their stone age culture because if their stone age culture doesn’t change, these people will come in through their bathroom window. ” This attitude gives an idea of the cruel disregard for the health of the Maori: despite having no proof, some still cling to the false “science” of colonialism that claims that colonized peoples are inferior, so it is hardly worth it. consider treatment equal to that of the colonizers. It’s easy to ignore someone else’s suffering if you can blame them for it.
Epidemiology is having its moment in the sun. Newsreaders and reporters had to learn to understand the word “epidemiologically” as we searched for the providers of this previously underrated branch of medical science to explain how and why Covid-19 was changing the world.
At the medical school here in Auckland, Professor Rod Jackson instructed us in the basics of epidemiology, with an emphasis on the differences between the incidence and prevalence of disease and how to evaluate unreliable research. It sounded great at the time, evidence-based medicine in its purest form. But there is a misconception that if we had enough evidence, we would act accordingly. Clearly that’s not true, because we’ve been counting, quantifying and rating disparities in Maori health outcomes for decades and the barrier is not evidence, it’s people and politics.
I was asked to comment on progress on Maori health issues during Jacinda Ardern’s leadership for this article. There is not much I can say on that front at this time, but there are many pressing priorities that could be addressed during this period if the government is willing to spend some of its political capital on those who need it most.
These issues were urgent before Covid-19, but are now on the brink of despair as the healthcare system tries to deal with the effects of the lockdown. We are fortunate to have experienced only short periods of lockdown compared to other countries, otherwise these effects would be much worse and long lasting. Some examples include delays in cancer screening programs, pressure on waiting lists for elective surgery, interruption of chronic disease management, exacerbation of existing delays in mental health treatment services.
I hope Jansen from the Immunization Advisory Group is right in saying that priority access to the vaccine is being considered, as that would not only be fair and equitable, but it would also signal a commitment from the government that they want to do something. more than just wringing hands about the life expectancy gap and the unfair burden of disease for Maori.
Emma Espiner (Ngāti Tukorehe, Ngāti Porou) is an award-winning writer, political commentator, and physician. Emma hosted the RNZ podcast on Maori health equity, Getting Better.
