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December 10, 2017

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“Cultural Safety” … what even is that?

December 10, 2017

 

Cultural safety for Māori is more than just the extension of generosity towards Māori regarding their cultural needs. It is more than ‘allowing’ more than 1 person in the room with a labouring woman because she identifies as Māori. It is more than asking ‘do you want to keep your placenta’ because we know Māori put the placenta back to the land.

 

These token gestures in relation to ‘letting’ Māori have their tikanga go nowhere near being enough in regards to meeting the collective obligations of our Treaty of Waitangi. This document (unlike any other in regard to colonial migration to Island nations) states that both Māori and European/Pākeha have their rights under the Treaty. Therefore ‘cultural safety’ for Māori is not a desired effect of generous European spirit, but an absolute right, expectation and obligation of the Treaty.

 

In this regard serious attention to what has transpired between then and now is also an obligation: as are restorative measures that start a process of repatriation, re-entitlement and re-embodiment for Māori in New Zealand. Research by many has told us that once that happens we will start to see trends of high levels of ill health, high representation in our penal system, and low levels of involvement in tertiary education for example, turn around. This is important on many levels: life experience of the individuals and whanau, economic growth and etc of the country, easing burden on the justice and healthcare systems…

 

It hardly needs saying that all women are individual — we all are, however therein I think ‘we’ can find an escape clause that sees ‘us’ not keeping the issue of Māori disenfranchisement within health constantly valid by making statements like ‘well not all Māori want to bury their placenta’ ‘some Māori hate having loads of people in the room’ ‘she was like totally not Māori’, ‘not all Māori want the same thing’.

In regards to my practice reality this paper has brought to the forefront of my mind some very pertinent truths in regards to midwifery in NZ and midwifery in NZ for women who identify as Māori in some or all their way of being.

 

It doesn’t matter that one Māori woman seems wholly able to participate, completely engaged and seemingly clear about her place in this world: that does not mitigate the collective manner in which Māori in NZ are not represented as full partners within health statistics, healthcare policy, healthcare education, and the healthcare workforce. In that regard we need in midwifery to produce more strategies that support and engage women who are Māori collectively, and therefore individually. We know from research, consultation and enquiry — that te ao Māori is not well represented within midwifery collectively in NZ, and that the eurocentric view is the norm, therefore more needs to be done to strengthen the place of Te Ao Māori and therefore women and families who identify as Māori, within midwifery and maternity care.

More midwives that identify as Māori is important. More ‘policies and guidelines’ within maternity that have a relationship back to Kaupapa Māori and consultation with iwi are necessary. More representation of Māori within our professional bodies (NZCOM and MCNZ) is necessary.

 

‘Resources’ are plentiful: Māori are getting it sorted, integration into midwifery seems a little slow to be honest.

These things are necessary not just to extend kind acknowledgement to Māori, they are necessary at the very least because that is what is written in our founding document: protection, participation and partnership. They are also necessary if we as a nation are going to move forward with equity.

 

We are a member of the United Nations — therein if we pan out to that larger picture we also see that we have a national obligation as part of the global nation… United Nations Secretary General, Ban Ki Moon (as referenced below) speaking of the 6 strategies that can be delivered at the country level for achieving The Road to Dignity by 2030: ending poverty, transforming all lives and protecting the planet:

 

(a) dignity: to end poverty and fight inequality; (b) people: to ensure healthy lives, knowledge and the inclusion of women and children; (c) prosperity: to grow a strong, inclusive and transformative economy; (d) planet: to protect our ecosystems for all societies and our children; (e) justice: to promote safe and peaceful societies and strong institutions; and (f) partnership: to catalyse global solidarity for sustainable development.

 

In my mind this is not a burden of duty placed at the feet of European New Zealanders — in fact far from it — it is the chance to free ourselves from the burden of the past and move with intent towards the future. Europeans do need to move sidewise and make room for Māori as at this point Pākeha New Zealanders world views, wants and needs are the dominant discourse that is seeing our bi-cultural partners marginalized. Māori have the answers and will self determine the future. If they are listened to and are given the space and means to lead, we will see how best to move forward.

Jane

 

Ban-Ki-Moon. (2014). The road to dignity by 2030: ending poverty, transforming all lives and protecting the planet: Synthesis report of the Secretary-General on the post 2015 sustainable development agenda. http://www.un.org/en/development/desa/publications/synthesis-report.html: United Nations General Assembly.

http://www.health.govt.nz/our-work/populations/maori-health/he-korowai-oranga

Manatū-Hauora/MOH. (2014). Equity of Health Care for Māori: A Framework. Wellington: Ministry of Health/Manatū Hauora.

Manatū-Hauora/MOH. (2015). Whānau Ora programme. from Ministry of Health/Manatū Hauora http://www.health.govt.nz/our-work/populations/maori-health/whanau-ora-programme

MOH. (2010). Tatau Kahukura: Māori Health Chart Book 2010 2nd Edition. Wellington: Ministry of Health/Manatū-Hauora. Retrieved from http://www.superu.govt.nz

Durie, M. (2009, June — July 2009). Pae Ora: Māori Health Horizons. presented at the meeting of the The Paerangi Lectures: Māori Horizons 2020 and Beyond, Palmerston North, Albany and Wellington. Retrieved from http://www.massey.ac.nz/massey/learning/departments/centres-research/te-mata-o-te-tau/taumata-paerangi-conference-2009/paerangi-lecture-series-2009.cfm

Leatham, B.-A. M. (2014). He Kanohi Kitea Ka Hoki Ngā Mahara: Ngati Porou kuia tell the stories encompassing their childbirth experiences. Auckland University of Technology.

Pitama, S., Huria, T., & Lacey, C. (2014). Improving Māori health through clinical assessment: Waikato o te Waka o Meihana. The New Zealand Medical Journal, 127(1393).

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