Misinterpretation of The Treaty of Waitangi.
The Maori people are the native people of Aotearoa (New Zealand). According to the Ministry of Health (2004) statistics, the native people of Aotearoa are over represented compared to the non-Maori population where they are more likely to develop cardiovascular diseases, diabetes and different types of cancers. Therefore the Maori population have a significantly shorter life expectancy, in comparison to the non-Maori individuals of Aotearoa (Ministry of Health, 2004). These contrasts between the Maori and non-Maori population will be discussed in this essay, in relation to the importance of The Treaty of Waitangi and the collaboration principle of health promotion.
The Treaty Of Waitangi
The term that best explains health promotion as working in the context of people’s lives is whakawhanaungatanga (Ministry of Health, 1998). Whakawhanaungatanga can help to promote health by building relationships while keeping in mind the Maori history so that we can understand why Maori are where they are today. Once we understand the Maori history and the obstacles they faced which landed them in the situation they are in today, health can be promoted to help Maori, in a way that is culturally appropriate. It is understood that there has been a cultural barrier between past methods of health promotion and the Maori population, as this is clearly reflected in the health statistics from the Ministry of Health (2004). Since noticing this significant barrier, health promotion now understands that there are crucial factors such as cultural identity that determine the outcome of health in some populations. As for the Maori population, this factor is known as tino rangatiratanga, for example; food, shelter, peace, equity and social justice (Health Promotion Forum, 2002). Which is why the current health promotion strategies strive to deliver practice by keeping tino rangatiratanga in mind whenever working alongside the Maori population. This ensures that we successfully address their wants and needs, thus effectively improving the Maori health status through the reorientation in the delivery of health promotion services. According to the Human Rights Act (1993), one of the basic rights is that every human has the right to a quality of life that enables their potential to flourish. Health promotion aims to achieve rightful health results not just for the Maori individuals, but for the entire population of New Zealand (Whitehead, 1991). Furthermore, honouring The Treaty of Waitangi will be taking a step in the right direction for health promotion (Health Promotion Forum, 2002). This would have been a little easier if self- efficacy and motivation were not compromised among the Maori (Bandura, 1998). This compromise is one of the many negative effects of the migration which led to prejudiced distribution of power, finance and resources (Baum, 2008). To address this unequal distribution, health promotion provides the principles and tools to improve poor health, status and literacy among the Maori through advocacy, education, facilitation and collaboration (Ministry of Health, 1998). Hence the Maori and children who are New Zealand’s priority population, can experience an improvement in their health outcomes and a somewhat reduction in disparities (Ministry of Health, 2000).
Do you think The Treaty of Waitangi was misinterpreted in regards to Health Promotion?
One of purposes of The Treaty of Waitangi was to protect the health and wellbeing of the Maori people, and that very factor was largely misinterpreted during the colonisation process (Health Promotion Forum, 2000). Before the treaty, the Maori had tino rangatiratanga over their land and society, thus making a declaration of independence as they were a nation in their own right (Health Promotion Forum, 2000). From the Maori point of view, tino rangatiratanga was not granted to the British through The Treaty of Waitangi, However kawanatanga was shared between the Maori and non-Maori over New Zealand (Mackay, 1985).
Treaty of Waitangi - Te Tiriti o Waitangi
This misunderstanding led to the reduction and restriction of oritetanga for Maori, and the mismanagement of the land affairs as the British exerted their dominance over the country. As a result of this discrimination, the Maori had not only lost their self-esteem, but it also took a negative toll on their health and wellbeing, as the loss of tino rangatiratanga denied Maori a voice (Mackay, 1985). The society did not consider Maori perspectives therefore social justice was slowly diminished (Mackay, 1985). Another action that caused the loss of Maori identity was when speaking their native language was banned the British.
The World Health Organisation describes health as physical, mental and social wellbeing (World Health Organisation, 1986). These also include the prerequisites for health which are equity amongst the nation and social justice. This shit in circumstances affected the Maori population in a way that caused them to lose their sense of belonging and cultural identity, thus causing them to have poor health and mental health outcomes (Mackay, 1985). Their cultural needs and unique way of life had been overlooked so severely that it caused them to have lower life expectancy, compared to the non-Maori population, as a result of poor health outcomes (Ministry of Health, 2004)
However, The Treaty of Waitangi was acknowledged as a founding document by the Waitangi Tribunal which the New Zealand government is obliged to follow (Mackay, 1985). Therefore its contribution towards policy making for health promotion strategies was crucial as the three principles of partnership, participation and protection are applied (Whitehead, 1991). There has been a shift in paradigms within New Zealand to reduce inequities for the Maori population regarding health care as a result of this social policy. The treaty obligation of tino rangatiratanga also confirms Maori as tangata whenua thus giving Maori a say and right to participate in the delivery of their health care (Health Promotion Forum, 2000). Furthermore, it is crucial that the application of treaty- based framework as mentioned in TUHA-NZ be applied so that the Maori may no longer be disregarded, and may gain oritetanga and equal opportunities in health care as it was initially intended when The Treaty of Waitangi was signed (Health Promotion Forum, 2000). TUHA-NZ provides a framework for strategies and goals that are aimed to improved relationships and give the Maori population equal opportunities to help achieve string Maori involvement with health care and promotion thus effectively improving the delivery of health services (Mackay, 1985). Health promotion in New Zealand encourages a holistic delivery of health care as we acknowledge that spiritual and mental health is just as essential as physical health (Ministry of Health, 1998). Hence health promotion attempts to apply culturally appropriate mediations, for instance a delivery that involves whanau ora (Baum, 2008).
Collaboration is about building alliances and working together and it can take place at various different levels. One of the ways health promotion seeks to reorient and initiate interventions is through intersectoal collaboration, including numerous stakeholders and organisations such as community groups (Robinson, 2002). In order for at-risk groups to access optimum quality health care without experiencing complications, and to diminish stigma that is often attached to vulnerable groups, it is extremely important to clearly identify community needs (Whitehead, 1992). Using a bottom up approach has been proven to achieve an optimized level of success in health promotion while working with stakeholders (Whitehead, 1992). Although health, education and social welfare sectors are able to share knowledge, goals and visions, it may be harder to accomplish individually, therefore it is necessary to optimise the use of resources such as funding and benefits. To help the Maori population identify their own needs and possible solutions, collaboration includes the local community. Community behaviour change and better health outcomes have been proven to successfully promote and protect health as it allows for working within different contexts while collaborating with local communities (Mackay, 1985). Vulnerable groups such as the Maori community may greatly benefit and attain positive health outcomes through community participation in problem solving and decision making which also encourages self-belief to remain motivated and strong in times of adversity (Bandura, 1998).
Unrecognised needs can sometimes hinder effective health care service, which is why it is important for stakeholders and Maori communities to identify and address such problem areas while collaborating with each other to ensure effective service delivery. For instance, a three year long research- based project was developed between the Huakina Development Trust, Alcohol and Public Health Research Unit and the Te Whanau o Waipareira Trust Board through collaboration where the aim was to prevent alcohol related problems amougst the Maori population (Moewaka & Barnes, 2000) whereas mainstream interventions where proving unsuccessful towards Maori. As reflected in the feedback given by Maori communities ,the collaboration proved greatly beneficial for Maori as the collaborating communities ensured their material was culturally appropriate and within context (Ministry of Health, 2000). This success can be further attributed towards the collaboration approach as it allowed a deeper understanding of the issues the Maori community was facing, thus the implementation of participation led to the acceptance of the intervention.
A similar situation was faced by Australia, as the native people were believed to be a diminishing race as a result of colonisation by the British (Wise & Signal, 2000). Although access to social welfare benefits were previously denied by the Austrian government, efforts are now in place to ensure optimum quality of health care delivery for the Aboriginals. However, historically the Australian government did not accept the best practice of health promotion as well as New Zealand had, thus making the struggle a lot tougher for the Aboriginal population than the Maori as the Maori had established the Waitangi Tribunal (Treaty of Waitangi Act, 1975). Moreover, the lack of Australian government’s acceptance and willingness to invest in health care equities for their native population and recognise the need for decolonisation further contributed towards the poor health outcomes for Aboriginals (Sherwood, 2009). As a result of unsuccessful health promotion strategies on behalf of stakeholders and the unpopularity of policies, the Aboriginals continued to be disregarded and underrepresented in good health outcomes since it proved a great obstacle for the Aboriginals to overcome (Sherwood, 2009). However, Australia has taken a step in the right direction by recently releasing a new Aboriginal Health Plan. The new Aboriginal Health Plan is a ten year long plan that aims to greatly improve health care outcomes for the Aboriginal people and reduce health inequalities between Aboriginal and the non-Aboriginal individuals of Australia (New South Wales Ministry of Health, 2012). The plan aims to improve situation in Australia by taking the bottom up approach while collaborating with various Aboriginal communities in New South Wales (New South Wales Ministry of Health, 2012).
An extremely important gain had been made in 1986 when the native language was announced as an official language of New Zealand (Mackay, 1985). Since then the overall situation has somewhat been improved as the status of language highly contributes towards tino rangatiratanga thus beginning to strengthen the lost Maori cultural identity which is a certain determinant of health outcomes. Furthermore, strategies and programmes have been modified to fit the cultural perspectives of the Maori population and are finally being formally addressed (Mackay, 1985). The principles of The Treaty of Waitangi are now continuously being applied as Te Korowai Oranga and TUHA-NZ which greatly give emphasis to the principles of The Treaty of Waitangi (Mackay, 1985) which include participation, partnership and protection of the Maori population.
Healthcare and The Treaty of Waitangi
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