LAWRENCE SMITH / Tips
A literature review led by Dr Emma Espiner (Ngāti Tukorehe, Ngāti Porou) revealed that Maori face systemic barriers to accessing hospital care. (archive photo)
“To put it simply, there is no point in solving someone’s transportation barrier by giving them a taxi ticket if the taxi takes them to a racist health service,” writes Dr Emma Espiner.
This is the line in his Friday diary New Zealand Medical Journal one reviewer advised him to withdraw, because it didn’t sound “scholarly.”
But the former host, now a housekeeper at Middlemore Hospital, didn’t become a doctor to pontificate, she did so to make sure people understand why Maori are “consistently performing on all metrics.” imaginable health ”, and help fix it.
Espiner (Ngāti Tukorehe, Ngāti Porou) led researchers from Middlemore and the University of Auckland in a study on access to hospital services and found that Maori were victims of hostility, racism, poor communication, practical barriers to accessing care and barriers to community care, including feelings of cultural insecurity.
* New Ministry for People with Disabilities needs a relevant Maori focus, advocates say
* Kaupapa Māori research project reveals structural racism in prostate cancer care
* Waitangi Tribunal: Lack of action against underfunding Maori health care as health gaps widen
* Dr Matire Harwood wants to fight racism in the healthcare system
The team reviewed a total of 23 articles, which addressed five ways to improve things – including building basic relationships – whakawhanaungatanga – with health providers, as well as manākitanga (prolonging love and care), the participation of whānau, cultural safety and offering practical things like means of payment and transport.
“It was important for us to look at documents that didn’t just state a problem, but question the problem,” Espiner said.
“You have to question every part along the path to effect change. “
The key was that barriers to hospital services had to be understood as more than just a lack of transportation, she said.
Whānau Ora’s commissioning agency has fought the Ministry of Health for data on Maori vaccinations against Covid-19. (TVNZ)
“This is all that surrounds the Maori experience in health care. We share stories and there are stories of whānau members who have had bad experiences and that sort of thing is really seeping into a whole whānau and the whole community and creates that barrier – emotional, mental whatever. You are already saying to yourself, ‘Oh my God, this is going to be a bad experience’.
This was reflected in the rollout of the vaccine and reluctance to vaccinate among the Maori, she said.
The doctor hoped the new Maori Health Authority, set up as part of the government’s health reforms, would pave the way for his list of solutions.
” One must be optimistic. Any type of change you have to think is an opportunity … I think the right people are in the room.
“But the timing of doing research like this and then looking at how Covid is experienced by Maori is a perfect case study of how we are doing wrong for our people.”
Treating healthcare like a one-stop-shop would never work for disenfranchised people, Espiner said.
“It’s really important to help people understand that it’s not about putting one group over another, it’s about fairness to improve health outcomes for everyone. “
Removing barriers to hospitals for Maori would remove barriers for all New Zealanders, she said.
“Truly responsive and united services with good communication, removing practical barriers will also improve the experience for non-Maori. It’s just all the other things our employees go through that make us more vulnerable to these barriers than others.