A Call to Action: Francis Kewene calls on PHA members to raise their collective voices

07 Apr 2020 1:07 PM | Anonymous

Francis Kewene is a Māori Caucus representative on PHA's Executive Council.

As a former Māori health promoter, a Health Protection Officer, and now a Hauora Māori Professional Practice fellow in the Department of Preventive and Social Medicine at the University of Otago, I felt a responsibility and obligation to volunteer to help with contact tracing for coronavirus.
Over a week ago I received an email inviting me to a training session at our local Public Health Unit. The tension as I arrived in the building was palpable. I arrived in a large board room already filled with familiar and unfamiliar faces. Everyone was sitting side by side, less than a metre from each other, which under the circumstances surprised me, and on one wall there was a screen filled with people in a number of different sites on Zoom.
The person leading the session launched straight into how we would conduct the contact tracing, the survey we needed to run through, and the resources we would need to support this work. I could feel the tension rising in my body. I could feel my brain spin as I felt a silent scream build: “Where is the whakawhanaungatanga? Where is the humanity of introductions? This is not my normal. This is not my normal!”
Then I could no longer hold the scream when I was told we would need to apologise before we asked the ethnicity question in the survey as “this question often makes people uncomfortable”. I was shocked. Enough apologising.
“Enough!” I raised my voice in a room of people who did not know me and whom I did not know.
“And by the way, if we are going to be working together, if we are to support one another, let’s connect first. We should have had a moment at the start of this sessions to introduce ourselves to one another.”
Silence. The training recommenced.
Each and everyone of us is doing our bit during these challenging times. Everyone is doing their best, but we know that doing our best must not be to the exclusion of Māori and our Māori normal. Our normal has changed, but we can still stay connected, we can still support, and find strength through our whakapapa.
My name is Francis Kewene, I am a small piece of paua in the eye socket of my tupuna carved on the wall of our wharenui. I am a mama, a sister, a cousin, and aunt. I am a worker, I am part of a team, I am part of a community trying to do what we can.
We as members of the Public Health Association choose to be here because we believe in the power of the collective. I reach out to you all, and ask members, particularly the Māori members of the PHA to raise our collective voice. Share what is happening in your communities with one another through this pānui. Through our email links we can support each other with our skills, expertise and aroha.


Te Rōpū Whakakaupapa Urutā National Māori Pandemic Group

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Letter to the Listener 28 July 2017 in response to Fever Pitch (Listener 21 July 2017)

Catherine Woulfe’s thorough investigation of rheumatic fever brings to the surface a range of important questions not only about this cruel disease, but also wider issues about health policy. The Government’s bold initiative to reduce the incidence of rheumatic fever as one of its 'Better Public Service' targets in 2012 certainly raised awareness of rheumatic fever for the general public as well as communities and families directly affected. But even when medical science and the public have a clearer understanding of the immediate causes of rheumatic fever, interventions like the $65m ‘sore throats matter’ still won’t stop the epidemic. 

Ramona Tiatia’s blunt description of the experience of affected families not only painted a picture of the impact on affected families and communities, it also highlighted the invidious choices our health funders face.  How much should we prioritise health spending between response to the urgent need of young people whose lives and potential can be devastated by the disease versus the expense of addressing the economic and social factors that underlie the reasons we have this epidemic at all?   

As several of the clinicians interviewed pointed out, it’s only when the poverty and over-crowded housing issues are addressed that we will make a real difference.

Rheumatic fever illustrates the contradictions in our health system identified in the recent American Commonwealth Fund report. Of the 11 countries the Fund monitors, the work our health professionals do is ranked among the highest. But our overall performance as a health system falls to the middle ranking because of our poor performance on access and equity. The Fund also notes that our per capita expenditure is among the cheapest. 

Failure to invest in real prevention - that is, poverty, housing, good nutrition etc. - will continue to drive conditions like rheumatic fever, whether the immediate cause is strep throat or skin sores, until we invest upstream.

Why not spend more on these conditions - the economic and social determinants of health? 

We all pay in the long run - the young people whose misery we tolerate and whose potential remains unfulfilled, the families whose sacrifices are unrewarded, and the taxpayer who picks up the tab.

Ngā mihi,
Warren Lindberg

CE Public Health Association of New Zealand


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