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ASSESSMENT 3 – REFLECTION

NURS.5001

DUE DATE: 2nd JUNE 2023

WORDS

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In this assignment I will discuss and describe positive Hauora Māori experiences prior to Te Tiriti
signing, how a particular Māori model of care can influence and be incorporated into my own
professional practice, and lastly a reflection on the implications of including the concepts of Te Tiriti into
professional nursing practice, including my own.
Positive Hauora Māori experiences were demonstrated in many aspects of Māori life prior to Te Tiriti o
Waitangi. Māori are interconnected with other people, the environment, and the cosmos (Rua et al, 2017).
In Māori health, multiple dimensions of well-being; such as the physical, spiritual, and ancestral are
incorporated to have a complete balance of mind, body, and mind, (Durie,2001).

Te Ao Maori is Maōri world view. A Holistic view of wellbeing that does not only cover general health
but all aspects of life for Māori. Haora Māori consists of balance with the environment, and a Māori
perspective regarding all dimentions needing to be included for this to be achieved. Marsden,(1988),
explains that it is,” the knowledge, comprehension or understanding of everything visible or invisable that
exists in the universe,”This includes the environment, Tikanga /customs, Whakapapa, Whanau, spiritual
connectedness, and the Māori language. (Mead,2003). Language is a large part of the culture’s identity as
speaking is brought into Karakia and Waiata which are very sacred customs going back centuries of
Māori genealogy. Speaking in Te Reo appropriately and respectfully and passing it on to the next
generation is vital for the protection of Māori culture and therefore Māori health and wellbeing, so it will
still exist in the future. Te Reo is also recognised by Māori as a symbol of identity and status (Ratima&
May 2011). Another positive aspect of Māori Hauora experiences or life pre Te Tiriti o Waitangi was the
way they lived communally. Marsden, (2003), explains that Māori historically functioned as a collective.
Living together in a Whanau or a larger Hapu (family) would have had health and safety benefits in those
times. Some examples of these would be security, whanau support, aroha/love, and togetherness. A
whanau would work together to support each other, knowing that together they are stronger. Māori have a
whakataukī,(saying) - ‘e hara taku toa I te toa takitahi, he toa takitini’ - my strength is not as an
individual, but as a collective (Maatakiwi, 2021). Living and working together as a collective, Māori
could have a sustainable existence. Raising stock and exchanging goods, such as meat, kumara and other
vegetables which grew in village gardens. King (2003) discusses how the importance of gardening to
have a sustainable food source influenced how and why Māori became more tribal, forming regional
tribes to protect their land and resources as competition for scarcer food sources worsened.
The tribal gardens also grew herbs and medicinal plants that could be used for practicing Rongoa Māori.
Plants and herbs important to Rongoa Māori healing rituals were Kawakawa, Harakeke (flax), Kōwhai,
Koromiko, and Mānuka (TePapa, 2023a). Rongoa Māori is the traditional Māori healing system and
another positive aspect of Hauora Māori. This ancient practice including medicinal plant use, Karakia

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(Prayer), and incantations, has been passed down through many generations and is still used today by
many Māori who want an alternative to Western medicine. Ritenga (rituals), Rongōa, Karakia (prayers),
Wai (water), surgical interventions, and Mirimiri are the five classes of Māori healing that support
positive Hauora (Te Papa, 2023b). Mirimiri is a traditional form of massage with the addition of Karakea
and Tikanga Māori. Mirimiri assists with stress management and increases circulation throughout the
body. Mirimiri promotes healing through physical touch and the use of Kohatu,(stones). Mirimiri means
“natural gift” and encompasses a person’s physical as well as spiritual well-being, (Te Manu
Toroa,2019).

In modern healthcare, there is a lack of emphasis on spirituality which is very much a part of Hauora Māori and
well-being. Māori Health models implement this dimension into healthcare today, (Ministry of Health, 2015).
Through the Treaty partnership at Tauranga Hospital, a unique secondary health service evolved, delivered by Māori
for Māori with the aim of better health outcomes for Māori while providing a culturally safe environment. The
Kaupapa Service and the model it uses embodies the values of Whanaungatanga and Manaakitanga by providing a
safe environment where relationships are formed with healthcare providers who understand differences and are
sensitive to obstacles that arise in life that can be detrimental to Māori health. Carlson et al, describes in
“Whanaungatanga: A space to be ourselves”, that the healthcare system is as an unnatural encounter for Māori and
extra time, care, and support are beneficial.

The Whanaungatanga model of care as described by Lyford and Cook (2005), is underpinned by a
concept of whanaungatanga, which to Māori is founded in spiritual, ancestral, historical, and traditional
beliefs and customs. Manaakitanga is also an important concept in this model, describing Aroha, care,
respect, and generosity. Wilson et al (2021) describes Whanaungatanga as connectedness, which the
Whanaungatanga model of care extends into all opportunities in nursing the individual, for example
including whanau in the planning and execution of care, meeting spiritual needs by way of Karakia, and
offering alternative treatment options such as Rongoa as their ancestors used.

Structured around Te Tiriti o Waitangi’s policies of partnership, protection, and participation, all nursing
care including my own Nursing practice would benefit from its concepts and patients would benefit from
the outcomes, which are culturally safe practice for patients and equality and inclusive care for Māori.
I feel communication is one of the most important things when caring for patients. I will ensure that they
have a connection with loved ones and the opportunity to have a private space for Karakia and to spend
time with their loved one who is unwell or a family member at a palliative level of care. The Whanau
need a place to come and Tautoko (support) their loved one and I would make sure a safe, private space
was provided for them. This will help ensure my patient is comfortable away from their home. This
action will help me build a trusting, positive rapport with the patient and aligns with Article 4, Te Tiriti O

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Waitangi, the oral article: Mana Māori;(Spirituality) Another key skill in nursing I will practice is
informing patients of their rights and I will educate them to the best of my ability within my scope of
practice regarding their illness or injuries to ensure they are fully informed of the benefits and risks of
their treatment. This action will give the patient empowerment in their informed decision making and
uphold their Mana which aligns with Article 2 Tino Rangatiratanga in having autonomy over their own
health.
I would refer Māori patients to organisations available for support such as Kaupapa Māori primary health
services. Examples of these in Tauranga are Te Manu Toroa and Ngāti Ranganui Iwi Society. Research
has shown that utilising these services assist in the individual feeling more comfortable with treatment,
and that being cared for by Māori who understand their wider cultural and spiritual needs as they move
forward with health treatment in the future leads to more equitable health outcomes (Wepa and Wilson
2019). This action aligns with Article 3, Ōritetanga; Mana Tangata (Equity).
In summary, Before Te Tiriti o Waitangi and the Europeans arrived in New Zealand Māori lived life to
Te ao Maori concepts day to day not understanding there was any other way in the world, Colonization
brought devastation to the Māori culture by the almost total loss of language due to government
forbidding the language in schools. This has been a major contributor to the inequity in Māori health
today as language is a large part of an indigenous identity. By aligning my professional nursing practice
to the principles of Te Tiriti will ensure that I am practicing in a culturally safe manner, protecting my
patients' rights to effective, equitable and safe healthcare, whilst maintaining their mana, and ensuring
that the healthcare patients receive is acceptable to them and their whanau.

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REFERENCES

Broughton, H. R. (1989, June). The well-being of the Maori. World Health, 20+. https://link-gale-
com.ezproxy.toiohomai.ac.nz/apps/doc/A7867923/ITOF?u=per_toi&sid=bookmarkITOF&xid=99ff37ff

Carlson, Teah & Barnes, Helen & Reid, Susan & Mccreanor, Tim. (2016). Whanaungatanga: A space to be ourselves.
Journal of Indigenous Wellbeing - Te Mauri: Pimatisiwin. 1. 44-59.

Durie, M. (1995). Ngā matatini Māori: Diverse Māori realities. Unpublished manuscript, Department of Māori Studies,
Massey University, Palmerston North, New Zealand.

Durie, M. (2001). Mauri Ora: The dynamics of Māori health. Auckland, New Zealand: Oxford University Press.
King, M. (2003). The Penguin History of New Zealand. Auckland. Penguin Books
Lyford, S., & Cook, P. (2004). The whanaungatanga model of care. Nursing Praxis in New Zealand,1(2),26-36.
Davis P, Lay-Yee R, Dyall L, Briant R, Sporle A, Brunt D, Scott A. 2006. Quality of hospital care for Māori patients in
New Zealand: retrospective cross-sectional assessment. The Lancet 367: 1920–1925

Reid, P., & Robson, B. (2006). The state of Māori health. State of the Māori nation: Twenty-first century issue in
Aotearoa, 17-32.
McIntosh, J., Marques, B. and Mwipiko, R. (2021), "Therapeutic Landscapes and Indigenous Culture: Māori Health
Models in Aotearoa/New Zealand", Spee, J.C., McMurray, A. and McMillan, M. (Ed.) Clan and Tribal
Perspectives on Social, Economic and Environmental Sustainability, Emerald Publishing Limited, Bingley,
pp. 143-158. https://doi.org/10.1108/978-1-78973-365-520211016
Maatakiwi. Ngā Whāinga – Te Wiki o Te Reo Māori Challenges 2021 – Stand
together.https://my.christchurchcitylibraries.com/blogs/post/nga-whainga-te-wiki-o-te-
reomaorichallenges2021standtogether/#:~:text=M%C4%81ori%20have%20a%20whakatauk%C4%AB%20
%2F%20saying,whakatau%C4%81k%C4%AB%20talks%20about%20team%20work
Marsden M 1988. The natural world and natural resources. Māori value systems and perspectives. Resource
Management Law Reform Working paper 29. Part A. Wellington, Ministry for the Environment
Meyst S. (2005). Learning how to be culturally safe. Kai Tiaki Nursing New Zealand, 11(5), 20–22.
Mead, H. 2003. Tikanga Māori: Living by Māori values. Wellington: Huia Publishers and Te Whare Wananga o
Awanuiarangi. 398 p

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Ministry of Health, (2015). Māori Health Models.https://www.health.govt.nz/our-work/populations/maori-health/maori-
health-models
Ministry of Health. (2017). Te Whare Tapa Wha. https://www.health.govt.nz/our-work/populations/maori-health/maori-
health-models/maori-health-models-te-whare-tapa-wha
Meyst S. (2005). Learning how to be culturally safe. Kai Tiaki Nursing New Zealand, 11(5), 20–22.
Museum of New Zealand Te Papa, (2023). https://www.tepapa.govt.nz/discover-collections/read-watch-
play/maori/maori-medicine
Ratima, M., & May, S. (2011). A review of indigenous second language acquisition: Factors leading to proficiency in te
reo Māori (the Māori language). MAI review, 1, 1-26.
Te Manu Toroa,(2019). Te Whare Oranga-The Wellness Centre. https://temanutoroa.org.nz/wellness-centre/mirimiri/
TePūkenga, (2023). NURS5001:Te Tiriti mō Mahi Mātanga.Wānanga: Te Tiriti o Waitangi Handbook, p4-7

University of Waikato, (2023). Te Au Māori/The Māori World. https://www.otago.ac.nz/maori/world/

Wilson, D., Moloney, E., Parr, J.M., Aspinall, C. and Slark, J. (2021), Creating an Indigenous Māori-centred model of
relational health: A literature review of Māori models of health. J Clin Nurs, 30: 3539-3555.
https://doi.org/10.1111/jocn.15859

Wepa D, Wilson D. Struggling to be involved: An interprofessional approach to examine Māori whānau engagement with
healthcare services. J Nur Res Prac. 2019; 3(3):01-05

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