Transcript Maori Models of Health - Asthma Foundation New Zealand

Te Hā o Te Tangata
Breathing Easy in Aotearoa
Mason Durie
Massey University
1.
2.
Māori understandings of health and sickness
place importance on context
The health context is shaped by four Pou Ora,
key markers that underly the health-sickness
continuum:
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3.
Hauora - Compatible environments
Toi Ora – Knowledge transfers
Whānau Ora Empowering relationships
Mauri Ora - Enhanced potential
Breathing will be easier when all four Pou are
aligned and the human mauri is flourishing.
Rangi and Papa
Locked into an
embrace that
excluded light and
life
Rangi and Papa
Forced apart by
the offspring
• Forests & birds
• The elements
• The seas and
waters, fish
• Crops
• Ferns
• Humankind
Separation enabled
Light and Life
Environmental
relationships, the
common bonds

The Whanaunga principle
‘While each species is unique, there is nonetheless a
relationship between all species within the natural
world. They are linked by time, inter-dependency and
common needs.’

The Ahiowhio principle:
‘meaning comes from an outward (centrifugal) flow of
energy; life is best understood by the relationships that
exist between people and their environments.’
Building
relationships
An Outward flow of energy
People, land,
flora, fauna,
water, air,
cosmos
Smaller entities
make sense when
viewed
in relationship to
larger entities
Relationships
and context
are a basis for health
Centrifugal direction

‘Health’ is widely used as a
synonym for sickness

‘Hauora’ has been a common
translation for ‘Health’
BUT

Hau = wind, air, human breath,
the security of home (hau
kainga), fame, and vitality

Ora = safety, satiation, survival,
life

Hauora positions people within a broad
ecological context
 environments are drivers of health.

The Hauora focus is on:
 associations between people with surroundings
 reducing risk from external natural and human
threats
 identifying new and emerging environments

A Māori world view of connectedness and
inter-dependence provides a framework
within which Hauora can be understood and
its significance to modern times appreciated

The implication is that health is essentially
about ‘living in the world’
Human health cannot be
fully understood without
taking into account impacts
from the wider environment
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Global environments
The natural environment
Urban environments
Metropolitan
environments
Marae environments
Home environments
Work environments
On-line environments
Whānau environments
Pastoral environments
Horticultural
environments
School environments
Roading environments
Toi =
Ora =
knowledge
art
human origins
birthplace
wellness
alive
safe
recovery
Toi Ora
Wellbeing associated
with
 Indigeneity
 a sense of home
 knowledge and
information
 Creativity

Health is enhanced by old
knowledge, heritage, and
remembered ties to an
ancestral home

Health is linked to artistic
expression, the use of
symbols and metaphor
derived from cultural
experience, and the
transfer of knowledge
between generations
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Knowledge that is based
on past journeys
Knowledge that recalls
longstanding world views
Knowledge that can be
used for ‘living well’ in
the world
Knowledge as a platform
for health and wellbeing
Ora
 safety
 life
 wellness
Whānau
 Kaupapa whānau –
group with a common
interest
 Whakapapa whānau –
group who share a
common genealogy
 Māori families – twogenerational
household
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Manaakitanga
the capacity to care
Pupuri Taonga
capacity for guardianship
Whakamana:
capacity to empower whanau
Whakatakato tikanga:
capacity for planning
Whakapumau tikanga:
capacity to transmit culture,
knowledge, between &
within generations
Whakawhanaungatanga:
capacity for reaching
consensus
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Interventions can be aimed at:
 changing the external impacts on
relationships – an ecological approach
(e.g. improving housing)
 building whānau capacities
(e.g. building manaakitanga: capacity to
care)
Whanau self management
 Healthy whānau lifestyles
 Full whānau participation
in society
 Confident whānau
participation in te ao
Māori
 Whānau economic security
 Whānau cohesion

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focus on the whānau as a whole
builds on whānau strengths and increases whānau
capacity
six key operational elements:
1.
whānau-centred methodologies shaped by the values, protocols and
knowledge contained within te ao Maori
2.
Intersectoral contributions
3.
a primary focus on best outcomes for whānau, through integrated and
comprehensive delivery
4.
skilled whanau practitioners
5.
expertise in whanau dynamics, relationships, aspirations
6.
practices that increase whanau skills, knowledge, financial status, and
self management (e.g. Online health records)
 Hauora
Compatible environments
 Toi Ora
Knowledge environments
 Whānau Ora
Nurturing environments
Mauri = a force for life
human integrity
human spirit
human vitality
individual uniqueness
Ora
= alert
responsive
lively
Spiritually robust
Culturally engaged
Emotional vitality
Positive thinking
 Energetic
 Able to participate
in activities, events
 Sustainable &
rewarding
relationships
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Mauri Oho
Indicators
Spiritually robust
Culturally engaged
Emotional vitality
Positive thinking
 Energetic
 Able to participate
in activities, events
 Sustainable &
rewarding
relationships
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Inspired
Inspirational
 Optimism
 Clear thinking
 Outward thinking
 Moving easy
 Breathing easy
 Liked
 Likeable
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Mauri Noho
Languishing
Spiritually robust
Culturally engaged
Emotional vitality
Positive thinking
 Energetic
 Able to participate
in activities, events
 Sustainable &
rewarding
relationships
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
Cultural & spiritual
alienation

Negative emotions
Knowledge gaps
Listlessness
Slow moving
Laboured btreathing
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Negative
relationships
Social isolation
Mauri Noho
Languishing
Spiritually robust
Culturally engaged
 Emotional vitality
 Positive thinking
 Energetic
 Able to participate
in activities, events
 Sustainable &
rewarding
relationships


Wairua
Hinengaro

Cultural & spiritual
alienation

Negative emotions
Knowledge gaps


Tinana


Whānau


Listlessness
slow moving
laboured breathing
Negative
relationships
Social isolation
Creating environments where:
the mauri can flourish and breathing is easy
Hauora
Compatible
environments
Natural & manmade
environments
Toi Ora
Knowledge
transfers
Intellectual
environments
Whānau Ora
Empowering
relationships
Social
environments
(home, work, leisure)
Hauora
Environs
Toi Ora
Knowledge
Whānau Ora
Family
Mauri Ora
Individuals
Factors
that
prevent
poor
health,
disease,
sickness
Green fields
Organic farming
Safe & nurturing
environs
School environs
Occupational
Health & safety
Access to old
knowledge
Marae experience
Exposure to
matauranga
Turangawaewae
Food –Housing –
Income
Parenting
Whānau inclusion
Whānau wealth
Whānau cohesion
Whānau modelling
Education
Employment
Personal resilience
& social skills
Self determination
Exercise, sport,
recreation
Risk
Factors
that can
lead to
disease,
sickness
Alcohol
Housing
Ag.-Hort sprays
Traffic density
Natural & man
made disasters
Food standards
Alienation from
heritage, culture,
old knowledge.
Discrimination,
racism, stigma
Family
dysfunction,
child neglect
Poverty
Violence
Cultural alienation
Educational failure
Physical inactivity
Unemployment
Lifestyles –
tobacco, drugs,
alcohol
Work stress
Detached from a
past
‘Breathing Easy’ Environments
Personal
Environments
Family & Social
Environments
Mauri Ora
Whānau Ora
Natural & Man-made
Heritage &
Environments
cultural environments
Toi Ora
Family, work,
Heritage &
Internal
&
culture
‘inner’
social
Knowledge
environments
environments environments
Hauora
Natural &
man-made
environments
The Asthma Foundation
New Zealand Respiratory Conference 2013
The overall challenge for preventing
and managing sickness and disease is
to create environments where
‘breathing can be easy’
Stay well
Kia Ora
Māori understandings of health and sickness place
as much importance on context as on individual
experience
2. The health context is shaped by four Pou Ora, key
markers that underly the health-sickness
continuum:
1.




3.
Hauora - Compatible environments
Toi Ora – Knowledge transfers
Whānau Ora - Empowering relationships
Mauri Ora - Enhanced potential
Breathing will be easier when all four Pou are
aligned and the human mauri is flourishing.