Rongoa--its place in the health system.
Subject: Health care industry (Social aspects)
Health care industry (Forecasts and trends)
Maoris (Health aspects)
Maoris (Social aspects)
New Zealand culture (Influence)
Folk medicine (Influence)
Medicine, Primitive (Influence)
Pub Date: 08/01/2011
Publication: Name: Kai Tiaki: Nursing New Zealand Publisher: New Zealand Nurses' Organisation Audience: Trade Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 New Zealand Nurses' Organisation ISSN: 1173-2032
Issue: Date: August, 2011 Source Volume: 17 Source Issue: 7
Topic: Event Code: 290 Public affairs; 010 Forecasts, trends, outlooks Computer Subject: Health care industry; Market trend/market analysis
Geographic: Geographic Scope: New Zealand Geographic Code: 8NEWZ New Zealand
Accession Number: 266344841
Full Text: The Waitangi Tribunal has released a major report, Ko Aotearoa Tenei, into the claim known as Wai 262, which concerns the place of Maori culture, identity and traditional knowledge in contemporary New Zealand law, and government policy and practice. Chapter 7 relates to rongoa Maori (traditional Maori healing). The Tribunal has produced a fact sheet that provides a brief overview of that chapter. We publish it in full here. (1)

Maori are facing a health crisis. Rongoa has significant potential to help address that crisis, because of its spiritual and biomedical qualities, and because of its potential to bring sick people into contact with the health system.

The Crown has suppressed rongoa in the past and currently fails to support it with the energy or urgency required by both the Treaty and the Maori health crisis.

What is rongoa and why is it important to Maori?

Rongoa is traditional Maori healing. It encompasses a way of understanding health that is based not only on the body but also on taha wairua (the spiritual dimension). It operates within a wider philosophical context in which people, places and events are seen as either tapu or noa. Breaches of tapu invite mental and physical consequences, such as disease. Tapu and noa provided the basis for a sophisticated system of public health in pre-treaty rimes.

In rongoa, then, tohunga or healers address both the physical symptoms and the metaphysical causes of any diminution of health or well-being. Rongoa thus encompasses karakia and titenga (rituals and incantations), as well as physical forms of treatment, such as mirimiri (massage) and traditional medicines based on plants such as manuka (which has antibacterial properties), koromiko (used to treat diarrhoea and dysentery), and harakeke (which has antiseptic properties and soothes skin ailments).

The practice of rongoa and the knowledge and concepts that underpin it are vital aspects of Maori culture itself.

What the Treaty requires

The Treaty gives the Crown the right to govern, but in return it guarantees the tino rangatiratanga (full authority) of iwi and hapu in relation to their "taonga katoa" (all that they treasure). The courts have characterised this exchange of rights and obligations as a partnership, and this is now a well-established Treaty principle.

In this context, the Treaty allows the Crown to put in place laws and policies to support and promote health. But in doing so, the Crown must, to the greatest extent practicable, protect the authority of iwi and hapu in relation to their taonga, including the practice of rongoa and the knowledge and concepts on which it is based.

However, even if rongoa was not the subject of Treaty Fights, supporting it would be justified for its potential contribution to Maori health, as explained below.

What the Tribunal has found The practice of rongoa was suppressed in New Zealand through the Tohunga Suppression Act 1907 (which remained in force until 1962). This Act came into force during a Maori health crisis resulting from poverty, poor sanitation, and a lack of immunity to virulent infectious diseases. Instead of resonding effectively to this crisis, the Act banned the activities of tohunga, and defined a core component of Maori culture as wrong and in need of "suppression" This was a breach of the Treaty.

The practice of rongoa has also been severely affected by environmental and social changes, such as the clearing of bush and urbanisation, which have cut Maori off from the sources of rongoa. In spite of these factors, rongoa has survived and traditional Maori healing continues to be practised today.

More recently, the Crown's attitude has shifted. In the 1990s, standards were put in place for tradtional Maori healing. In the same decade, health funding agencies began to fund rongoa services, and contracts for these services expanded significantly after 2000. However, explicit funding for ingested rongoa ceased in 2004 and rongoa still accounts for only a tiny proportion of all health funding. In 2003, the Ministry of Health's Maori health strategy recognised the value of Maori traditional heating, and in 2006 a rongoa development plan was published. In 2008, the Crown supported the establishment of a national rongoa body Te Paepae Matua mo te Rongoa.

Maori health is again in a state of crisis. Maori have signficantly lower life expectancy, and much higher rates of heart disease, stroke, lung cancer, diabetes, asthma, meningococcal disease, schizophrenia, and many other illnesses. Rongoa is not the only answer, but expanding rongoa services could be a significant step in improving Maori health. The medicinal properties of many rongoa remedies (such as manuka and koromiko) are well established, and the spiritual dimension of rongoa is important for Maori well-being. Demand for rongoa services could bring more unwell Maori into the primary health care system.

The Tribunal's views is that current support for rongoa, while an improvement on the past, has lacked urgency and remains inaedquate and in breach of the Crown's Treaty obligations.

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The Tribunal recommends the Crown make urgent changes, including:

* recognising that rongoa has significant potential as a weapon in the right to improve Maori health,

* identifying and implementing ways to encourage the health system to expand rongoa services (eg by requiring primary health care organisations servicing a significant Maori population to offer rongoa clinics);

* adequately supporting the national rongoa organisation Te Paepae Matua to play a quality control role in relation to rongoa, and

* gather data about the extent of current Maori use of rongoa services and likely ongoing demand.

The Tribunal has also recommended the Ministry of Health and the Department of Conservation co-ordinate rongoa policy, to ensure that rongoa plants survive and that tohunga can access them.

Reference

(1) Waitangi Tribunal (2011) Ko Aotearoa Tenei--Factsheet 8. Rongoa (Traditional Maofi Healing). http://www.waitangi-tribunal.govt.nz/ doclibrary/public/reports/generic/Wai0262/wai262Factsheet8Rongoa (TraditionalMaoriHealing).pdf. Retrieved 11/07/11_.
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