Publications

Congratulations to Dr Ramil Adhikari, Chairman of PHANZ’s Wellington Branch for receiving the Civic Award for cultural affairs at the Upper Hutt Civic Awards and Regional Community Awards ceremony on Thursday (July 28th).

The annual Civic Awards are the highest award for outstanding voluntary service to the community.

Upper Hutt Mayor Wayne Guppy who presented the award to Dr Adhikari said the ceremony provided an opportunity to thank award recipients for their personal leadership, inspiration, sacrifice or devotion to a cause.

Dr Adhikari received a certificate and a medal, and will have his name added to the Civic Awards board on display at the Upper Hutt City Council reception.

Pictured with Dr Adhikari are Gail Duncan, Co-President PHANZ and Rahini Unnyal, 2 DHB lead from Wellington who were on hand to support and congratulate him at the event.

A korero by Rahui Papa, written by Grant Berghan

During the time of the Steering Group led by Sir Mason Durie, a sub-group was appointed to consider and recommend appropriate Maori names for the two entities, Health New Zealand and the Maori Health Authority. The sub-group was comprised of Maori leaders from throughout the country – Moe Milne, Rahui Papa, Selwyn Parata, Rikirangi Gage, and Hana O’Regan. In considering the names, Sir Mason Durie urged the group to anchor their thinking in Te Ao Maori.

After a series of stimulating debates, it was clear that we were united on the stories of Tawhaki, that ancestor who binds all Maori in Aotearoa New Zealand. The challenge would be how to weave together a name for a large organisation like Health New Zealand, with that of a smaller organisation such as the Maori Health Authority. We needed to ensure the names were both distinct and yet complementary. So, we decided to look to the Tawhaki narratives for inspiration. The essence of our thinking was grounded in the wellness of people. Therefore, the names needed to reflect a unity in thinking and purpose and the synergy of effort and resources that is required to support the achievement of wellbeing for all New Zealanders. That is the thinking behind the naming of the two organisations.

So, it was the ancestor Tawhaki who in some of our histories ascended the heavens in search of the baskets of knowledge. After extensive discussion amongst the sub-group, the concept “whatu” was chosen leading to Te Whatu Ora, with its many interpretations including a stone, to show, to observe, to see, and it’s reference to the practice of weaving.’

Te Whatu Ora refers to the weaving together of many plaits to achieve wellness.

Meanwhile, Te Aka Whai Ora is a reference to the method of ascending the twelve heavens to reach the baskets of knowledge. Tawhaki had received instructions from his grandmother to adhere to the main line (the centre) as he climbed the different heavens. He did this and was successful in attaining the three baskets of knowledge. The intimation is that we should stay centred in all that we do if we are to be successful in achieving the wellbeing of all people.

And so it is that the group decided to adhere to the korero of Tawhaki, for his retrieval of the Whatu and his adherence to the main line.

Statement on the health system reform for Asian and ethnic communities 

The speakers, panellists and facilitator of the special session on Asian Health at the 2nd Health Forum on International Collaboration with Asian Countries agreed to make a statement on the health system reform of New Zealand, for Asian and other ethnic minority groups. 

Read the statement here

After last month's budget announcement, the 4th Well-Being budget, PHANZ National Office team members (Alana, Policy Analyst; Lavinia, Communications Advisor; Chris, Policy Advisor - Māori) huddled down to review the budget initiatives and tasked themselves with selecting their top pick and why they are looking forward to seeing investment in this area. 

Alana, a new mum, was keen to investigate what budget initiatives targeted the first 1000 days of a child's life. Research shows that it is critical to invest in the first 1000 days, between a woman’s pregnancy and a child’s 2nd birthday, to ensure every child gets the strongest start to life. Alana was pleased to see investment in Specialist Mental Health and Addiction Services as it included maternal and infant mental health services too. Suicide is the leading cause of maternal death in Aotearoa, and wāhine Māori are 3x more likely than Pākehā to die by suicide during pregnancy or within six weeks of birth (see Helen Clark Foundation ‘It Takes a Village’). Although there are many determinants that affect tamariki within their first 1000 days, initiatives that support the mama’s mental health particularly during the fourth trimester were welcome investments.

Lavinia, who is passionate about planetary health and the urgent need to combat the climate crisis, was keen to review the Budget’s investment initiatives to reduce emissions and meet our climate goals. Our health depends on the health of our planet. For Lavinia, Budget2022 showed a commitment by the Government to combat the climate crisis.

Of course, there are criticisms about what could have been done better and what still needs to be done. But let’s focus on the positives, shall we! It was awesome to see the recognition of Indigenous knowledge and the vital role it has to play in the fight against climate change, with $162 million set aside for transitioning whenua Māori entities to lower emission land use, and developing a Māori Climate Action Plan which will include mechanisms to ensure diverse Māori participation in climate policy and climate action. The package also includes $36 million to strengthen mātauranga-based approaches to reducing biological emissions.

Steps are being taken and initiatives have been invested in to cut emissions and slow the pace of global warming, to ensure a healthy planet for our future generations. But it takes a concerted effort by us all, it takes a village, to achieve these goals.

Chris, a Māori public health advocate and journalist looked at the package of measures involving Māori and the wider message we can draw regarding our focus areas. Whilst numerous generic measures announced such as with housing, dental treatment and solo-parenting may have significant application for Māori, our PHANZ 'Advocating Public Health Policy for Māori' checklist was applied revealing quite a number of boxes can be ticked by what Chris calls a smattering of allocations across climate, business and determinants of health for Māori - plus the big health re-set. The key will be how many of these are delivered as part of the current system that often fails Māori or one that is taking heed to open up new ways of approaching things that resonate with Māori and includes checklist items like "is clearly based on a framework concordant with Māori views" or "recognises diverse Māori realities". 

Pre-election, one might recognise Labour spin playing down opportunities for red-neck kick back if Māori are mentioned too often due the high rate of systemic failure it oversees - so they have pitched it about right with various mentions, whilst leaving otherwise obvious pressure points (think Three Waters or justice system) to be covered by general allocations and underlying equity theme. A downside only hearing the 'equity' narrative per article three of Te Tiriti, is we don't hear enough about article two initiative where Māori self-determination can flourish having removed colonial shackles. It is encouraging to see our Pacific cousins acknowledged with allocations for increasing their voice, and capacity in health, education and employment. The energies of all is going to be required to grow our response to the kaupapa ahead - our PHANZ focus at present includes Planetary Health, Determinants of Health, Poverty and Workforce Development. The 'mauri' meter on each of these is bumped up a notch by last month's budget but will require the right kawa or package of actions to make the most of things.

He taiao tōnui mō ngā reanga katoa – a flourishing environment for every generation.  

As the world picks up speed in the fight against climate change, the vital role and contribution ofIndigenous knowledge to help combat the crisis is increasingly being recognised. 

So much so that the recently released Environment Aotearoa 2022 Reporthas changed the way it reports its findings, drawing more on mātauranga Māori and exploring the link between the environment and our health and wellbeing. 

This unique approach, distinctive from other approaches around the world, interweaves different knowledge systems, presenting a richer and more relevant picture of the whole environment and the connections with people.  

More importantly the report builds towards a more sophisticated understanding of how to bring different bodies of knowledge together in future reporting.  

Environment Aotearoa 2022 uses Te Kāhui o Matariki (the Matariki star cluster) to organise the evidence in the report. 

PHANZ Māori Advisor Chis Webber welcomed the report and saidit enabled a Māori lens that values environmental elements through kinship relationships, ‘to be understood and treasured in hearts and minds rather than scientifically divided and conquered as resource for development’.  

‘Western science doesn't see Papatūānuku as an entity to be cared for like our mother, Māori science does,’ he explained. 

Mr Webber said Māori understandings of the world can deepen our collective action to recover life-sustaining mauri or life forces of our planet that are diminishing towards our own demise. 

‘It is encouraging to see indigenous knowledge recognised for the vital role it has to play in the fight against climate change. It is equally encouraging that words alone are backed up by cultural references and infographics with the sincerity and potential to open more engagement with kaupapa Māori in the drive for solutions.  

‘For an environmental status report that doesn't make recommendations, its loudest message is like the traditional pou in the ground inviting others to do likewise or ignore it at their own peril.  

‘PHA members and stakeholders are encouraged to develop reference points like this to magnify and hasten the work while we can. Mā whero, mā pango, ka oti te mahi - leadership and followship together will get the work done,’ added Mr Webber. 

Dr Dan Hikuroa, Senior Lecturer, Te Wānanga o Waipapa, Waipapa Taumata Rau (School of Māori Studies and Pacific Studies, University of Auckland) said people were viewed as part of the environment in the report.  

'That approach is consistent with the holistic Māori worldview,' said Dr Hikuroa, who was part of the mātauranga advisory board that helped craft the report. 

“The structure of the report around Te Kahui o Matariki, further reflects that worldview, and I believe is perhaps the first time an environmental report has genuinely woven together mātauranga and science, and the result is exceptional.” 

Secretary for the Environment Vicky Robertson said the report brought together a wide range of information to give us a broad picture of the health of the environment.  

‘Wellbeing is linked to a healthy, functioning environment,’ she said. 

Environmental indicator data underpinning the report comes from local and central government, crown and independent research institutes, industry associations, and in a small number of cases, international sources. 

Forest & Bird Chief Executive, Kevin Hague warned that althoughthe report showed that nature was helping us in many ways, it was clear that much more needed to be done to protect nature so it can continue to support and protect us.  

‘The previous reports [2018-2021] show that all environments – critical to New Zealanders’ wellbeing – are struggling with the impacts of human activity in our warming world. We rely on nature, yet it can only help us cope with the impacts of climate change and benefit our wellbeing if we take decisive action to restore and maintain its healthy state.”  

The report, produced every three years by the Ministry for the Environment and Stats NZ, draws on nearly 50 environmental indicators, including 11 updated specifically for the report.  

Some of the report’s key findings: 

Pressures of land-use change, and intensification, pollution, invasive species, and climate change are having detrimental impacts on the environment. New Zealand’s rare ecosystems and indigenous species are under threat with 94 per cent of reptiles threatened with extinction or at risk of becoming extinct, and nearly three-quarters of terrestrial birds threatened or at risk. 

The area of highly productive land that was unavailable for agriculture increased 54 per cent between 2002 and 2019. Our climate is warming, glaciers are melting, and sea-levels are rising. Air quality in Aotearoa is improving slowly at a majority of measurement sites, but in many places, pollution levels are above the new World Health Organisation (WHO) 2021 guidelines. 

Tēnā koutou katoa

Ko Ruapehu me Taranaki ngā Mounga

Ko Kurahaupo me Aotea ngā Waka

Ko Whanganui me Matanehunehu ngā Awa

Ko Te Atihaunui-a- Pāpārangi me Taranaki ngā Iwi

Ko Ngāti Hau me Ngā Māhanga ngā Hapū

Ko Hiruhārama (Patiarero) me Pūniho, Parihaka ngā Marae

Ko Whetu Marama Erueti rāua ko Doreen Ngawai McLeod ōku matua tūpuna

Ko William Angus Te Warehi Erueti rāua ko Sharon Marlen’e Clark ōku mātua

Ko Karmin Erueti tōku ingoa

Nō reira

Tēnā koutou, tēnā koutou, tēnā tātau katoa

I am looking forward to being a part of the wider team and excited for my new journey within the Public Health Association. I have over 22 years’ experience working within Public & Population Health, Health Promotion, Māori Health and the Community Development sector. During this time, I have had the opportunity to cross over into an array of roles and responsibilities with the added privilege of being a Justice of the Peace and Celebrant since 2015.

Over my personal and professional career my drive and purpose has always been to make a positive contribution to support and empower positive change for Whānau, Hapū and Iwi.

I will always uphold my values, continue to learn and grow and share my knowledge, skills and life experiences to make a difference in people’s lives.

Mā te rongo, ka mōhio

Mā te mōhio, ka mārama

Mā te mārama, ka mātau

Mā te mātau, ka ora

Through Resonance comes Cognisance

Through Cognisance comes Understanding

Through Understanding comes Knowledge

Through Knowledge comes Life and Well-Being

The Baader-Meinhof Phenomenon, also known as the frequency illusion, recency bias, or red car syndrome. Is where something you recently learned or heard or thought about starts to seemingly appear everywhere. Your awareness of it increases, and you start to detect it everywhere. Lately, this has been happening to me in regards to the power of data and data systems. The simple act of collecting and reporting and analysing data can provide huge insight and promote behavioural change – for good and for bad.

Reporting Data

Data can be collected and reported to make a positive change to the well-being of people. For example, Mind the Gap is New Zealand’s first pay gap registry. It is a database of New Zealand businesses that shows who is publishing their pay gaps for gender, Maori and Pacific Peoples, and what those pay gaps are. Evidence shows that simply reporting pay gap data can have an influence on reducing those gaps. For example, by applying what the impact of pay gap reporting has been in other countries to New Zealand, a woman earning the current median wage ($26.37) could receive $12.80 - $35.77 a week more (that’s up to $1788 extra a year). To date, no country has introduced ethnic pay gap reporting. Therefore the impact of mandatory reporting on the wages of Māori and Pacific men and other ethnic workers, and particularly Māori and Pacific women could be life-changing.

See Mind the Gap website or policy brief for more information.

Exploiting Data

Social media platforms are fruitful repositories of data. Unfortunately, data from social media users can be exploited by businesses to make a profit. Exploitative marketing can target vulnerable people that may be feeling susceptible to the advertising messages. For example, 51% of parents and pregnant women surveyed for a new WHO/UNICEF report say they have been targeted with marketing from formula milk companies, much of which is in breach of international standards on infant feeding practices. In the WHO report ‘How marketing of formula milk influences our decisions on infant feeding’, it uncovers systematic and unethical marketing strategies used by the formula milk industry and highlights the impact on families' decisions about how to feed their infants and young children. Just one example of how data can be misused to individually target vulnerable mothers, but what if social media algorithms were used for good? To find the vulnerable mothers online and actually direct them towards help.

Data deficiencies

New analyses by the World Health Organisation (WHO) revealed that the full death toll of COVID-19 (between 1 January 2020 and 31 December 202) was approximately 14.9 million (range 13.3 million to 16.6 million). Drastically higher than previously reported death tolls of around 5-6 million. The disparity is largely due to many countries lacking adequate data systems. Measurement of excess mortality is an essential component to understand the impact of the pandemic but data deficiencies make it difficult to assess the true scope of a crisis.

The SCORE for Health Data Report and Technical Package was developed by WHO and partners to assist country data systems to monitor progress toward health-related goals. The SCORE global report included 133 countries, but New Zealand was not one of them. While some countries have achieved a sustainable capacity in key areas, no country has a fully mature health information system capable of meeting its evolving needs.

In Aotearoa New Zealand, we should take a critical look at our data systems to determine if we are able to properly monitor health priorities and identify critical gaps in a timely manner.

Nā Chris Webber

Kua hinga he totara nui - In late March we lost one of Aotearoa’s 'tallest trees' having been at the front line on numerous fronts challenging and expanding our thinking and development as a nation. A tribute to Moana, collating some of this contributions and ongoing ripples for action is provided by the Action Stations team. Much of his work speaks to the heart of things that need to go right before many of our efforts in public health can be effective and equitable.

I recall attending one of the 2013 hui Moana Led with Margaret Mutu and team on Constitutional Transformation - our questionnaire starting with 'If we could have a new constitution tomorrow, what are the key values or tikanga you would like to see it based upon?' This was followed up by 'What do you think of the Bolivian idea about having a special constitutional recognition of the Earth Mother?' Here we are some years later starting to recognise Te Mana o Te Wai and other principles for protecting Planetary Health as a most pressing need. Also reminding ourselves daily about the key values or tikanga we need to operate on.

Nō reira e te manu taikō - haere koe i raro i te manaakitanga a te Runga Rawa, kia a rātou ki tēra taha, hei whakapai huarahi mā tātou. Aroha tino nui.

"To honour the treaty, we must first settle colonisation” these are the words of Moana Jackson, and we’ll keep living by them. To say our event, Te Tiriti-Based Futures + Anti-Racism 2022, was a “success” seems to be the wrong word. Treaties aren’t settled, they are successful when they are lived. So, we are proud. We had over 40-thousand registrations, that means that over 40-thousand times someone decided they wanted to learn more about Te Tiriti, they wanted to practice anti-racism, we are really proud of that. When we are talking about Te Tiriti, we are talking about trauma, but we are also talking about hope.  

We are grateful to our partners and to our volunteers, our 10-day online wānanga held many treasures, taonga tuku iho, wisdom that should influence our behaviour and demand that we question how we come to know what we know. The health inequity Māori face in Aotearoa is unrelenting, Covid-19 has been no different. Māori death rates are higher than Pākehā, these deaths are the result of racism. There is hope in arming people with tools to be anti-racist. That is what we did at our event. Tiriti-based work has to be unrelenting, Ka whawhai tonu mātou mō te āke, āke, āke! We’ve started planning for 2024, we have a draft schedule and the line-up is already hard to get onto. If you have skills you want to volunteer, let us know, we haven’t put our tools down. I want to give Matua Moana the final word, in the foreword to Te Tiriti o Waitangi-based practice in health promotion a free comprehensive resource written by Grant Berghan, A/Prof Heather Came and others, he stated “while progress is being made in understanding the Tiriti relationship, there is still some way to go."

- Eridani Baker

Global Public Health Week (GPHW) from April 4 – 8. 2022 brings together institutions, communities, and public health actors from around Aotearoa, New Zealand and the world to recognize the contributions of public health and its workforce. This annual event engenders discussion on the best practices and missing gaps fundamental to disease prevention and the promotion of health and wellbeing.

‘The Covid-19 pandemic has made the public health field more apparent and appreciated. However, the risk of regression post-pandemic is high. We cannot lose this momentum; we need to act now to prevent the next pandemic. Making public health visible and understood is a key step for emergency preparedness. Facilitating sharing of the knowledge, resources and barriers faced by public health professionals globally is key to improving public health in all contexts,’ states the World Federation of Public Health Associations.

PHANZ CEO Grant Berghan said Global Public Health week was an opportunity to stop, reflect and reset according to the public health challenges and opportunities that were in front of us.

‘The global reference enables us to appreciate our dependency on this planet we call home, and the importance of our relationships with ourselves and all other things that live with us. At the deepest level these are moral issues that require personal commitment and co-ordinated public health action. It’s time for a much more assertive public health activism.’

The theme for the week is “Public Health Matters: Building the New Future”.

In addition to the main theme, each day will focus on a specific theme:

• Monday, 4 April: Building COVID-19 Resilience
• Tuesday, 5 April: Reversing Climate Disaster
• Wednesday, 6 April: Achieving Health Equity
• Thursday, 7 April: Strengthening Public Health Associations and Communities
• Friday, 8 April: Preventing the Next Pandemic

Join us in this initiative to make public health stronger!