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The National Public Health Advocacy Team was established by DHB Chairs and Chief Executives at the beginning of 2020 to address the structural and commercial determinants of health – specifically relating to alcohol-related harm, obesity, and smoking – in order to keep people well and reduce the burden on our health service, help eliminate health inequities, and make it easier for New Zealanders to live longer and healthier lives. 

Our small team utilise strategic communications to secure public and cross-party support for a more assertive national policy along with smart regulation and legislation. Our priorities for 2021/22 are:

• Advocate to central government for evidence-based policies to reduce obesity and support healthy food environments
• Develop and implement a campaign to review and strengthen the Sale and Supply of Alcohol Act 2012
• Support DHBs to achieve the Smokefree Aotearoa 2025 Goal

The prevalence of smoking, obesity and alcohol-related harm are significantly higher amongst Māori and Pacific than the rest of the population and are major drivers of inequities. The Crown’s failure to protect Maori from preventable disease is also a breach of Te Tiriti o Waitangi as set out in the Wai 2575 claim and other Waitangi tribunal claims such as Wai 2624 in relation to alcohol.

The National Public Health Advocacy Team invites feedback from PHA members and would welcome a collaborative approach. We are particularly interested in hearing from the Māori caucus to see if the mahi we are focussed on is one that you are supportive of. 

- Dr Rob Beaglehole
Rob.Beaglehole@nra.health.nz

Living in Peace: a fundamental determinant of health

On the 24^th of February 2022, Russia instigated an unwarranted and callous war on Ukraine. No longer can people in Ukraine live in peace – a fundamental determinant of living a healthy life. They have been forced into war, and there are no winners in war.

The Public Health Association of New Zealand (PHANZ) is unreservedly opposed to the war on Ukraine and we are looking for pragmatic ways to be of service to Ukraine during their time of need. Through our research, we have gathered information from both Ukrainian and Russian sources on how we, the people of New Zealand, can be of help.

Here is a summary of what we found:

EDUCATE YOURSELF – ignorance is not bliss

In Aotearoa New Zealand, some 17 thousand kilometres from Ukraine, many of us may have been unaware of the rising tension that had been building between Russia and Ukraine and the reasons behind this. On our remote island, we have no experience of being a bordered nation and the blurring of cultures that happen around the edges, nor what it must be like to live next to Vladimir Putin’s Russia. But it’s time to respect the situation and get up to speed. If you haven’t already, you can now find many articles, videos, and podcasts dedicated to explaining the history of Ukraine and the Soviet Union, and the reasons Putin invaded another nation. We need to respect the gravity of the situation and the first step in doing that is to understand the history, Ukraine’s precarious position between Europe and Russia, who are the players in this, and what are Putin’s motives.

SPREAD THE TRUTH – unravelling years of disinformation

Propaganda is defined as “information, especially of a biased or misleading nature, used to promote a political cause or point of view”. Under Putin’s rule, the people of Russia have been subjected to 20 years of mind-bending propaganda. Disinformation is not new. Russians have been told lies and are still are being told lies about the war, or as Putin calls it “a special military operation.” The technology being used to spread disinformation is getting more convincing and harder to detect. People opposed to the war on Ukraine are being urged to spread the truth on social media. Perhaps this could drown out the fake news or find its way to the people in Russia that may be unsure what to believe. Though we have seen some Russians protesting against the war, and assume there must be more that share the same belief (but are understandably afraid to come out), there are others that think it is a good idea to keep NATO’s forces away from Russia. Then there are some that just don’t know what to think, which is completely understandable when disinformation is a regular part of your society. As one blogger put it “imagine if every person in the world told you that the snow is green. Sooner or later, you’d start believing it, feeling guilty for ever thinking otherwise. You’d block away any doubt because fear of embarrassment and shame would overweigh the need for accuracy”. So share, tweet, post, blog, TikTok or whatever. Social media can be a powerful tool when used well and Russians against the war are asking you to amplify the truth to drown out the disinformation.

 

GET ACTIVE – challenge and protest, peacefully

Show your solidarity to the people of Ukraine and peacefully protest, whether that be in-person or online. As world leaders react to the war, we should be urging them to do all within their power to help Ukraine. In Aotearoa, parliament unanimously passed the following sanctions on Russia – but were they enough? And how effective are sanctions like this anyway?

Well, sanctions have worked before. In South Africa for example, anti-apartheid groups rallied for punitive economic sanctions, boycotting South African products and the like. Ultimately leading to enough societal pressure to end South Africa’s racially oppressive system. But will sanctions work in Russia to stop a war, and stop it soon? History tells us that it will take time and effective protests must involve at least 3.5% of the population, and in Russia’s case that equates to about 5.08 million people. That’s not impossible, but it is difficult to imagine 5 million people in Russia providing an organised resistance against the war, particularly when such strict penalties apply. On the other hand, the international sanctions placed on Russia may have some impact on wealthy Russian oligarchs, men who carry some political weight in Russia, friends of Putin and the like. It will be interesting to see how the sanctions play out – some suggest that Russia is hurting but is unlikely to be enough for the narcissist Putin to step back. He would never want to appear weak or defeated and current negotiations between the two nations are difficult at best.

 

DONATE

If possible for you, donating money is another way that you can help Ukraine. The humanitarian aid needed on the ground in Ukraine, the immense displacement of Ukrainians, refugees now fleeing their loved country to find peace elsewhere, are just the start of what healing from this war will look like. A lot of people will be needing help and there are many agencies you can engage with to financially support these causes.

 

PUT PLANS IN PLACE FOR THE UNTHINKABLE – a nuclear winter

A nuclear disaster, the imminent threat of nuclear war, and the after-effects on our planet. I have a real mental disconnect when thinking about this. I don’t want to believe that it’s possible even when I know that it is. Nuclear winter describes the hypothetical phenomenon that a nuclear disaster will have on the climate in the short and longer term. It is hypothesised that there would be cascading impacts on the planet, such as widespread firestorms leading to severe and prolonged climatic cooling as well as devastating impacts on the ozone and biodiversity. Our climate targets will mean nothing if the planet is irreparably damaged by a severe nuclear disaster. So, now is the time to plan for such a scenario. It may seem over-dramatic, planning for such a disaster (though the current pandemic may say otherwise) but do we really want to be caught unprepared? Putin cannot be trusted to hold the planet’s best interests at heart - we should be planning for the worst and doing all we can to oppose a nuclear war.

 

ADVOCATE FOR AN END TO ALL WARS

Unfortunately, Putin’s war on Ukraine is not the only conflict happening in the world right now or in recent times. The Middle East has been afflicted with what seems like endless wars and humanitarian disasters. Understandably, comparisons are being made between the widespread coverage of the situation in Ukraine, the urgency to act and support their refugees, and how the world has typically reacted to wars in the Middle East. But is it helpful right now to say let’s help Ukraine but why didn’t you do something about Yemen, Palestine, Afghanistan… etc? PHANZ caught up with Natalia who is a Russian New Zealander, and to that question “Why didn’t you do something about…” she says – “you’re right. I am human and we have weaknesses and strengths. And one of our strengths is the ability to recognise when something is wrong and try to right it. Let’s make this point the turning point. Let’s stop ALL WARS. Let’s admit that we didn’t care much about other wars when we should have. Let’s feel fragile and scared, scared for the lives of our children. And let this make us strong to stand up and demand to STOP ALL WARS.”

Living in peace is a fundamental determinant of health. All wars must be stopped.

Interview with Sione Tu’itahi, Executive Director for the Health Promotion Forum of New Zealand on the Geneva Charter for Well-being 

In December last year a senior leadership team of the Health Promotion Forum of NZ (HPF) and its collaborators joined over 5000 participants at a global health promotion conference who met virtually and in Geneva, Switzerland and agreed on the Geneva Charter for Wellbeing.  

The 10th World Health Organization (WHO) Global Conference on Health Promotion marked the start of a global movement on the concept of well-being in societies and the Charter highlighted the need for global commitments to achieve equitable health and social outcomes now and for future generations, without destroying the health of our planet.  

PHANZ caught up with HPF’s Executive Director Sione Tu’itahi to find out more about the Charter and its key elements, such as the inclusion of the knowledge and leadership of Indigenous peoples, the contribution made by the HPF team to the Charter and its relevance to Aotearoa New Zealand.  

 

PHANZ: The 10^th World Health Organization (WHO) Global Conference on Health Promotion which was held virtually and in Geneva last December has been hailed as marking the start of a global movement on the concept of well-being in societies? How did you and the rest of the HPF senior leadership team and contributors find the experience of participating in this conference? 

Sione: Our team was delighted and humbled by the invitation from WHO for the Health Promotion Forum (HPF) to offer a workshop on planetary health and indigenous knowledge at this world conference.  

For HPF the invitation reflected on the close working relationship that we have built with WHO since the 2019 World Conference on Health Promotion that HPF co-hosted with the International Union for Health Promotion and Education (IUHPE) in Rotorua. Our theme of Waiora: promoting planetary health and sustainable development for all was very timely. Planetary health is the most significant health challenge in the world today. And we advocated for the role of indigenous peoples and their co-leadership in that conference. The WHO delegation at the conference were very impressed with our work, hence the invitation to contribute to their 2021 conference. 

PHANZ: What are some of the key elements of the Charter that are of direct relevance to Aotearoa New Zealand and how much of a role did you and the rest of the team play in contributing to the Charter. I believe you played a key role in getting an acknowledgement of the spiritual dimension of well-being included in the Charter. Why is this element so important? 

Sione: All delegates to the WHO conference were given the opportunity to contribute to the Charter. On behalf of our team, I contributed the concepts of planetary health, indigenous knowledge, the spiritual dimension of well-being, taking a systems-approach and elevating the consciousness and perspective to a one-world society, rather than viewing the health challenges from an individual state level.  These ideas were well received by some members of the drafting team of the Charter, who came back to me for some refinement.  Some of the ideas I contributed were also reinforced by one of the members of our Global Working Group on Waiora Planetary Health at IUHPE. So, it was a good team effort. 

The Geneva Charter for Well-being is of significant and direct relevance to Aotearoa New Zealand for a number of reasons. First, the Geneva Charter builds on the 1986 Ottawa Charter. In our country, health promotion is based on the Ottawa Charter and Te Tiriti o Waitangi. Second, the Geneva Charter points out planetary health as one of the major health challenges for humanity today. Third, it acknowledges that Indigenous peoples and their knowledge can contribute solutions. Fourth, the charter broadens our understanding of health and well-being to include physical, mental, social, economic, ecological, and spiritual wellbeing.  There are other important aspects of the charter for New Zealand, but these are some to start with. 

PHANZ: It’s so encouraging to see the inclusion of the knowledge and leadership of Indigenous peoples as a key element of the Charter. Do you see this as a ‘breakthrough’ especially when it comes to planetary health?  

Sione: Including the last two dimensions of ecological and spiritual wellbeing in the Geneva Charter is quite a milestone achieved, especially from an Indigenous perspective. It means, among other things, our human family now can see the inherent oneness and interdependence of all aspects of life, and that our environment or Mother Nature is one with us. So, there cannot be human well-being without planetary well-being.  

It is heartening and encouraging to see the Charter acknowledging the leadership of Indigenous peoples and the stewardship on sustaining the well-being of the planet and the environment. This is something that Indigenous leaders and their co-workers across the world have been advocating for over many decades as part of seeking the human rights, to stop racism and colonisation, raising their concerns at a number of international platforms such as the United Nations and its many agencies. We have come a long way and many initiatives are now in place to address these concerns, but we still have a long way to go at both national and global levels.  

Meanwhile, the Geneva Charter provides an opportunity, and while it comes with a huge responsibility, I am sure Indigenous peoples across the world, together with their colleagues and co-advocates, will rise to the challenge. And I am sure we here in Aotearoa will continue to play a leading role. 

PHANZ: Past epidemics, and the current Covid-19 pandemic have shown us the importance of resilient health systems. How much of an impact will the Charter, which focuses on a ‘wellbeing society’ and what needs to be done in order to better prevent and respond to the multiple health and ecological crises we face globally, have on our response to any future outbreaks/pandemics?   

Sione: While not entirely new, the concept of a ‘well-being society’ is a more recent framing in different parts of the world. And while it manifests in different forms across diverse contexts and levels, it has some core elements that the Geneva Charter outlines. Among these elements is a more comprehensive understanding of health and well-being which I mentioned earlier – from physical and mental to social, economic, ecological, and spiritual. Health is not just physical and GDP. We must include the well-being of the planet and make sure all our human systems and activities are contained within the sustainability capacity of the planet. We have overstepped this planetary capacity and that is why we are facing global challenges such as pandemics, floods, global warming, and melting of polar ice. In other words, promoting well-being societies is a health promotion response to these challenges. It was heartening to see at the conference that New Zealand and a few other countries were commended for using the well-being approach and therefore are doing well in advancing the holistic wellbeing of their respective countries. 

 

PHANZ: According to WHO the Charter will drive policymakers and world leaders to globally commit to achieving equitable health and social outcomes now and for future generations, without destroying the health of our planet. This sounds positive, but how do we get them to ‘commit to concrete’ action? 

Sione:  My take is that the Charter is a call for a societal approach at the global level and down to the local level. It provides a road map for institutions, communities, and individuals to do their part in our collective responsibility in creating a society that is healthy, peaceful, and prosperous, and where power and resources are distributed in equitable ways for the well-being of all at the global level, and down to the local level.  

The Charter has outlined a pathway with five areas for action, similar to the framework of the Ottawa Charter. It requires a lot of study and application over the next few years. Similar to the gains made by the Ottawa Charter in informing and driving initiatives across the world to improve the health and well-being of societies, the Geneva Charter can do the same and more.  

It can do more because the challenges of today are different from those in the 1980s. Also, we have learned over the intervening years that some of our human systems such as capitalism and neo-liberalism, colonisation, racial and gender prejudice, other forms of discrimination, and exploiting the environment are not working and we are suffering.  

Today the environment is top of the agenda in all international meetings from the World Economic Forum to the UN. One can observe the same at the national level. World leaders are now taking health and well-being more seriously because they now see the inter-connectedness between pandemics, the economy, the environment, and geo-politics. In other words, all the determinants of health are connected as part of a whole system. Therefore, we must take a systems and eco-social approach.  

More importantly, we need to elevate our consciousness to think and act for the well-being of the human family, not just one’s country. To use an analogy, our home planet is on fire. Focusing on our individual country room is a sure recipe for more catastrophes for all.  Self-interest is a luxury we can no longer afford. And the spiritual dimension of well-being reminds us that our relationship with our fellow human beings, and our planet must be ethical and spiritual if we are to flourish individually and collectively.  

 

LEARN MORE ABOUT THE GENEVA CHARTER FOR WELLBEING 

Join Sione and a panel of experts at a webishop to explore and discuss the potentials of the 'Geneva Charter for Wellbeing' to inform health promotion in Aotearoa in the next few decades on April 7 from 11am. The panel comprises Dr Mihi Ratima, a leading academic in Māori public health and Kaupapa Māori research and HPF’s Deputy Executive Director Leanne Eruera, both of whom spoke at the conference.  

Register HERE or email emma@hauora.co.nz for more details. 

Te Kōkī Hauora 

Te Kōkī refers to the bird song chorus when manu of all kinds gather at dawn to sing and kōrero together.  When they stop singing there is an immediate silence and they flit back to their various places of mahi and habitation until the next kōkī.    

Te Kōkī Hauora is the name given to the gathering of manu hauora to kōrero and meet (online and kānohi ki te kānohi – face to face).  In this context, the network refers specifically to Māori working within mainstream Public Health Units (PHU’s) throughout Aotearoa. 

Background 

During the Level 4 COVID-19 response the PHU’s came under unprecedented pressure. Along with others, many Maori staff struggled with the additional work and whanau pressures. COVID-19 exacerbated existing inequites and institutional failures that already existed in the public health sector. A group of Maori within the PHU’s came together to:  

• have a safeplace to kōrero withother Māori experiencing the same issues 

• provide collegial and cultural support 

• find out what is happening outside of their rohe and how hapori Māori were coping with COVID-19 

• share insights with eachother 

• support those that needed it (addressing isolation) 

• create working groups, and share plans and ideas 

• discuss issues affecting whanau Maori i.e. thethreewaterreforms 

• host guest speakers that could inform the group on what is happening upstream (service managers, MOH, etc) and discuss ways that we can better address the inequities 

In the begining, the group went from two to ten to 60 Māori on the weekly zoom.  This eventually led to the national Māori COVID-19 hui hostedby Waikato in 2020.  The network continues to meet regularly. 

Last year, after a series of discussions with Te Kōkī Hauora members, the national office of the PHA, and the Ministry of Health, it was agreed that the PHA would provide administrative and pastoral care support services to the members of Te Kōkī Hauora. We are pleased to be able to support our colleagues in the PHU’s and to strengthen the relationship between ourselves. At this stage, the roopu have agreed to meet at least monthly, and are working with the PHA to develop a workplan that meets the group’s needs. We will keep our members updated with our progress.  

 

Grant Berghan 

Chief Executive Officer. 

 

Come and join us for a welcoming and relaxed series for Māori and non-Māori in public health to share and learn.

A featured theme and guest speaker each month supported by all the 'tangas'.

Let us know you're interested HERE.

A warm welcome to Chris Webber who has joined the PHA  as a senior policy analyst (Māori) and Dr Alana McCambridge as a policy analyst. Both Chris and Alana will work part time. Read more about them on our staff page.

The Public Health Association is calling members and affiliates past and present to engage their expertise and experience for the next phase of COVID-19.

You can access the form here - it will remain open for feedback until 23rd of February.

The form is split into 6 sections and will take approximately 10 mins;

• Checking in
• Confidence in your sector
• Status report
• Action steps
• Issues to flag
• Advice - short term, long term, and in regards to Māori/Pasifika/Asian communities. 

We sincerely thank you for your contribution. This information will inform the PHA's strategic direction towards the COVID-19 response in 2022. 

TE TIRITI-BASED FUTURES + ANTI-RACISM 

MARCH 19 - 28 2022

REGISTER!

PHA is proud to be a partner of Te Tiriti-based futures + Anti-racism 2022. 

There is once again an incredible line-up of speakers and leaders who over 10 days will discuss topics including institutional racism and anti-racism, decolonisation, building Te Tiriti-based futures and transforming our constitution. Overseas presenters will also discuss their experiences with these issues from their contexts.

The final day will be different this year. It will be a platform for emerging voices called: Kei mura i te ahi - 24 hour marathon for racial justice powered by PechaKucha. This will be an epic 24-hour marathon of short interactive talks from students and recent graduates pushing the boundaries in anti-racism in Aotearoa and internationally. 

After the event, most of the open-access webinars will be posted online, where they will become permanent resources for anti-racist activism and Te Tiriti education. 

The organisers are a group of Māori and Tauiwi with experience in activism, research and community development. 

READ THE PROGRAMME

Comments from our new Senior Policy Advisor - Māori, Chris Webber

Waitangi Day 2022 is the first one our organisation can celebrate having embraced Te Tiriti with a constitutional 50 percent Māori partnership on our executive council. With Nari Faiers Co-President (Māori) and a good muster of Māori talent we've achieved both a milestone in capacity and options for progressing the next phase of our journey. This includes myself, taking a leave of absence from executive council to fulfil a pressing need for Māori policy work on contract - backfilled by other Caucus representation. 

This leads me to our Kapiti Island hapu slogan in the title - Haere He Awatea, it really does feel like a 'new day dawning' and I wish to acknowledge our members for taking us there. My great great grandfather and Māori MP Wiremu Parata, took the 1877 'Treaty Nullity' case to court after his grandfather Te Rangihiroa had signed Te Tiriti at Kapiti 4 June 1840. With the colonial system fixed on The Treaty being 'a nullity', generations of loss persisted through to today - with large parts of our available capacity still absorbed into putting things right. Like public health, it is going to take the collective efforts of all to achieve the vision and possibilities provided by Te Tiriti.

Nō reira e hoa mā, we are in times of transition within and without - and with change comes opportunity to keep navigating to the chosen destination. Ko te tūmanako ko te pae ora mō tataou katoa - let's fix the vision of equitable wellbeing for all in our minds and imagine us all happily there together and what path and set of 'tangas' (wairuatanga, whanaungatanga, ūkaipōtanga my top three) were required for it to work for Māori, leaving no-one behind. To me, this is Te Tiriti in action. Mauri ora!

When Doors Open

by Dr Alana McCambridge

By now you have probably heard of the name Charlotte Bellis. The pregnant Kiwi reporter that was unable to secure a spot in MIQ and so willingly contacted the Taliban and travelled to Afghanistan for “safe haven”. Charlotte then penned an open letter to the New Zealand government and got in contact with her PR friend to make some noise. She wielded the power of the media both in New Zealand and abroad to make her point heard, gaining sympathy and calls for change to New Zealand’s tight border control. She appeared on television, radio, and used her social media platforms to tell her story. With many re-using it as a political dagger to criticise the governments pandemic response. Her story was so widespread that her application was promptly reassessed and she was offered a coveted spot in MIQ.

Lucky for some.

The ‘some’ being those with an exuberant amount of privilege. The kind of privilege that makes doors open - nothing is ever out of reach. The kind of privilege that Afghani people, particularly women, do not have under the Taliban regime. Charlotte was a reporter in Afghanistan – she knows of the atrocities the Taliban have committed and will likely continue to commit. She would know that there are currently huge concerns for missing Afghani women activists. Women in far worse off situations to her, situations where Afghani women, particularly pregnant ones, can only dream of calling their country a ‘safe-haven’. Situations that are mostly unimaginable to the New Zealand people.

But alas, Charlotte with all her knowledge of Afghanistan expertly centred herself – a white woman needing help – sidelining the serious and devastating humanitarian issues being inflicted on Afghanistan by the Taliban. She let the media machine eat up her story as she knew it would, providing soundbites and news headlines humanising the Taliban, and personally sharing posts to her instagram of people in support of her plight that were “impressed” by the Taliban’s kind gesture. A calculated gesture that most of us can see for what it really is.

Nevertheless what’s done is done and there are always lessons to be learned. So with the clarity of hindsight, opposing viewpoints being published in the media (albiet to a much lesser extent – please see open letter from Muzhgan Samarqandi for instance), and her MIQ room now secured. Charlotte would be free to see the error in her ways and try to make amends. To clear up some of the hurt that her fiasco has caused Afghan communities.

However it has been over a week since the door flung open and she got what she wanted but Charlotte has not mentioned Afghanistan at all. She posted a statement online and made a few twitter posts, mainly still laying blame to the horrid MIQ lottery system. You know, the one she bypassed, while the rest of us waited for our number to come up (myself and my newborn baby included). The system that although is not perfect - as no system ever is - has undoubtedly saved hundreds of Kiwi lives.

So perhaps her silence is because she is still living in Kabul supported by the Taliban (despite the power of the New Zealand passport that could take her to safer places). Or perhaps critical self-reflection isn’t her thing? Or maybe she is just another foreigner in Afghanistan, pitching themselves as a champion, but only when it suits.

Someone recently said to me that ‘privilege is invisible', invisible to those who have it. I was really hoping it wasn’t true.

Got an idea for a Think Piece? Let’s discuss!