Tihei mauri ora: The right to breathe the Tū Kotahi Asthma Māori Trust story

May 6, 2018

Too many Māori babies and children are being robbed of tihei mauri ora — the breath of life, the air that keeps us all alive.

Asthma is threatening the survival of more than 30,000 Māori children in this country. The preventable illness steals their right to do simple but meaningful things with ease like sing, perform a haka and run really fast like their asthma-free cousins and friends at the marae or on the sports field.

They are the children who get left behind in the education system because they are too sick to go to school too many days in the year. They are the children who the health system is oblivious to until they turn up in droves in hospital emergency departments at a rate three times higher than non- Māori children.

But at Kōkiri Marae in Te Awakairangi there is hope and an unwavering love for these children among a group of nine hearty grandmothers, mothers and aunties who all have a background of working in health.

In response to the shocking hospitalisation and death rates of Māori from asthma and respiratory-related illnesses, concerned Māori in Te Whanganui a Tara region set up Tū Kotahi Māori Asthma Trust in 1995. The organisation continues to be on a mission to address the long-term asthma and respiratory problems of Māori in the region, says the Trust’s general manager Cheryl Davies.

“I really don’t like focussing on the statistics, they make me angry and we’ve got too much work to do to be angry.

“Our Māori people are all too aware of the realities — they live them every day — and reminding them of how sick and sad they are doesn’t help, so we are constantly looking at their strengths and building on those.

“We believe that the solution lays in tino rangatiratanga — Māori taking the lead when it comes to their health and well-being.

“Our job at Tū Kotahi is to ensure whānau have the knowledge, information and tools so they can effect the change and transformation that’s needed.”

Tū Kotahi is the first group in the country to develop an asthma programme especially designed for kōhanga reo — a Māori development initiative created in 1982 by Māori elders to strengthen Māori language and philosophies within a cultural framework.

There are 460 kōhanga reo throughout the country and they are the learning nests for thousands of children under the age of five.

“Connecting with parents, caregivers and kōhanga reo tutors in regular contact with tamariki is critical to saving lives,” says Cheryl.

The Tamariki Manawa Ngāwari (children breathing easily) programme is made up of workshops, toolkits and resources in te reo Māori. The programme teaches teachers and whānau the triggers, signs and symptoms of asthma as well as the different types of medication, devices and treatments so they are more assertive when dealing with doctors and nurses.

“Through asthma education, our people will have the confidence to help prevent and lower hospital admission. The well-being of the child and whānau is the essence of this kaupapa.”

Over the past two years the programme has been rolled out to 28 of 29 kōhanga in Te Whanganui a Tara. Cheryl is hoping that with more support it can be taken to every single kōhanga in the country.

“We are getting interest from kōhanga throughout the country which are concerned about the lack of asthma education delivered in their native tongue and that comes from a Māori worldview.”

In the meantime the Trust is looking at developing a free smartphone app alongside the programme to capture elements of the 438,000 Māori people who have access to the internet.

“We are constantly exploring innovative ways to make contact, engage, educate and facilitate the most effective forms of support and resources with the wider whānau of tamariki.

“Working with the national office of Te Kōhanga Reo gave us the opportunity to essentially pilot an asthma programme in the Wellington area that has been both insightful and effective.”

Marama Tākao of J R McKenzie Trust says she is extremely proud of what Tū Kotahi has achieved.

“The programme is giving knowledge and information to hundreds of whānau who knew very little about asthma.

“Now they have the tools to prevent asthma or manage it better and that’s got to be a great thing for them, their communities and our nation,” says Marama.

Tū Kotahi is one of several organisations that operate from Kōkiri Marae which was established in the 1970s in response to skyrocketing unemployment among Māori in the area.

The complex was originally an army base used by the US forces. Four generations post its birth, the marae is now a hive of Māori led efforts aimed at combating the many health and social inequalities faced by Māori in the area.

“At Kōkiri we have teams trying to tackle every health misery that affects our people from the womb to the grave. And the kōhanga reo on the
marae complex is a daily reminder of why we do what we do.”

The mission at Kōkiri is one of passion, dedication, vision and skills of service according to need, flexible yet structured, challenging yet supportive, focussed yet holistic, says Cheryl.

“While we come from a Māori worldview, we support everyone in our community who comes to us — Māori and non-Māori.

“Our doors are always open to anyone who enters them because those were the values of our ancestors and they continue to be ours today,”
says Cheryl.

Aotearoa New Zealand has the highest death rate from asthma in the developed world and it is estimated to cost the country $800 million a year.

Inequalities in asthma outcomes for Māori children are striking: Māori have significantly higher rates of hospitalisation; suffer higher severity of asthma symptoms; are less likely to have a peak flow meter or asthma action plan; and fewer are prescribed preventive treatments, resulting in poorer overall control. While the prevalence of asthma has decreased for European children in our country over the past few decades, this reduction has not occurred for Māori.

– J R McKenzie Trust