From Wednesday 1 April, Coast communities will have their own Community Based Assessment Centre (CBAC) providing immediate support for patients with respiratory conditions. The Ngati Porou Hauora CBAC is based at Te Puia Springs Hospital and will operate on a 24 hours basis.
Last Thursday the CBAC servicing the Gisborne community opened at the War Memorial Theatre. Both the Te Puia Springs and Gisborne CBACs have been recently established to provide a place for patients having breathing difficulties or showing signs of respiratory illnesses(such as pneumonia) to be assessed by a doctor.
Under the current Level 4 Covid-19 lock down, the majority of patient consultations are taking place over the phone to abide with social distancing measures. However for patients with respiratory issues, there is a greater need for kanohi ki te kanohi assessments to be conducted,to help identify what further treatment is required.
Rose Kahaki, CEO of Ngati Porou Hauora, says the process to be assessed at the Te Puia Springs CBAC follows the same protocols as other CBACs that have been set up in other regions recently.
“Call your local Hauora clinic in the first instance and the GP will determine whether you need to be seen by the CBAC. If it’s after hours however, contact Te Puia Springs hospital and one of our clinical staff can make the referral.”
Dr Willem Jordaan, GP and Clinical Leader for the NPH Puhi Kaiti clinic in Gisborne has been redeployed to run the Te Puia Springs CBAC. Dr Jordaan will join the East Coast team who are currently providing GP services to the five Hauora clinics on the Coast and in Kaiti. We have also accepted an offer of assistance from Dr Nathan Joseph, former chair of Te Ohu Rata o Aotearoa (the Maori Medical Practitioners Association), who is taking leave from his West Auckland GP practice to assist Ngati Porou Hauora.
The CBAC is the latest addition to the services Ngati Porou Hauora is providing as part of their Te Mate Karauna (Corona virus) response preparations. Last week the Covid-19 test drive through opened at Te Puia Hospital. Appointments are made for people who have been referred by Health Line or a NPH GP. To have the swab test you do not need to get out of your car, as a nurse will conduct the swabbing through your car window.
• If you think you may have Covid-19 symptoms, please call the Healthline number 0800 358 5453. If you can’t get through to the Healthline, call your local NPH health clinic or Te Puia Hospital (06) 864 6803.
• The Covid 19 test drive-through at Te Puia Springs is open from 9am to 4pm every day.
NB: No walk ins. If you turn up without an appointment you will be turned away. If you or your whanau are unable to get to a swabbing centre, your GP will make alternative arrangements for testing. If you require assistance with transport for Covid-19 testing, please contact Te Puia Hospital (06) 864 6803.
• The Ngati Porou Hauora CBAC at Te Puia Springs is open 24 hours via referral from your GP. If you are having trouble breathing or showing respiratory illness symptoms, please contact your local Hauora clinic for a referral. If it’s after hours, call Te Puia Springs Hospital (06) 864 6803. If you live in Gisborne, contact your local GP or Healthline 0800 358 5453.
Since the Level 3 and 4 Covid-19 alerts were announced by the government a week ago, Ngati Porou Hauora has actioned a range of measures to help prevent the spread of Te Mate Karauna (Corona virus) and created new systems to deal with cases identified within our rohe.
One of the first immediate actions was the introduction of the process to access medical advice from Hauora clinics. The majority of consultations are now conducted by phone or video call,instead of kanohi ki te kanohi, and Ngati Porou Hauora Chief Executive, Rose Kahaki, says the new system is working well.
“Our Hauora clinics and their respective communities have adapted quickly to this new process,and the results are very noticeable. There has been very little foot traffic within our clinics andour hospital, which is helping to reduce the risk of community transmission to our patients, theirwhanau and our kaimahi.”
“Our Hauora kaimahi have taken on huge workloads and pressure to help us to prepare and respond to this ‘unprecedented’ situation,” says Rose.
“In a very short space of time, they have had to constantly learn new protocols and procedures in line with the Covid-19 directives from the Ministry of Health. Because this virus is so new, and the guidance we receive from the Ministry and government changes on an almost daily basis,we all have had to constantly re-think and re-adjust how we do things and what resources we need.”
“However, this issue isn’t only isolated to Ngati Porou Hauora. All over the motu, from the smallest PHOs to the biggest DHBs in the country, we all have had to adapt to a constantly evolving environment. None of us in this modern era, have ever dealt with a global pandemic,but we are quickly adapting and learning what we need to do to look after our communities here at home.”
Included within the scope of NPH kaimahi who have had to quickly adapt, are the Caregivers who assist pakeke with their home-help needs.
“We have an amazing workforce of around 46 Caregivers out there, all members of our communities, who have stepped up and taken on the additional protocols for caring for our pakeke in their homes,“ says Rose.
“They are well aware of the risks of community transmission and are vigilant in undertaking the necessary new procedures, such as the wearing of PPE (Personal Protective Equipment) gear.As essential service workers, their contribution to helping us to continue to provide services under the present conditions to our pakeke is invaluable.”
Although the necessary systems are being put in place across Ngati Porou Hauora, Rose acknowledges support from the community is extremely vital in helping to combat Te Mate Karauna within the rohe.
“We thank members of the community who have been adhering to the ‘Noho ki te kainga’ message. It really is true - Stay Home and Save Lives. As the Iwi health services provider, we can only do so much. However, if we all work together, to follow the guidelines that have been set, we can help protect our most vulnerable from this ngangara Mate Karauna.”
• If you think you may have Covid-19 symptoms, please call the Healthline number 0800 358 5453. If you can’t get through to the Healthline, call your local NPH health clinic or Te Puia Hospital (06) 864 6803.
• For more information about Covid-19 go to the official website www.covid19.govt.nz or the Ministry of Health website www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus
Yesterday the national four-week lockdown began and Ngati Porou Hauora urges all our whanau to help eradicate Te Mate Karauna (Covid 19) by staying at home, and only venturing outside to access essential services or for exercise.
“Me noho ki te kainga e te iwi,” says Rose Kahaki, Chief Executive for Ngati Porou Hauora. “To break the transmission chain of the virus we all need to practice self-isolation and social distancing under the Level 4 alert.”
“This means only having one designated person leaving your house to get stores from the shop. Or to visit one of our Hauora clinics as directed by clinic staff or to pick up your medicine. Going for a walk to get some exercise is okay, but when-ever you do leave your property and are around other people that are not from your household, please remember to practice being at least 2 metres away from them.”
“We also support the pleas made recently by Tairawhiti emergency services, and ask our whanau to not go out hunting,fishing, gathering kaimoana or horse riding. If there is an accident or incident, this potentially exposes the emergency crews, their whanau, and health care workers to transmission of the virus. It also places more strain on the health services of our district. We are all in this together.”
“We support the work over the past few days of the Health Protection Officers from Hauora Tairawhiti DHB.”
“They have been meeting all passengers arriving at Gisborne Airport to ensure they are aware of self-isolation protocols. This includes not only providing information to whanau returning from overseas, but also to whanau coming back from around the country and visitors from outside the region.”
“The Health Protection team have also been following up on the safety and well-being of local people who have been referredto them by Healthline. Some of these people have arrived into the country within the last 2 weeks and were instructed to self-isolate, and to keep away from other whanau members within their household. We are working closely with Hauora Tairawhiti, and made aware of developments as they arise.”
“In the last few days there were rumours of a suspected Covid 19 whanau member in Ruatoria, causing a high volume of concerns from members of the community. We are here to reassure you this is not the case. We have followed up with the whanau and the Health Protection team, and we can confirm that the person has been tested and the test has been proven negative.“
“We need to continue to be vigilant, and we will work together with the Health Protection team and whanau, to ensure our whanau are safe and practicing self-isolation (including bubble within a bubble).”
“As of 1pm yesterday, there were no reported cases of Covid 19 in the Tairawhiti region. To ensure it stays that way, and to keep our pakeke and whanau are safe, we must all continue to be vigilant, remember to horoi o tatau ringaringa, practice social distancing when around others outside our households, and to keep trips outside the home to a minimum.”
“We also urge voluntary members supporting the community to keep safe, abide by the rules and ensure you maintain a 2 meter distance away from others. If there are any concerns, contact Ngati Porou Hauora.”
“To be informed with latest national developments, we encourage you to watch the daily briefings by the Prime Minister and Director General of Health on television and social media. They usually occur around midday or early afternoon.”
· If you think you have Covid-19 symptoms, please call the Healthline number 0800 358 5453. If you can’t get through to the Healthline, call your local NPH health clinic.
· To read the statement about NPH’s recent changes to operating health services in the rohe, go to the website www.nph.org.nz
As a result of yesterday’s announcement by the government that the Covid-19 Alert level has been raised to Level 3, and will move to Level 4 by midnight Wednesday 25 March, Ngati Porou Hauora (NPH) has made the following changes to the health services we provide to Ngati Porou whanau in the Tairawhiti region.
In alignment with this announcement, these changes are being made to help prevent the spread of the Corona Virus to our Ngati Porou communities.
• We are trying to prevent contact between patients
• Minimizing face to face consultations
• Increasing video and audio consultations
• Encouraging whanau to self-isolate
To enable us to continue to provide Health services to our Ngati Porou communities on the coast and in Gisborne, it is important during this time of national lockdown that everyone unites in the fight against Covid-19, tiaki a tatau pakeke, Horoi o ringaringa, noho ki te Kaenga!
• If you are not feeling well and need to see a doctor or nurse, please continue to contact NPH. However please contact us by phone to make an appointment. Do not visit the clinic.
• We are here to treat people who are unwell. Winter is approaching; people will still get sick; we don’t want anyone to wait till they are really sick. We want them to call us early before their health gets worse.
• If you need a repeat of your prescription, or need help with administrative matters like ACC referrals, contact us by phone. Please do not visit the clinic.
• If you think you have Covid-19 symptoms, please call the Healthline number - 0800 358 5453. If you can’t get through to the Healthline, call your local NPH health clinic.
• Your first port of call will be the receptionist. The receptionist will ask you some questions to help decide whether you need to contact the Healthline, need help with administration matters or you need to be referred to the nurse.
• The nurse will determine whether you need to have a doctor’s appointment and will make an appointment with the GP which will be conducted over the phone, face to face or video call.
• Consultations are free to all enrolled patients – effective immediately.
• There is a single point of entry to the hospital which is the main entrance. All other entrances will be closed.
• The main door will be locked from 5pm everyday throughout the night, this is to maintain safety for staff, patients and whanau in the community.
• The duty nurse will open the door for those who need to come into the hospital.
• The Te Puia hospital ward will be on lock down. However, we are considering the issue of visiting, and we will make a decision as soon as possible.
If you or a member of your whanau has:
• a fever, sore throat, shortness of breath or coughing
• returned from overseas in the last 14 days
• or have been in close contact with a suspected or confirmed case of Coronavirus
Call the Healthline on 0800 358 5453 for advice. The call center is open 24 hours a day. If you can’t get through to them, call Te Puia Hospital on (06) 864 6803.
• If you do fit the criteria for Covid-19 testing, you will be directed by Healthline or your GP, to the nearest swabbing centre. There is one at Te Puia Hospital and one in Gisborne.
• The swabbing centre at Te Puia Hospital is a drive through. Do not get out of your car, the nurse will conduct the swabbing through your car window.
• These are not walk-in centres. You will need to meet the criteria for testing and be referred by the national Covid-19 Healthline or by your GP. If you turn up without an appointment you will be turned away.
• If you or your whanau are unable to get to a swabbing centre, your GP will make alternative arrangements for testing. If you require assistance with transport for Covid-19 testing, please contact the Hauora.
• Please note we are following the guidelines by the Ministry of Health, which at this point has set criteria for testing. If one whanau member meets that criteria, it doesn’t mean that your whole whanau will be tested. NPH is following the same guidelines that all health providers around the country are following.
• There are limited resources available at this time, so NPH has to prioritise who they test. We cannot swab everybody.
• We will be driven by public health direction and regulations- these could also change as things develop.
• Please be patient as this is a process that everyone around Aotearoa must follow.
The free Flu vaccination programme will continue to be rolled out to our Ngati Porou whanau who are most at risk. This includes: pakeke over the age of 65 years, pregnant women, people with a history of respiratory ill-ness, people with chronic health conditions and those who are immuno-compromised. While the flu vaccination won’t protect you from Covid 19, it will help to ‘flatten the curve’ of demand on our hospitals this winter.
• NPH teams are working with whanau who are needing vaccinations to be administered in their homes.
• Whanau who can travel to a Hauora clinic, will have the flu jab administered in the Clinic Car park. Verbal consent will be required prior to the vaccination being administered.
• If you are not enrolled with Ngati Porou Hauora, but fit the criteria for a free flu vaccination, please contact your local Hauora clinic.
• For people who don’t meet the free flu vaccination criteria, further vaccinations are being planned to be rolled out on April 13.
For all other Covid-19 related information and the latest news go to www.covid19.govt.nz
For contact details of all Hauora clinics go to www.nph.org.nz
A young Ngāti Porou geneticist is using DNA from her own people to fight Type 2 diabetes.
Māori suffer from the condition at nearly twice the rate as non-Māori.
Twenty-two-year-old Anezka Hoskin is part of a team at Otago University researching whether there is a gene that makes Māori and Pasifika people more prone to Type 2, or adult onset, diabetes.
The team previously found two genotypes that link Māori and Pasifika people with gout, which may account for their high prevalence of gout.
Now they want to know whether there is a similar genetic link between Māori and Type 2 diabetes.
The research is part of a decade-long partnership with Ngāti Porou Hauora and much of the DNA comes from Ngāti Porou people who donate a blood sample.
Anezka says it's a huge privilege and a big responsibility to handle the tapu specimens from her own iwi, including her own whānau.
The lab practices tikanga Māori when handling and disposing of Māori DNA samples.
Anezka’s interest in genetics began when her sister was diagnosed with Type 1 diabetes in childhood. Type 1 diabetes is known to be genetic while Type 2 diabetes is often linked with obesity and diet.
Anezka hopes that if they do find a genetic link to Type 2 diabetes it will help remove the blame and shame that people often feel.
She believes feeling whakamā often prevents people from seeking treatment.
Corrina Parata is currently the sole midwife for the East Coast, and after 18 years, says she still gets goosebumps when she recollects all the precious moments. Corrina believes that people who work on the wild and remote Coast build a specific set of skills that are different from urban health professionals. Corrina was inspired to be a midwife when she attended the birth of her niece. After a bad experience with the care at a large hospital, her sister decided to home birth despite complications. With the support of a midwife the baby was delivered safely. “The empowerment and healing for my sister to be able to take back control was so important for her. This experience and feeling the energy in the room that day made me want to become a midwife” Corrina said. Corrina decided to train though the Tihei Mauri Ora program under Becky Fox at Wintec. There weren’t many registered Māori midwives at that time, and Corrina remembers this kaupapa Māori based training being really powerful.
During her training she reflected on her own experiences having a child as a young Māori woman, and realised the lack of cultural safety practiced in the health system back then. She wanted to change this. It makes sense that Corrina then came to work for Ngāti Porou Hauora where Ngāti Poroutanga (the local culture) is recognised as a core value and vital for health and wellbeing. She says that Ngāti Porou Hauora supports her to run a midwifery service that works within her own culture. “When women give birth here they usually do so knowing that whānau who have gone before them were also born here. Through the practice of midwifery, you become a kaitiaki. Not just through supporting each child being born on their tūrangawaewae (cultural homeland), but in advocating to make sure we maintain a maternity service here on the Coast.” It isn’t just the midwifery service that works this way, it is across the whole service. “If there is family needing karakia or waiata.
All the staff drop tools and get in there to support. I feel like my wairua (spirit) is intact working this way.” Corrina believes that people who work on the Coast build a specific set of skills that are different from urban health professionals. Because it is wild and remote, it is even more vital to provide quality care and so the team have sharp and diverse skills. It can be consuming and overwhelming especially with the challenges of winter – no power, flooding, trees down over the roads, the water pump isn’t going. This is the reality of rural practice. You just need to carry on. It’s not for the faint hearted. Working this way over the years has made Corrina reflect on the bigger view of public health. She says that she never used to be political, but this work has developed her as a person. She is now a staunch feminist and advocate for social justice. “Why should Coast whānau not have access to quality care? Just because we choose to live rurally that shouldn’t be denied of us. It is this that gives me the burning flame to stick it out when so many say “oh I’d never work there”. Despite currently being the only midwife on the Coast, Corrina has regular contact with practitioners all over the country.
She remotely mentors five rural midwives in other areas of New Zealand, and meets regularly with a group of other rural midwives. This group shares ideas to improve their service and often have robust debates where they challenge each other on their practice and decisions. This online community of practitioners supporting each other is huge for preventing burn out – something we are seeing in the media as a concerning issue for midwives. Corrina also finds healing in the natural environment of the Coast. She loves fishing and the ocean. “I knew the local community had accepted me when they told me where the best fishing spots were” Corrina laughs. Twenty years and more than 500 babies later, Corrina says she still gets goosebumps when she recollects all the precious moments. “It is the highest calling and greatest honor to care for women and their families through the birth of a child. Women can feel quite vulnerable and frightened so you have to look after their wairua as well as the medical side. Being a midwife means whānau (families) place their trust in me and that trust means everything.” Looking forward, Corrina strongly believed that Ngāti Porou Hauora should continue to look at how we grow our own midwives, and is excited about the opportunities the learning institute will offer in moving forward with this goal.
This year Ngāti Porou Hauora opens the doors of the Te Rangawairua o Paratene Ngata Research Centre, based at Te Puia Springs Hospital. The name honours the vision of the late Dr Paratene Ngata: for Ngāti Porou Hauora to lead our own research developments, becoming “a tikanga and research based centre of excellence for Hauora Māori”. The name has been gifted to us by Dr Paratene’s whanau and in English translates to ‘The Inspiration of Paratene Ngata’. The centre will provide a basis for building on the research initiatives and relationships which Dr Paratene inspired Ngāti Porou Hauora, our communities and university researchers to build over the last 15 years+.
It is our intention that the centre will be a catalyst for growing sustainable research partnerships that enhance our work with local communities and scientists from a range of disciplines to generate new knowledge and better health outcomes that empower our people to live well and live longer. Initially, the centre will enhance research that has been focusing on increasing knowledge about factors, including genetics and nutrition, which contribute to the prevalence of the debilitating metabolic conditions which compromise many people’s lives: type-2 diabetes, gout, obesity, heart & kidney disease, and the impact of sugar. Through NPH’s newest research partnership, with the Maurice Wilkins Centre for Molecular Bio-discovery, an expanded collaborative network of scientists, health researchers and providers will work with us to further advance understandings about metabolic conditions - with the aim of informing significant improvements in treatment and prevention.
Teepa Wawatai, chairman of Ngāti Porou Hauora Charitable Trust Board, said diabetes, gout, heart and kidney disease were four important health issues affecting Ngāti Porou, and these will be a focus for initial research. “We are excited about the new Research Centre and believe the work that happens there result in better ways to prevent and treat these conditions while also delivering jobs and educational outcomes. This mechanism allow us to deliver these outcomes in a way that does not divert resources from our critical frontline healthcare roles.” Importantly, integral to all activities of the research centre will be regular opportunities for our communities (including schools), health professionals and scientists to meet with each other to share knowledge and co-define priorities, and for Ngāti Porou and other māori students, practitioners and researchers to develop skills in research of relevance to māori and rural health.
Four Ngāti Porou people participated this year in the week-long Summer internship for Indigenous peoples in Genomics - SING. The substantial advances in this field and the increasing focus on Māori populations and indigenous species have highlighted the urgent need for Māori to engage and understand enough about the technical, ethical and cultural issues that are being raised. SING is an initiative that emerged from the Te Waka O Tama - a recent project and is now a key activity within Genomics Aotearoa. SING is run by Assoc Prof Maui Hudson, Dr Phil Wilcox and Katharina Ruckstuhl, and is designed to develop our understanding of genomics alongside some of the best researchers in New Zealand.
Indigenous Genomics Aotearoa is a network of Māori with expertise across the fields of genomics, informatics technology, business and environmental stewardship. The network is being developed as part of a Vision Mātauranga Capability Fund project led by the University of Waikato, The University of Auckland, and the University of Otago with support from Ngā Pae o te Māramatanga Māori Centre of Research Excellence, and two National Science Challenges (Biological Heritage and Science for Technological Innovation). Some of the topics covered in SING were: Introduction to Māori research and ethics, introduction to genetics, epigenetics, ELSI research in tribal communities, bioinformatics, Māori perspectives and gene editing. A highlight of the internship was a presentation from Dr Joseph Yracheta, a faculty mentor from SING USA, bringing his experience working with American Indian and Alaskan Native interns. Four Nāti applied for the internship and gathered for a week in late January with fourteen other Māori participants. The Nāti interns were Ben Rangihuna, Anezka Hoskins, Matiu Bartlett and Huti Puketapu-Watson.
Ben Rangihuna is from Tikitiki and is currently studying medicine at Otago University. This year he will be studying quantitative genetics alongside Dr Phil Wilcox (Rakaipaaka). Anezka is an emerging young Ngāti Porou scientist, currently completing her Master’s degree. She aims to make a significant contribution to the field of genetics, and plans to proceed to a PhD in Human Genetics and to apply for entry to one of the top five programmes in the world (in the UK, USA, or continental Europe). Matiu Bartlett is from Wairoa Hawkes Bay and moved to Gisborne 6 months ago to work at Ngāti Porou Hauora in Te Hiringa Matua which is a new parenting support service working with hapu mama who are struggling with drugs and alcohol.
Huti Puketapu-Watson, Deputy Chair of Ngāti Porou Hauora (NPH), also participated in the SING internship to help build capacity in the emerging arena of genetics given that NPH has great potential to become a leading iwi health service provider in the movement towards precision or personalised medicine. This potential has been developing through NPH’s long-standing research programme with the University of Otago research teams led by Prof Merriman and Dr Te Morenga, and our contributions to the Te Mata Ira project led by Maui Hudson to develop Māori guidelines for genomic research and bio-banking. Also as Chair of the Ngāti Porou Miere Board, Huti learnt that the Honey Landscape research currently being carried out by Ngāti Porou Miere in collaboration with other iwi & Plant and Food and Landcare, had significant relevance in the discussions because that research focuses on DNA profiling of our manuka. Dr David Chagne presented an outline of the Honey Landscape research to demonstrate what was undertaken in the process of gene research and editing.